DEP/DUA/1/29/04 (Transcript version)

Margaret Grieve

(1782)

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Margt Grieve.

Case of this patient consists of but few sympt.

In these however have suffic charact of a disease very comm on this country.

And that too with people of all ranks.

Prob. from mode of life, partic from hot tea as artic of diet.

At least from this conj with other causes would acct for affect being more freq now than formerly.

Disease to which here alude is Dyspepsia.

This term as express a genus of disease adopted by sever nosol.

But by none so partic consid or distinctly defined as by Dr Cullen

Here indeed must admit that in our case many of sympt ment in his definit wanting.

But to be observd that affect there defined as occurrs when most distinct markd.

And that every day inst of the disease subs. for long time before assumes that form.

The gener. terms of Dysp. Apep & Diapep. in strict accept [signif] slow or diff. digest.

But under these gener. terms may with prop. include all stom compl. occurring as idiopath disease & not depend on any local cause as schirros or like in the stom.

That such the affect of pres. patient cannot admit of doubt.

Not only indic by want of usual appetite for food, but by uneasiness which food creates.

For in place of ready digest, pain weight & oppression

And although natural condit of stomach, not such that vomiting easily excited, yet when does take place, affords tempor relief.

To these also another sympt superaded, viz bound state of belly.

This likewise if not constant, at least very gener. attend, of Dysp.

And not improbab that here some truth in conj of patient, that all other ailments, to be ascribd to this cause.

For at least certain, that by bound state of belly, Dysp. alway aggrav.

From these diff circum howev, may inferr that disease of pres patient but slight

And even in most distress state seldom dangerous.

Upon whole then in pres situat of patient no ground for being alarmd.

At same time though slight, may prove obstin

And indeed, after has once taken place to consid degree, few dises more diffic to be entirely removed.

At least liable to be renewed again from slightest accid

Partic from irregul in diet want of due exercise in open air, sedent. empl, or like.

These circum however, may readily presume unfav. to compl. recov. with pres. patient.

Hence then expect rather to allev than entirely remove compl.

This however hope may soon be able to accompl. even by single circum of keeping belly gently open.

But may be still more readily & completely effected if at same time such artic empl. as tend to strengthen tone of stom & encr. action

As answering this purpose however, whole tribe of veget [balsam] so commonly empl. that have even got gener. appelat of stom. med.

Was with intent now mentiond then, that pract here employd were directed.

Began with prescrb. for this patient, pills consist of equal parts of Aloes. Assaf. & Soap.

These pills to which give name of Pil. Foetid cum Aloe. I very freq empl. where with gentle purgat. mean also to obt effect of expelling wind from bowels.

And among all artic which have tried with these intent. find few answ. the purp. better.

As here much bound these pills at first empl. to extent of gr V both morning & evening.

But while in this disease is of conseq to keep belly regul, much caut. in avoid brisk cathars.

For much evac in this way, also aggrav affect.

And indeed the discov. prop purg, often greatest part of cure.

With our patient purgat already directed has hitherto answ. very well.

But from appreh of doing too much have at last report, conf patient to evening dose only

And as a strengthenr of stomach have directed in formr part of day use of infus Amar with Tinct [Am]

This combin, in many such cases, I have found attended with best effect

And hope that in pres. inst, no other med may be necess.

And that in no long time pat. may be dismissd from attend, with affect if not entirly removed, yet consid allev.

But if after prop. trial pres. remed shall not be found to succeed will still persist in simil course.

That is use of gentle laxatv & stomach bitters.

And as conj both these prop. have next thoughts of trying Rhubarb.

But in this must be determ by circum in which shall find patient after trial already begun