DEP/DUA/1/39/26 (Transcript version)

Ann Hay

1786

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Ann Hay April 1^st. 1786.

In history of this patients case many sympt enum.

And these of such nature that either may or may not be conn.

Accord when form. spoke of her expr. some doubts respect.

Then obs. that could form no posit judgm. till saw more of it.

But at same time inclind to look upon it as being an affect of hyst. kind.

And from all that since seen more disp to that opin.

Pat. indeed not at that time of life when hyster most comm.

Is also a married woman with whom a much less freq. disease than unmarried.

And to all this must be added that some app. not common from of Hyst.

While several sympt as freq at least with othr affect.

But on other hand well known that this disease in sympt diver. to almost incred degree.

And while every sympt here pres often proceeds from this cause is more prob. that whole to be reff. to one origin, than that subj to great diversi & compl. of affect.

First sympt ment. [pains] of back & sides from var. of causes.

Perhaps more freq from Rheum than any othr.

But also often attend of Hyster.

And this the rather prob. from sense of empt. as she expr. it, with which attended.

Anoth remark set of sympt are erupt & concom.

This also of very various kinds.

And among othr causes well [know] often to proceed from Hyst.

Of which presumpt afforded in pres case, from transit nature.

For during visits here nevr saw any thing of it.

Hence if not hyster, of little comp.

But of all sympt. most remark & distress. was fits to which subj.

These cannot inded to be said to have [exact] resemb. to what com occur in hyster.

But at same time, more resemb. to these, than to any other.

While may also be added, that under form here descr. prop hyst. fits not unfreq app.

And such fits freq. altern with hyster ones, in most distinct markd form.

Fits said you will observe to consist in [comp] syncop.

And while this precedd by vertigo & headach followd by Glob. hysterr.

A circum giving at least strong presumpt of nature.

And even consid by some as [illegible] of this disease.

Hence then, from this circum I own, led to consider all other sympt, as dep on same causes.

And may add, that susp. corrob, by affect of urine.

A partic often attend of hyst.

Upon whole then, from these consid, led at first to susp. diseas of hyster kind.

And this conject a little confirmd, as during course of attend, no indicat of any other affect.

While, under med directed with view to hyster, very consid mitig.

Here however, though patient dismissd free from affect, cannot speak with confid of progn.

For in affect of hyster kind can by no means place much depend on tempor relief of sympt.

And if opin of its being hyster well found, may expect return from slight causes.

Is however, of no small conseq, in such cases, to obt. even tempor. remss.

And indeed, after this, more to be done by avoid causes, than by med.

Hence then in this situat of patient consid farther use of med & farther attend as unnecss & improp

Here however cannot say, that relief obt by pat, was conseq of med we directed.

For of these greater part, intended merely with view of obv. sympt.

But in this way, is I think prob., that had at least some influ.

Began by prescr. comp powder of Crem of Tart.

This natur. indic, both by state of belly, & of urine.

Hoped that while gave free disch by former, might also encr. quant of latter.

For no doubt, that while Cream of Tart. powerfully diuret, both it & Sulp. gent. purgat.

Accord, in latter affect at least, were not disapp.

Still however, urine cont, both scanty, & what very comm [connectd] with that, high coloured.

Directed therefore contin.

But while empl. this was also desirous of having recourse to some med, with view to other compl.

Partic to fainting fits, attended with glob. hyster.

And on idea that not only these, but othr compl. also, of hyster kind, had recourse to Zinc. under form of Calc.

An artic, from which, even in some cases of Epilep, but still more freq. of hyster, have I thinks seen matter. adv.

This artic, empl. under form of pills

And given at first, to extent of about seven gr, which with an adult consid as being to comm, a full dose.

Soon after first dose, affected with severe vomiting.

And not impossib, that this the affect of pills.

This however did not prev. her from contin use to same extent.

And what renders it doubtful, that affect of pills, afterw. nothing of this sympt. from use

While upon whole, found other compl. consid easier.

With this however, again more consid return of costiv.

To Cream of Tart. therfore, substit pil foetid cum Aloe.

Former artic less necess, as urine now without any affect.

These pills, as much affect as could have wishd, in opening belly.

While at same time, at succeed report, found her in every other resp. free from affect.

And in this situat as already obs., consid farther contin of med, for pres at least improp

Dismissd therefore from farther attend