DEP/DUA/1/33/22 (Transcript version)

Susan Tans

1783

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Susan Tans Janr 10^th 1783.

Sympt enum in case of this patient can hardly be consid as the charact of any affect entering definit of Nosol writers.

Her most distress sympt, freq & irregul sensat of coldness, pain of back, sickness at stom, & affect of breathing occurr in many diff. diseases.

And not what prop consid as [consist] hyster fit.

Here however when consider cause of affect & manner of attack, little doubt that of this nature.

For first we are told excited in conseq of accid fright.

This also operated on syst at time when probab. pecul. irritab in conseq of exhaust arising from [nerves]

This conject [rend] still more prob. not only by manner of attack, but also by some other sympt with which attended

Partic by feeling in abdom. which from descript given may unquest consid as glob. hyster.

And to which prob. diffic of breathing attending some of fits to be referrd.

Hence then, though does not corres. to defin of Hyster, given by Dr Cullen & others of best nosol. writers, yet have no doubt in consid it as ex of that affec.

And here may obs. that hyster one of those affect which almost impossib to define.

For sometimes app. entirely with one set of sympt sometimes with anoth.

And indeed diffic to say under what variety of forms may not appear.

In so much that in pract am inclind to think an useful [distinct] may be estab between prop. hyster fits & what may be cald merely hyster sympt.

And in case before us notwith suddeness of attack as well as relief, consid it rather as [ex] of what may be calld hyster sympt than of prop. hyst fits

From this view of disease could not entert very sanguine hopes of speedy [term]

For though in gener. not danger yet in many cases an obstin disease.

And here situat of patient that viz of contin to suckle child rather unfav.

For from operat as const. cause of exhaust. supports irritab. state of nerv. syst. on which disease very much depends.

Hence then, though to some [females] nursing benefic, yet this one of those affect, in which benef to be derived from giving it up.

But with our patient situat in life an unsurm bar to recomm a pract which could not afford.

And from contin of nursing were also necess restraind from empl of some pract which might otherwise have been used with advant.

But while these circum against patient, others which at least [somewha] in her fav.

And partic so that disease yet but of short contin.

That induced merely by an accid occurr.

And that had never arisen to any great height.

Expect which might have been built on these circum from event [which] has now taken place may inferr would not have been ill founded.

For patient already dismissd from farther attend free from affect.

But while make this observ. must also add that can by no means consid case as compl or radic cured.

On contrary reason to presume that affect may again be renewd by very slight causes.

And should not here be at all surprized at future applic of patien from return of same sympt.

Mean while however a remission has at least been obt.

And this am inclind to think, in part if not entirely to be attrib to pract here empl

Began treatm you will observe by direct for her the use of two diff med

The Pil. Foetid cum Aloe & the powder of Valer.

From first consist of equal parts of Aloes, Assafoet. & Soap had chiefly in view the supp. regul disch by belly & expuls of flatul from alim canal.

But was princip from the last that expected here any perman. benef.

Valer. indeed a med with regard to which very diff sentim. entert.

While by some consid as of alm no effic whatever by others held in very high esteem.

For this diversit in fact diff expl given.

Partic that effic of med much [vard] by soil in which grows.

And said to be much more powerf. as growing wild in hills, than as reared in gardens.

Said also to be a much more activ artic, when taken up during middle of winter, than at any other season of year.

How far from these circum any real consid diver in active powers cannot from my own exper draw any probab. conclus.

But of this at least am well persuaded that when of good qualit from pecul impress on nerves of stom. has remark influ on whole nerv. syst.

Is but too common with us to cont ourselves with referring all med having much influ on nerv. power to gener heads either of stim or sedatives.

But under these very extens classes artic diff very widely from each other in their nature are compreh.

And this diversit not merely in degree but in nature also of effect.

For my own part am inclind to think that perhaps no two artic referrd to tribe either of stim or sedat. effect of which precisely of same nat.

And impress given by active princip cont in Valer. as essent diff. from what arises from Aether, Volat, alkali, essen oils, as from that prod by Opium, Hyosciamus or Cicuta.

While influ however of Valer thus pecul. is also consid.

And in many of most obstin affec of Nerv kind have myself empl it with great advant

Here therefore hoped that use might be attend with benef.

From situat of pat however that viz of nurse [darent] not vent. to empl it in large dose

For from single circum of excit sickness at stom & vomiting which sometimes effect of large doses, no inconsid inconv might have arisen.

This therefore led to empl at first to extent only of ℥i. in day

Under these med sympt soon consid relievd.

From use of pills however belly rather looser than could have wishd.

While from Valer. no uneas at stom. From this therefore led to order later to be taken to double quant at first prescribd.

While pills again directed to be taken only every second night.

These at succeeded report found to have still had suff influ in mov. belly

While from empl of Valer all her sympt contin to be much dimin.

And indeed relief soon so great that reckond farther attend unnecss.

Would fain hope that benef. thus obt. may prove perman.

At same time would not be surpr. if from any accid again subj to return of compl.

And that the rather as from contin of nursing subj to cause of inanit which must tend to augm irritab. of system.