DEP/DUA/1/34/34 (Transcript version)

Christian Bell

1784

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Christian Bell. April 17^th 1784

In history of this pat. case many sympt. enum.

And not improb. that disease somewhat of complic nature.

For in pain & distens of stom with acid eruct. have evid dyspep. sympt.

But by much greater part of her affect. consist of sympt of hystr.

This affect manif indic by glob. hyster. rising to throat & threatning suffoc.

In pains of temples also temples also & back part of head attended with vertigo & dimness of sight, have anoth great charact of this disease viz Clavis Hystericus

And this may by the way obs. was the sympt. on which Dr Sydenh in part put chief reliance as charact the affect.

May also consider as hyster sympt. those univ. tremb. with which affected during late frost.

For that these of nerv. kind plain app. from [contract] of fingers & hands.

Notwith these however as well as freq. attacks of glob. yet had not here what could be calld prop. hyster. fits.

For among all the sympt ment. none of those convuls. agitat. of legs & arms resemb. hyster. epilep. which constit chief app in prop. hyster parox.

Hence then case of this pat. as well as that of one lately [consid.] to be consid as afford example of hyst. app. under form of hyster symp.

In this however sympt indic an affect of alim canal not entirely to be ascribd to that cause.

For although with hyst. these often connected, yet there here seems to be also some degree of dyspep.

A circum from which necess. led to form less fav. prognos.

For no doubt that the disease very gener. more obstin in compl. than in simple state.

Anoth partic also from which should be inclind to inferr obstin, is state of menst disch.

These though regul in point of time, at least when is not pregn. are yet obs. to be in uncom. large quant.

A circum which in hysterica by no means a rare occurr.

But when it does occurr always tends to support & aggrav affect.

And hence to encrease obstin.

Anoth circum much against [speed] recov. here, is long contin, which disease has already had.

Before she came under our care subsisted even for sev. years.

And during that time has had sever. children.

An evid proof that even very consid changes in the constit not suffic to susp. it.

When to all these circum is added that disease even in most simple & slight state, often baffles utmost efforts of art cannot here look for exped cure.

At same time no part of compl. can be consid as threatn immed danger.

And if shall not be able to accompl. a cure may yet afford opp. for trial of diff. remed.

And of obs. how far these capab. either of allev. or counteract the affect.

From complic here, of dyspep. with hyster sympt, was led to have recourse to remed with both intent.

With view to first empl. the Infus Amar of which need hardly observe that basis in Gentian one of best Veg. bitters

And which, in such cases often of greatest use as destroying acid, strength tone of stom, & prom. digest.

With view to hyster. again had recourse to Pil. Foetid cum Aloe.

These from Assafoet. which cont, often best effect, in allaying inord. action, & in expuls. of flatul.

While again proport. of Aloes, in general suff, to keep belly open.

But when pills taken only to ext. of five grains as cont. little more than one gr of Aloes seldom that in this way prod more consid effect.

Here I think reason to believe that from both med good effects obt.

Although at same time operat of latter not altog what would have expected.

That infus attended at least with tempor. good effect may have been inferrd from her being but little distressd with pain of stom. vertigo or glob. hyster. during use.

Though at same time probab. that in prod this relief partic in prev returns of glob. Assafoetid also had influ

But from the pills, much more effect than should have expected in moving belly.

For in conseq of each had three or four loose stools.

This effect though of conseq advant. that belly should be kept open, could not fail to be prejud.

Partic if contin for any length of time with a syst. already pecul. irritab.

Hence then became necess to [interm] use of pil, with Aloes.

Did not however wish to lose the benef of the Assafoet.

And therefore to Pil. Foetid cum Aloe, subst. Pil. Foetid [Simp]. [which] consist merely of Soap & Assafoet.

From these has no reason to expec any influ as prod change on state of belly.

Assafoet indeed it must be allowed possess somewhat of purgat power.

But unless in very pecul [illegible] can hardly be consid as operat as a purgat.

And unless in doses, much more consid than here empl, has not even affect of moving belly.

And indeed from influ on stom. effect of large doses rather that of vom than purging.

Here however reason to pres. that very remark. pecul of habit had existed.

For from simple foetid pills more influ in moving belly than from those with Aloes.

Under use of these however with contin of Infus. amar. other symp very much dimin

And became entirely free from the Glob. hysteric

Was not however free from every  symptom.

For had been subj. as were [inform] to one very severe attack of pain in her stom.

This however prob. connected with anoth app which now also took place & of which pat. had not before compl.

viz severe flying pains which while attackd diff parts of body were partic distress. in feet.

And often contin with viol there even for space of day.

These by no means an uncomm app. in hyster.

And partic when does not occurr under form of regul hyster. fits.

These pains, though hold diff situat [are], am inclind to think, very much of same nature with hyster. headachs, or Clav. Hyst.

And indeed was disp to consid severe attack of pain in stom, to be of same kind.

Now therfore thought that less reason for contin of use of Assafoetid Infus Amar

And although from Assafoet, might have expected that tend to inordin action would be removed, yet strong obj occurd to it, from looseness excit

To both med before empl. [therf] substit anoth. the Calc. Zinc.

This an artic from which as allaying tend to inordin action have often I think seen best affects

And partic in hyster. cases [when] given in combin with Valer.

Here however wishd to see [effect] by itself

And therefore gave it as comb. only with a small prop of Magn. for obt. prop. formula.

What has been effects of it have not yet had opport of [learning]

But if pat. contin easier & returns of pains dimin shall wish to persist in use for some time.

And hope that by means of it such relief may be obt. that farther attend unnecess.

If however no good effect & sympt. much as at pres. have thoughts of trying Valer. by itself.

And perhaps after that, if still unsuccess, may use them in conjunct.

In these diff. partic however as well as in other pract. afterwards to be empl. must be very much regul. by situat in which shall find patient.