DEP/DUA/1/41/06 (Transcript version)

Nelly Gordon

1787

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Nelly Gordon. Febr 16^th 87.

In history many sympt.

And these occur in var. affect.

But none which are not freq. attend of Hyster.

And of this formerly obs. consid pres case as ex.

Does not indeed exact. corresp to defin of Hyster by Nosol.

But a disease under var of forms.

Sometimes under form of prop. fits.

Sometimes of Hyster. sympt.

Is from formr chiefly that defin of nosol. drawn.

In case before us however ex of latter.

And that may obs. hardly adm of defin

Sometimes entirely one set of sympt sometimes anoth.

For proof need only referr to accur descript of Syden.

Will there obs. that considers disease as in some inst charact. even by single circum of Clav. Hys.

A pecul. pain of head.

But if this sometimes case more freq by glob. Hyster.

Sense of ball rising in alim canal till reach even aesoph.

And these prod as it were sense of suffoc.

Perhaps in some degree from comp. of Trachea by oesoph

Perhaps, from constrict simil to that which takes place in oesoph prop to Trachea.

But whatever cause here very [distin] marked.

And serves to give, if not cert proof at least strong pres of Hyster.

Am by no means indeed incl. to adopt opin of some who consid it as pathog.

That is as a sympt occur in every case of Hyster.

And as never pres in any othr disease.

Am inclind to think that neith one nor other well founded.

For on one hand have met with not a few inst of dist. markd Hyst where did not occurr.

And on other have seen it cases of mere flatulent where every other circum against suppos of Hyster.

But yet where occurs always give presumpt.

And here conj. with many concurr. circum.

Both age & sex of pat. in fav of suppos of Hyster.

For is a female at that period of life when very comm.

And besides glob. all other sympt what freq occur in Hyster.

Panic fainting fits, attacks of heat & cold, flying pains &e.

And indeed concl. affect Hyster. rather from all sympt taken tog. than from any one.

And from compar. of case of our patient with gener history of disease little doubt of it.

One circum indeed may be [cons] as rather singul.

State viz of urine.

Is we are told in small quant & of high colour.

And in gener. disch with sense of heat.

This latter circum to be consid as immed conn with former.

Sense of heat effect of stronger saline impreg.

And that from mere want of diluent

As indic indeed by high colour.

This it must be allowed not a common occur in hyster.

Nay oppos. state very freq. remarkd.

Urine not only copious but [illegible] & colour less.

This however although a freq. by no means a const sympt.

And as occurring evid indicates influ of disease as affect kidney.

If however in some cases effect in one way, may concl. that in a disease so much varied, in other cases effect in diff way.

And therefore rather evid, of affect being Hyster. than against supp.

With this view of disease progn could not be very fav.

For even in app. slightest cases often a very obstin affect.

And here could not be consid as slight.

For attend with some at least of most alarm sympt.

Such for example as deliq.

But Hyster faintings even when to greatest height, more alarm than danger.

Much less so than in perhaps any other affect whatever.

Patient for days togeth out of one faint into anoth. without any fatal termin.

In gener even almost instant recover.

Indeed Hyster. by itself rarely fatal

Comm so only be induc othr disease.

Hence here no appreh of danger.

And if sympt not slight were not at least of long durat.

Accord to acct given us when came under care subj only for 3 week.

And during that time had not resist powerful remed.

For if opin of disease well found cannot consider as such either blood [leting] or even blisters.

These on contrary partic former very apt to aggrav affect.

And accord this, in opin of patient herself had been case.

But as unacq with partic circum when these pract had recourse to imposs. to say, how far prop or even necess.

But if even means of aggrav [affec] might be consid as ground of hope.

For to be expected that influ would now soon cease.

And that aggrav. to which had given rise would thus be termin.

Hoped therfore that by remed more adapt to nature of disease might soon give some relief.

And that in no long time might obt such remiss that farthr attend unnecss.

Not howevr that could consid patient as cured

For obstin of disease depends more on recurr from slight case than from long contin at once.

And after prop remiss obt more to be accompl by regul. cond of life than any thing else

In treatm remed empl. directed with two views.

1^st The obv. urgent sympt.

2d. Remov. of that condit of habit. giving tend to inord action by which more urgent sympt. [induc]

With first of these intent had recourse to Pil. Foetid cum Aloe.

From these as possess purgat powr hoped for some affect as disch wind.

But still more as remov. inord action, in alim canal.

For no doubt that as allayin action a powerf. antispas.

And accord where sense of ball from flatul. often affect of remov.

For this not merely effect of wind but of stric, by which that wind is confined.

And of this exclus. of globus rising to throat some evid in case before us

For at times sensat as if abdom full of balls.

Cannot however say that here prod of desired effect.

Had indeed some influ as opening belly.

But from this no pecul disch of flatus.

And in other resp. sympt much as before.

But though this conseq of first trial yet hoped that by longer contin greater benef might be obt.

Hence directed that should persist in use.

But did not [choose] to trust to these alone.

Thought it necess to employ a med by which disp to inord action [dim]

For this purp. had recourse to combin of Calx of Zinc with Valer.

Of these artic latter cheifly used as [excess].

Though at same time no doubt that has effect of allaying tend to inord action.

And that therefore justly ranked among tribe of nerv. med.

But here chief confid in former Calx of Zinc.

An artic for introd of which chiefly indebt to Dr Gaub.

Had indeed long been used for some purp in med as exter. applic.

But till pub. of his Adver. [illegible] thought of as intern remed.

And accord to acct there given his attent calld to it by very partic circum.

A remed sold by an Emp of nam of Luddem under title of Luna fixata had become very fam in Holland.

Was empl. & sometimes with success not only in affect of convuls. but sometimes even of Epilep. kind.

Dr Gaub. from having witness success induc to anal. it.

And had reason to concl. that active basis Zinc in state of calc. united with other artic [merely] for conceal.

Having used Zinc by itself found it prod of same benef.

And soon after pub. acct of it in Adversar. in Dissertat De Luna fixata Luddeman.

To that referr for most full acct

Since thus introd has been a great deal empl.

And as may readily be concl. diff opin formd.

Has partic been much used in Epilep.

A disease well known incur. in many inst. by any remed yet known.

Hence not surp. that should often have faild.

And accord. some who from repeated disap. hold it to be med of no effic whatever.

This however an opin which from repeated exper. think can safely venture to contrad.

For have met with many [inst] in which was in my opin evid success.

Very first patient with whom I empl it upw of 12 years ago a man lab. under Epilep. of name of Peter [Macmillan] never afterw any return of fits.

Since that have indeed emp it with many epilep & without [success]

And of these great major as already said, in my opin incur. by any means

Case to which allude not only one success.

Have empl it in many others with advant

Much more indeed in Hyster & in Convuls. strictly so calld than in Epilep.

Nor is my success with it to be consid as in any degr. [surp].

For now concur. testim in fav of many of most emm pract.

And although far from consid it as specif. yet ever since becam acq with empl. internally have held it to be powerful & usef. med.

As such had recourse to it with pres. pat.

Empl. to extent of gr V ter de die.

From this dose at first consid sickness & even vomit.

But these effects only of first exhib.

For in few days much dimin

And although at first no influ on disease, yet soon glob. Hyster less distress.

While other sympt also mitig

But after this sickness again so far aggr. that led to [interm] [use]

Was however unwill to [return] trial app. attend with advant.

And as susp. sickness might in part be affect of Valer. resolv. to alter form.

Accord pres. it under form of Pills with Crumb of bread.

Since these taken no inconv.

And at same time all affect much mitig.

In so much that if no [illegible] shall hardly consid farther atten as necess.

And look on case as addit ex of good effects of Zinc.

If recurr. which may readily happen either from influ of [illegible] or other unavoid [acid] shall still think of persist in Zinc till at least full & fair trial.