DEP/DUA/1/40/56 (Transcript version)

Helen Adam

(1786-1787)

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Helen Adam. Janr 13^th.

In hist. of case many sympt.

And indic in some degree compl.

Some as vomiting would argue bile.

Partic from colour & taste of matt. [disch]

Others, as sense of ball & constr. Hys.

And of same kind also cold & hot [fit]

But formerly gave it as opin that cheif. effect of flatul.

And that from this other symp prob. origin.

For well known that wind in alim canal cause of many sympt.

And indeed Flatulent, though not entering most nosol. syst. in my opin prop. to be consid as genus of disease

Formerly then disp to view case of this pat. as prin an inst of that

And this view course of disease has I think conf.

For soon yeilded to treatm prop.

Must however own, did not then expt. that termin would have been so quick.

Had indeed little appreh of dang.

For of diff compl of which [here] [ap] none fatal.

And viewing flatul as foundat of others, less alarm than if idiopath.

Besides this but of short durat.

Hence less diffic in comb. it.

But at same time even slight case will run on to great length.

And susp. notwith mitig of symp that yet freq. recurr of attacks.

In treatment from view given of case what seemd cheif obj. remov. of flatul.

And this consid as very much effect of Costiv.

Hence then chief obj to keep belly open by means of a med tend als to expuls of wind.

For this purp. directed Pil. Foetid cum Aloe

Equal parts Aloes. Assaf. & Soap.

Latter cheifly to give form

Two others consid activ.

In aloes a very cert. purgat even in small doses.

Partic when mean merely to open belly

This effect have even in doses of few grains

And not much more from larger.

A pecul. of this purgat that effect by no means encr. in prop to quant. taken.

Hence well fitted for habit costiv.

Esp. as no tend to bind belly after op.

And perhaps more used for obv. cost. that any other.

From assafoet. also some effect in opening belly.

But by itself not much of purgat.

Unless in inst where reten of faece effect of spasm.

For in obv. spasm in alim canal a very powerful effect.

And thus oper. as one of most effect means of expelling wind.

Hence then combin of aloes & assafoetid seemd partic prop in pres inst.

And here in every respect attend with desired effect.

Had influ. both in keeping belly open & in promot disch of flatus

And to this may I think with probab. attrib. her being no longer affected with sensat of ball.

As well as being free from [return] of vomiting.

Soon after began pills, anoth [symp]

Erupt viz on skin.

This however could in no degree supp effect of med.

And doubtful if any connect with dis.

For neither attend with aggrav nor allev of sympt.

And any rate of short durat.

And before any opport of [seeing] it had entirely disapp.

Hence afforded no ground for alter of plan.

And merely therefore directd contin.

These during course of following week more effect in mov. belly.

Or at least in gener. three loose stools in course of day.

This however might in part be effect of sourness at stom.

For well known that prev. accid often that affect.

Hence while dimin quant of pills directed Magnes. for countr. acid.

Under this got entirely rid of that sympt.

And at same time entirely free from any return of other effect.

Hence reckond any father atten unnecss.

And dismissd sooner I own than at first expected.