DEP/DUA/1/35/16 (Transcript version)

Peggy Duff

1784

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Peggy Duff. June 19^th 1784.

In history of this patients case many sympt enum.

And of these not a few in comm to variety of diff diseases.

While at same time may be [inducd] by very diff causes.

Hence then not without doubts respect affect to which patient subj.

And partic at loss to determ whether should consider her as only lab under one disease, or as subj to a compl. of affect.

Of all affect however [describd] by pract auth. none in which have more freq concurr, of greater numb of sympt, than in hystr.

This disease often in partic attended, with such fits of tremb & shaking, as here descr. to occurr.

While pain of head, at least of partic kind, reckond so much chara of affect, that has got name of Clavus Hyster.

And no sympt. more comm. attend of that disease than vertigo lassitude & aversion to motion

Irregul of menst. disch, seldom wanting either as sympt of cause of the affect.

While simil affect of belly, pulse & [appet] may at least be said to be by no means rare.

And indeed hardly any disease of which may not at times feign the sympt.

Hence to this source may also referr. pain of breast, diffic of respir & other pector [sympt].

But this by no means only supp which may be entert with regard to the affect.

And that too on probab. grounds.

For mother you will obs who has had const opport of obs progr of disease, entert a diff opin.

She attrib all sympt. to which her daughter subj to accid fall.

And by this we are told, that both head & breast sust very consid injury.

From injury to the formr howevr, headach vertigo & other sympt may readily be expl.

While again from injury to latter have a cause that may readily induce, both dyspn. cough & pain of breast.

Hence then must be allowed that suppos of moth not altog without [probab]

And in some degree at least corrob. by comm & contin of diseas

For informd that sympt to which now subj began soon after fall.

And that ever since has cont. to lab. under them.

But notwith this am I own rather inclind to formr opin.

With regad to Hyster in gener. nothing more common than to find pat. desirous of tracing it, to some partic accid.

Hence then nothing surpriz that sympt. should without good ground, by attrib to this cause.

While again, if had really [proceed] from injury to breast & head, should not have expected that would have been of so long contin. & so stationary.

In all probab. in much shorter time than space of six years, would either have entirely disapp or termin fatally.

On contrary however as far as can we learn at least been stat.

A circum very freq with hyster compl. which may also add are an occurr. very comm at this period of life.

Upon the whole then inclind to consider disease of pat. as afford us an example of hyster.

And from this view may consid as less danger than if affect of injur to head or breast.

Hyster indeed very gener. proves not only a troublesome, but an obstin disease.

And will not be surprized if patient shall derive, but little benef. from all that can do for her.

But at least may remark that is seldom a dangr disease.

And may at least expect that in no danger of falling victim to affect.

But that compl. may be somewhat alleviated.

And with view to this various pract may be empl.

Some of them having effect as obviating urgent sympt.

But more espec operating as counteract morbid irritab.

Was chiefly with first of these intent, that had recourse to Pil. Foetd.

These consist of equal parts of Assafoetid & Soap have in gener. some influ as opening belly.

But more espec act from pecul impress which Assafoet gives to nerves of alim canal.

And in this way no doubt that affects whole nerv syst

Partic serviceable as promot exp. of flatul from alim canal.

And often also as counteracting various sympt of Nerv & Spas kind.

Hoped therefore that might both dimin, fits of shaking, vertigo & headach.

But in these partic, expect by no means answ.

For during use, for space of week while other sympt. cont as severe as before, fits of shaking rather aggrav.

This therefore no encourag at least to persist in use.

But notwith this partic, should still have been disp to give farther trial, had it not been for anoth circum

Effect viz which had on state of disch by the belly.

Is indeed as already obs, prop of Assafoetid to have tend to open it

And with dispos. which here occurrd to constip this affect to be wishd for.

But at same time every evac tending to exhaust, unfav. in such cases.

For by this means morbid irrit cannot fail to be much augm.

And here, contrary to expect, Assafoetid, though taken only to extent of little more than gr ii, had effect of induc daily sev loose stools.

Even suppos therefore that aggrav. of other sympt. merely [accid] this an obj to contin.

Omitting Assafoetid therefore had recourse to anoth med.

Put patient you will obs on use of Calx of Zinc, comb with Valer.

From both these in cases of morbid irritab. best affects often obt.

But here partic disp to [put] depend on former.

Need hardly obs. that Zinc as a remedy against affect of convuls & spasm kind, first introd by Dr Gaub of Leyden.

And for account of its introd may referr you to a [paper] in his Advers. de Luna fixata Luddemanni.

These repres. as proving sometimes affect even in inst of Epilep.

After recomm of Gaub. tried by many practit.

And as not found to answer [expec] in every case, not a few disp to consider it as very insignif.

For my own part must acknowl that cannot consider it as answ fully to charact given by Dr Gaub. [Hart] & others

Yet have been much deceivd in obs, if have not on diff occas, seen it prod of best affects.

And this opin corrob. by testim of many diff pract. who have pub. acct of success as empl. in partic cases.

These effects often obt from it when exhib by itself.

Or at least with no other artic than suff. to give prop. form.

Such for example crumb of bread for format of pills, Flower Liquor for powder or the like.

But here comb. with an artic which expected would operate not merely in giving form but also as adjuv.

The powder viz of Valer.

This artic long in use against disease of the spasm kind.

And as well as Zinc has also been said to [procure] cure even in some inst of Epil

Whether however has ever had this affect or not, yet that does possess antispas. powers, is I think unden.

And in this state of combin, am inclind to think that have seen better effects from Valer & Zinc, than from either separ.

On idea therefore that pat subj to an hyst. affect, & on ground of [form] exper, had here recourse to use.

Cannot however say, that trial hitherto made, gives ground for sang hopes.

For after taking first powder pain of breast consid aggrav.

But that this not to be attrib to the med may be inferrd from succeeding doses not being prod of same affect.

And although no great change yet upon whole rather allev of symp

From this therefore led to give it at least a farther trial.

And if no partic occurr to alter resolut, may wish to persist in use for some time.

At least conj it with as much air & exercise, as circum of pat will allow.

If this unsuccess. and still retain idea of affect being of Nerv kind, may have recourse to Per. Bark & Chalyb.

To cold bathing, otherwise prom [adv] cough & dysp & pain of breast, occurr as obj.

And not imposs. if affect realy origin from fall, that these may yet occurr as partic claiming prin attent.

But in that case pract must be regulated by idea which shall then form of disease.