DEP/DUA/1/33/38 (Transcript version)

Janet Morgan

(1783-1784)

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Janet Morgan Febr 7^th

Disease of this patient though but short time under our care affords ex both of complic & success of affect

And with regard to some of sympt room for doubt.

At same time none which could be consid as very import.

And indeed termin rather by operat of syst. itself than by any remed here empl.

When came first under care, one of prin sympt severe pain affect. right side of head.

This we are told extended from angle of jaw, to crown of head.

From situat alone then some presumpt of toothach

But this still farther corrob. from its being obs. that farthest back tooth manif carious.

At same time this suppos not altog free from object.

Or at least anoth which on prob. grounds also may be adopted.

Pain it is to be obs. not commonly such as commonly occurs in toothach

Neither confined to diseased part nor even manif traced to it.

Is farther remarkd that subj to period returns.

A circumst. at least rare with respect to toothach.

But besides these partic case what created still greater doubt, other sympt to which pat subj

Was affected also you will obs. with great uneasiness from swelling & distens of stomach

And partic with sensat of ball arising to fauces & prod sense of suff.

A sympt well known by title of glob. hyster.

And indeed consid by many as a certain pathog of that affect.

Of that disease have farther [chara] in variable state of spirits.

And although no prop hyst. fits yet could be no doubt that when came under care subj to hyst. symp. whatever might be nature of head.

But to be obs. that headach also often a hyster sympt.

And even [accur.] Syden. considers that species of headach which he terms Clavis hyster. as one of most disting marks of the affect.

Here therefore not impossib that whole sympt at commen. may have been hysteric.

At same time still greater reason I think for imagin that pain of head connected with carious tooth.

And this I own idea of disease when she came under our care.

Of prognos which then formd as case already termin unnecess to say much

Shall only obs. that did not expect would have ended so speedily.

This indeed not wonderful with regard to pain of head suppos it toothach.

For well known that even while carious tooth remains has yet often if not complete termin at least very entire & consid remiss.

But hyster when once begun an affect seldom termin so soon.

Often of most obstin nature

And but in rare inst that yields even to most powerful remed in a short time.

In this case indeed several circum very favourable

Was app. not of delicate but of strong & vigour habit.

Had never before been subj to any attacks of this disease, though had already arrived at 22^d year.

While app. good & belly regular menses in every respect natural both with regard to period & quantity.

But above all disease had been but of short contin.

From all these partic then taken togeth, had reason to hope that in no long time cure might be accompl.

But must own did not look for it so speedily.

And while very doubtful how far to be attrib to med here empl. am also not without appeh with regard to perman.

But whether shall return or not for pres at least free from compl.

And only remains to consid how far this to be attrib to pract here empl.

First began pract you will obs. by putting this pat. on use of Valer.

A remedy of which must own I entert a good opin.

To this in some degree led from operat which it exerts as a Carmin.

For can be no doubt that has a tendency to prod expuls of wind from the stom.

And from this reason to hope that might in some degree afford relief to patient.

For no doubt that in part at least her uneasiness proceeded from this cause.

As a carmin however might easily have had recourse to diff artic both more immed & powerful in action

But here inclind to give pref to Valer. as expect from it other [effec].

For no doubt cannot be denied that from action on stomach has influ on whole nerv. syst.

And that thus highly useful as allaying tenden to inordin mot.

From this circum not only counter spasm & convuls agitat, but tends also to allay pain.

And accord have often found it prod of very great advant in hyst or nerv. headachs

On suppos. therefore, that pres headach might be of this nature imagined that might be of service not only against sympt evid hyst. but against this also.

Valer as a nervous med empl in diff. forms.

Not unfreq. used under form of mere watery infus.

And by water no doubt that active powers in part, if not comp. [extracted].

Still oftener however, recourse had to it, under form of volat Tinct.

And here the menst. empl. the Spirit Sal. Ammon. [vinos], not only extracts virtues, but also powerfully coop. with it.

Here however, in conseq of strengh of menst. dose of Valer itself very much limited.

In so much, that may in gener. be consid, rather as exhib of Volat Alk, than of Valer.

And upon whole for obt real & full effects of Valer. consid exhib in subst as only prop. mode.

When given in this way dose limited only by state of stom.

And although some with whom excites vomiting yet in gener. born with ease to extent of sev. [dram] in course of day.

Is always however advis to begin with moder. doses.

Here therefore ordered to quantity of ℥p. ter de die.

But besides Valer. had at this time recourse to anoth med also

Use viz of Anod Balsam extern applied.

Into this formul. though sever [activ] artic enter as Opium [illegible], oil of Rosem &e, yet that on which influ prin depends is Opium.

And as may justly be consid, as most powerful means of allaying pain, when taken intern, so has likewise that effect from extern applic

And in this way from immed action on subcut. nerves of part has very powerful influ in remov. pain, where obj to intern use or without those [inconv] of which is often prod.

In this way even in pain of toothach has often very consid effect.

Hoped therfore that whether headach from this cause or not might give relief.

In this however were disapp.

For though Valer. regul taken & balsam duly app. yet pain of head nothing removed.

And now attended even with symp more clearly than before demonst a local affect.

For consid swelling of parts affected had occurred.

From this led to imag that allev might be obt. from giving determ to other parts.

And on this acct with contin of former med directed applic of blister betwixt shoulders.

In the effect of this however were also disapp.

For from some accid did not rise so as to be prod of any disch

And probab. little operat in any other way.

But whether had any influ or not, headach now entirely left her.

And was also at same time free from all the other sympt, with which affected when came under our care.

In this situat farther contin of Valer or And Bals. seemd unnecess

And the rather omitted use as new sympt had superveened.

For now compl of pain & uneas in her throat with some obv inflam.

For remov. of this had recourse to extern applic of Volat Linim.

And at same time ordered a small prop of Cream of Tart with view of gently opening belly.

How far these any influ in forwarding resolut of this inflam will not pretend to say.

But at succeeding report was free from all her affect & therefore dismissed.