DEP/DUA/1/40/60 (Transcript version)

Daniel Miller

(1786-1787)

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Daniel Miller. Janr 19

In history of case many symp.

And greatest part referd to alim canal.

No doubt that many of these as sense of ball, excess eruct &e immed effects of air in bowels.

But shew also inord state of action.

And to this are to attrib, eruct. sense of constric, vomit, and &e.

These well known to be [train] of sympt occur both in Dyspep & Hypochond.

And formerly gave it as opin. that rather example of latter affect.

Cannot indeed say that mental affect, great charact of hypochond to any great degree

Cannot be said that compl of patient partic engage attent.

But in this case many sympt comm in hypochond. seld. occurring in [pure] dyspep.

Among others may mention vertigo & deliq anim.

Disturbd sleep during night.

And affect of urin disch.

All these often to high degree in hypoch.

And often concom or forerunner of state of mind by which pecul. charact.

While in dysp. even to greatest height seld. discov.

Here therfore give presumpt that mental affect in hypochond, will either soon follow or have even already taken place

For may be observd that see so little of pat. as to be hardly able to judge of this

And for any thing we know to [contrary] pres state of mind may be very much that of hypochon.

With this view of affect cannot form any sang. hopes of speedy recv.

For though not dangr yet in gener very obstin.

Espec. when of long stand.

And with our pat had already in some degree subs for 10 years.

Can hardly therfore enter. hopes that able compl to rem. them.

But to be obs. that only of late subj to consid aggrav.

And may entert some hopes that by prop remed may be able somewhat to mitig affect.

And that in no long time may be brought again to former condit.

In this inclind to think that from treatm empl. some progr alread made.

For at two succeed reports consid mitig

Cannot indeed expect that will not from slight accid be subj to aggrav.

But still if enjoys in gener relief that has done for some weeks past, may be consid as much better.

In treatm. remed empl. directed with two intent.

Seemd first & perhaps not least import obj. to obv. urg. sympt.

But besides this prop also, as far at least as could be accompl. to counteract morb. condit of alim canal on which these depend.

And partic by restor due dispos. to natural & regul. action.

Was with first intent ment. that began treat of case by Pil. Foet. cum Aloe.

Where great uneas. from flatul with costiv know no med answ. purp. better.

Does not indeed in every case sit easily on stom.

And partic where natur. disp. to vomiting.

This sympt then might here have been thought obj. to empl.

And in my opin was so.

But at same time, trusted that might be prod of greater benef. than inconv. from even encr. of vomit.

While by no means cert. that would be case

And accord. could not be said, as app. from subs. report that had any influ in that way.

For though vom still cont. was not more severe than before.

Cannot however on other hand say that relievd uneas from flatul.

For still much distr. with uneas from wind.

But had at least some influ in moving belly.

And after began use less distressd with costiv.

Prob. also to attrib to pills relief in disch of urine.

For this not unfreq conseq of employm.

And where urine released from flatus in intest easy to see how may have effect.

A case very common

In so much that among vulg. will every day hear of affect of this kind disting by app. of windy grav.

In this manner then may have given rise to more free disch.

But no so easy to see how should have dimin sense of heat.

And indeed diff to say from what this sympt here arises.

But while in some inst not to be denied that very comm in Hypochond.

And while in some inst & at some times scanty & high coloured, in others profuse & limpid.

But whether all these changes to be ascribd to pills or not yet no circum had occurd as obj to use

Hence therfore resolvd to [illegible ] in employm.

But with this wishd also to employ some [remed] with view to radic cure

With this intent & with view of restor. dispos to natur. action in alim canal, had recourse to a chaly conj with Peruv Bark.

A scruple of latter united to gr x of Rubig Ferr & taken twice a day.

From this combin, in cases where much distress from flat. with tend to inord action, have I think in former inst seen benef.

And here inclind to think that not altog. disap. in des. effect.

Still indeed contin to be subj to returns of vomiting.

But this not at least immed conseq of powders.

For these from begin sat easily on stom.

And after use for forthnight though still [distr] with eruct yet vomit less consid.

While at same time, pills affect of giving regul disch by belly & other sympt rather easier

At succeed report indeed some aggrav.

Prob. effect of some accid escap obs.

Perhaps even of some irreg. with respect to diet.

But whatever cause again mitig.

And for two weeks past consid easier.

In this situat no thought of chang. plan.

And if contin thus [easy] shall not even be displ. at good opport of dismiss.

For after contin for ten years cannot as already said enter any [strong] hopes of compl. recov