DEP/DUA/1/35/36 (Transcript version)

Margaret Brown

1784

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Margt Brown. July. 23. 1784

Sympt. enum in this patient case cannot be consid as distinct marking any disease.

But at same time exhibit [nothin] which can be consid as singul or uncomm.

And most if not all of them occurr in many diff. affect.

When however such a collect of sympt united more freq. in hyster. than in any other affect.

Is not, it is true, subj to those sympt by which most accur nosol have defind Hyster.

Have none of those convuls. charact prop. hyster fits.

And have not even that symp consid as so much charact disease the globus hyster.

But well known that hyster as most distinct markd by these sympt. puts on other app. also.

Sometimes charact by one set of sympt sometimes by anoth.

But no sympt more freq than affect of head.

Indeed seem to constit no less urgent part of disease, than affect of alim canal.

When therefore have here comb. pain & distens of abdom. may consid whole as origin from one cause.

And although disease does not app under form of prop. hyst. fits defind by most nosol. yet may be consid as afford an example of that affect.

And app. under form of what may be calld Hyster. sympt.

To this disease age of patient may be consid as pecul fav.

For no period of life at which disease more freq. comm. than that at which pres. patient has arrivd.

Period viz at which menst flux in gener. comm.

Indeed from connect which has with menst either as obst. or encr. was inferrd that disease always connected with depend on morbid state of [ut]

And hence has been [derived] name of hystr, by which so long & so univ disting.

But although suppos of const depend on uterus ill founded, yet that very much influ by state of that viscus unden.

And here when consider circum of case not improb. that such a cause operates

For to be obs. that although pat has already arrived at 15^th year yet no disch of this kind has ever taken place.

Could not indeed be consid as very great singul. if absent for still greatr length of time.

But at same time with major of females even in this country app. prior to this.

And when no othr cause can be assignd for compl. have at least some presumpt that may origin from this.

Am therefore disp. to view it as an example of Hyster. ab emans. mensium.

The Hysteria Chlorotica of Sauvage.

A disease no less freq. than varied in app.

And often app. under such modif as the pres.

From this idea respect name & nature of disease progn at least so far fav.

For hyster seldom consid as dang very rarely a fatal affect.

When has such termin is in gener. only either after long contin or of app. under very anomal. form

But on either on these [scores] [nothing] at pres at least which could be consid as alarming.

And if conj as to origin well found, have reason to hope, that by regul. menstr. all sympt may soon be termin.

While this again may be expected even as conseq of operat of syst. itself.

At at any rate till these either inadequate, or till more [alarm] sympt indic obst arise nothing to be done with this view.

Hence then when pat came under care app. to me that pract cheifly to be directed to allev. of sympt.

And is accord. with this view that remed hitherto empl have been directed.

Of these sympts the most urgent was constip to which subj.

Had even reason to susp. that from this cause some degree of fever had arisen.

For when first applied for assist had been we were informd without any stool for space of sever. days.

And although free from febrile anxiety encr. heat or even thirst, yet pulse much quickned.

Seemd therefore advis that a stool should be procured as soon as possib.

And most ready means at least of obt. it was by having recourse to an [injec]

This the rather advis as from almost all purgat oper. briskly have reason to expect more than single stool.

And with hysteric females cathar very gener. at least to be avoided.

For as well as other causes of [exhaus] augm irrit state on which disease so much depends.

Hence then with view to immed relief inject seemd most advis.

As an inject here had recourse to an infus of Senna

Which as a purgat one of most cert. that can empl.

While at same time, has less [effect] in operat as [acrid] stim to rectum than those of saline kind.

To Senna with view to [expuls] of flatul. added a proport of Cham flowers.

As by this hoped that distens of abdom of which she compl. might in some degree be obv.

For although not partic sensib of motion of wind yet concl. it to proceed from that cause.

While however empl. this [injec] with view to immed obv. costiv. seemd no less necess. that meas. should be taken to prev. occurr in future.

And with this intent directed the Pil. Foetid cum Aloe.

Though effect of Aloes as a [purga] neither immed nor consid yet very certain.

And even in small doses of few grains seldom fails, of giving motion of belly.

Remarked even that this as cert from small as from large doses.

Or at least that effect by no means encr. in prop. to quantity taken.

Here however, from great [tendency] to obstip, could not expect that very little would answ. the purp.

Directed therfore a pill every morning & evening.

And while expected that aloes would obv. costiv looked also for benef from antisp. power of Assaf.

By this hoped that even [headach] & vertigo might in some degree be allev.

And still more that might tend to remove distens of abdom.

In operat of these med were not at least altog. disapp.

For while inject operated well, pills had effect of giving a stool every day.

Still however, notwith allev. of other sympt. distens of abdom contin.

But this hoped might be [illegible] in same course be removed.

After however trial for some time longer without effect had recourse to anoth med.

A mixt viz of Infus Amar with Tinct. Aromat.

This given with view of encr. tone of alim canal & by this means of syst in gener.

What has been affect of it have not yet had opport of learning.

But hopeful that by means of it some farther allev. of sym may be obt.

And that pat. may soon be in condit to be dismissed.