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DEP/DUA/1/39/16 (Transcript version)
Sarah Allan
1786
Sarah Allan March 4th 1786
Sympt. enum in hist of this pat. case as former. obs. all of that kind which every day occurr in inst of dyspep. Here no reason, from exam by touch, from sensat of pat. from const. fixd pain or any other partic inferr that orign from any loc affect. And although have by no means in hist of case every sympt. ment. in defin of dysp. yet little hesit in viewing this as prin affect. But from circum which have learnt since came under care, cannot consid it as only compl. to which subj. Besides this also subj to anoth affect in all prob. in no degree conn with former. An erupt. viz of herpet. kind Not indeed gener. [over] surface. But to consid degree app on both arms. Cutan affect of diff. app. not unfreq. obs. conn with stom ailm. This partic demonst. from the tend they have to altern with each other. Thus while erupt. consid, stom compl. entirely disapp, & [contr]. A natural conseq. of that connect, which well known to subs between stom & surface But in these cases erupt seldom circum, & partial. Seldom that remains as it were stat. for any consid length of time And very gener. two affect of same duration. In all these partic however, case very diff. with pres. pat. And hence here disp. to consid two affect, as altog unconn. A circum also by no means rare. For not to be expected, that any one being pres, should afford def. against other. While thus however consid patient as subj to compl. of diseases, Dysp. sympt, partic when came under care both most urgent, & most import. And in these also, there took place some pecul. This partic the case, with respect to app. for food. In most inst of Dysp. there occurs an avers. to food. This indeed so much the case that anorexia gener. consid as one of sympt charact the disease And accord, introd into definit of best nosol. But in case before us, appet even uncom. keen. Without entering into theory of hunger, a consid foreign to [bus] in this place, may only obs, that this would argue quick solut of alim in stom For evid not hurried through intest, without prop solut, as abund app., from state of stools. As in that case there would occur both looseness & disch also, in an undigest state. Hence then, reason to presume that only causes to give distens of stom, by being dissolved. For as long as distens takes place perhaps no inst of what can be calld hunger occurring. From this then some ground for presum that in induct of stom ailm here a morbid cond of succus gast. had some influ. Have long been inclind to imag that with morbid condit of this fluid, stom compl. much more conn than comm thought. Now univ allowed that in perform funct of digest succus gastric, has in all anim, very great influ And partic that in those who like hum species, have [illegible] stom, does much more than both musc. action & fement put togeth. Hence then but reason to inferr that while as well as other secret, liab to disease states, there should from time arise affect of digest. And thus as well as musc action on which again longer or shorter retent in stom [depp]. should be very much concernd in induc of Dyspep. In most inst of Dysp. howevr reason to believe, that either active or quant of secret dimin. For in place of ready solut food, remains like load at stom. And in place of keen appetit there occurrs avers to victuals. From contrary circum however in pres inst. some reason to pres. that either encr of activ, or quant. And this state also may readily conceive often united with sickness vomiting, acid eruct. pains & other dysp. sympt. But presumpt of morbid affect now ment drawn from state of app. corrob. by another circum The nature & condit viz of that pain in region of stom with which so often affected. In most inst Dyspep. not without pain. Partic takes place when stom distend either with food or with flatul. And in this way no time at which may not occurr. Butpartic remarkd to occurpartic remarkd to occur after food taken. And in gener. indeed, some degr of uneasiness, till either digest or disch by vomiting. In case before us however more especially obs. when stom empty. And then occurrs with uncom degree of severity. In so much even, that said to give tenden to deliq. animi. From these circum then natur led to conject some other cause. And is I think no improb. suppos, that might be effect of menst furn. by stom. This fluid, even in natur. condit, unquest possess. very strong solo power When morbid encr of activ, may be capab. of giving painful impr. to stom, even when def. by liv. [prom] Espec. if stomach empty, so that no other matter on which actv exerted Hence then, from this circum, some addit presumpt at least, of morb. condit in succus gastric. And upon whole disp to conj that here, with dimin of vigour in musc. fibres of stom, there occurrs encr of activ in menst. furnishd for solut of ailment. On this idea of affect. when formerly spoke of case, was disp. to hope that might soon have fav termin. As far as effect of morb. encr of [energ] in succus gastric reason to hope that soon even of itself termin. And as far, as dimin tone of stom had concern, was at least an affect of no long stand. Although therefore in its nature often obstin, had at least some reason to hope that by prop remed might soon be counteracted. Was indeed somewhat against patient, that origin of unhealthy constit. And partic that formerly liab. to bowel compl. But notwith this hoped that affect in pres form at least not of long contin. Now however reason to think that expect. more sanguine than ought to have been. For after has now been for two months under our care, can hardly say that much progr to recov. At same time in sever respects compl. certainly easier. And even not improb. that migh have been still better, but for irreg in her own part. Partic lately when affect much allev. Began pract you will obs. by prescrb. for this patient an emet. with view of evac stom & thus pav. way for other med. Partic those which from [acting] as stimul to musc. fibres of stom might both strength tone & change state of secret. And with this view had recourse to a mixt. consist of equal prop. of aromat & bitter tinct & Pep. M. Wa. To this formul in Dyspet affec have often had recourse & I think with very great adv. Consider it as one of most conv. & powerful formul. for exhib of bitters & aromat. And these need hardly obs. so much used in such affect, that even known by gener title of stom med. In obvious operat of emet was not disapp. And stomach mixt seemd at least to have so far a good affect. For after some contin of use stom ailm, partic sickness vomitn & acid eruct very consid dimin. Still however not free from pain when stom empty. And still rather uncomm keeness of appetite. These however hoped might also be overcome from contin of med. And accord at succeeding report all compl. consid relievd. Progr. however in this way did not contin unif. For without any manif cause afterwards rather aggrav. To this however paid but little regard. For during course of Dysp. affect is very common even from most triffling accid. Such for ex. as slight irreg of diet being more sedent than usual or the like. Still therefore hoped for cure from persist in course begun. And accord soon became so little affected with stom. compl. that reckond farther contin unnecss. To omiss of use the rather led as compl. that occas some degree of vertigo. An affect which might possib. [arise] from spirit menst. by which Tinct. formd. At this period when stom compl so easy were informd of other affect erupt viz on arms. This had never before though it necess to ment. And indeed was rather deform to her than prod of any uneas. Imag. that might easily yeild to extern app. of Vitriol Acid Accord directed Ungt Vitriol While at same time omitting mixt. directed Pil. Aloet. with view of keeping belly open, that return of affect might not be ind by costiv. After this prescr. however saw nothing of her from some time. A conseq. of now thinking that little farther occas for assist. But being accid subj to costiv after pills done became subj to vom which again led her to apply for assist. Found however that in other respects stom compl. easier. And that affect on arm very consid dimin Imag. therefore that might yeild to farther contin. And with view to vomit had recourse to Tinct. Amar [comb] with [illegible] & [Rhei] By this hope soon again in former [illegible] If not meas to be adapted to accom.