DEP/DUA/1/29/36 (Transcript version)

Ann Mill

(1782)

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Ann Mill.

Disease to which this patient subj. cannot be said to be very distinctly markd.

Yet for my own part, little doubt in pronoun. that is subj to an hystr affect.

If indeed compare sympt here enum with definit of hyster, as introd into nosol. syst, will find that by no means an exact resemb.

Yet no sympt here which is not a very freq occurr in hysteria.

And well known to be one of those diseases, which on diff occas. puts on very various forms.

In most syst, what have been defind are prop. hyster. fits.

And indeed, these only form of disease, prop capab of definit.

That is of distinct descript in few words.

But although Hyster. fits often altern, and complic with other hyster sympt, yet either may occur separ.

And while in many cases, fits without other sympt. so often affect consists of Hyster sympt alone with prop. fits.

And this seems to be case with pres. patient.

In globus hyster, have one of most common sympt of the diseas

And indeed what by many consid as pathognom.

Without however [contend] for this, may at least repres it as one of most common sympt.

Same also may be said with respect to swelling of stomach, pains of abdomen, & of back.

In bound state of belly, & irregul menstruat., have also what are freq occurr in Hysteria

Upon whole then little hestitat in pronoun that pat. liable to this affect.

Especially as no sympt in case which can be consid either as indic anoth disease or as giving any diffic to suppos of Hyster.

Only thing in this point of view that deserves ment is state of Spt.

Patient we are told subj to unif lowness of Spts.

In Hyster on other hand common state is that spirits very variab.

Sometimes much depressd often remark high.

This state however by no means essent to hyster.

And has I think with improp. been introd. into definit.

State of mind with hysteric women still subj to influ of same causes as of those not liab to that affect

And here for depress of patient, a very manif, & powerful cause.

Loss viz of husband & being left in state of widowhood, with sever helpless child.

This cause am even inclind to think has had consid influ in induc hyster.

But anoth circum also which has prob. operated more powerfully

That viz of suckling an infant.

Are informd in hist of case that affect dated from period of deliv.

From which, presumpt at least arises, that somehow connected with that & subseq. state.

Well known however that among various causes induc. hyster, those exhaust syst not least consid.

At time of deliv often very consid cause of exhaust in lochial disch.

Are not indeed told that with our patient this any thing uncomm in point of quantity.

But still with tender woman espec in depressd state, may be supp. to have had some influ.

And this not a little augm by subseq nursing.

Nursing indeed, reckond by many & those too names of first emmin. most healthful state for [illegible] [wom]

But though this may gener. by the case, yet by no means univ well foundd.

And many inst, in all ranks of life, where highly prejudic both to parent, & inf, that mother should suckle her own child.

This especially case where during nursing appetite not encr. in prop. to demand.

For then must be constant source of exhaust.

This however remark case with pres. patient.

Accord. during nursing, state of [exhaus] went even so far, as to prod. freq fainting

Can have no doubt therefore, that this very prin cause, both as induc & support other compl.

From this circum however progn. more favour, than would otherwise be the case.

For by giving up nursing one great cause of affect removed.

Accord after weaning child, which did few weeks before came under our care, had no more returns of fainting.

Reason to hope also, that in other respects will have good effect on [const]

And flatter myself, that by this & other means which have it in power to employ, compl. soon allev if not compl. removed.

At same time to perfect cure state of pat. spirits & other circum unfav.

But in attempting such relief as could here be afforded, from what alread. obs of nature of case, may be concl. that great obj to be aimd at was the strength & invig syst.

With this view it was, that had recourse to Peruv Bark.

For although before said to be empl. without success yet then given to so small extent, that could not be consid as having had fair trial.

Was now therefore intent to exhib it to quant of ℥ii, in course of day, cont regul for some length of time.

But while had recourse to this, was necess also to obviate an urgt sympt. viz Costiveness.

And the rather as had reason to suspect, that from use of Bark would be still farther augm.

While even in state to which before took place, no doubt that aggr. [affec]

With view to this had recourse to combin of Aloes, Assafoetid & Soap. P. [Foet]. cum Aloe

From which while move the belly still farther advant in such affect as tending to expuls of wind.

Under these med, as app. from last report, compl of patient consid relievd.

And hopeful, that by contin, this relief may be encreased & secured.

Must however admit, that expect. no less consid from giving up nursing than from any med we can employ.

If therefore recov should now be speedily effected, will not be disp entirely to to attrib it, to pract at present directed.

But if neither to be obt. from regimen nor med, future pract must be accomod to situat in which shall then find patient