DEP/DUA/1/41/10 (Transcript version)

Alexander Burn

1787

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Alexr Burn. Febr 25. 87.

Of This patient have seen very little since last spoke.

For soon gave up attend.

Hence while not subj of those trials in pract which pro. no farth opport of obs. disease.

Still therefore liable to same doubts resp it as formerly.

Then obs. however that disp to consider it as ex of Dysp.

A name as expr a genus of disease but new.

And accord term hardly empl by any pract auth.

But though name new disease by no means.

In all ages & in all countries one of most comm affect

And neither more nor less than what here comm known by gener. title of stom ailm.

This indeed it must be allowed includes even very opp. & diff affect.

But so does Dyspep.

For by no means to consid it as corresp to exact defin of nosol.

For even in same pat. app. of that set of sympt by no means perm.

But although sometimes entirely one set of sympt, sometimes anoth yet gener [tenour] of sympt. pr. unif.

And comm such as indic slow & depr. digest.

In this respect from gener hist of case such coincid. as to leave little doubt of affect.

Must however be allowed that here not altog without pecul.

At least as related in history given us by patient.

Indeed this so much the [case] that formerly obs. would be improp to risk conject on some partic till truth ascert.

But of this now no prospect of any farther opport.

Taking case however as repres to us some pecul.

Perhaps to consider as such even very first sympt ment in hist.

Sense of Ball viz moving up & down in Abdom.

And from thence [ascend] to stom.

A circum princip obs. we are told after meals.

Uneasiness imm after meals one of most comm app in Dysp.

But in gener. does not appear under this form.

For most part, consists princip. in sense of weight at stom.

And not unfreq with pain.

Often also distress from flatul.

But cheifly under form of eruct.

Flatul prob. chief cause of pres [sym.]

But here app. more under form of globus hysteric as calld.

Of this sympt. had very lately occas to state opin.

Consid it as by no means pathog.

Although freq in hyster. yet as sometimes abs there sometimes occur in other dis.

And indeed as being merely effect of inordin & irregul motion of alim canal with wind pent up

And in conseq of its thus propag sense of ball.

Here then, though no other symp giving disease title to name of Hyster. yet may presume that dispos to such action.

And that this excited even in infer. parts of alim canal by impress of food on stom.

When however this inord action reach stom. would app. that [there] diff. modif.

For in place of glob. propag to throat vomit ensues.

An [inod] action in which diaph. more concern than stom.

But at same time an [inord] action well known to arise either from pecul impress made on stom or from pecul condit of that org.

Accord a very common sympt in almost every inst of Dyspep.

In vomiting which here ensues a pecul progr. with resp to taste of matter disch.

At first acid, afterw tasteless, then bitter

This if not comm remarkd, at least not an unnat progr.

In dyspep in gener. tend to acid in stom very strong.

Hence till acid disch. this taste may natur be expectd.

After this disch however nothing to be evac but more watery fluid immed effused into stom.

Hence necess. tastless.

But from violent straining bile emulged from gall bladder & [illegible] into stom

Hence bitterness.

When straining violent sometimes told tinged with blood.

These more conseq of rupt of small superfic vessels.

And indeed const attend of alim [all] severe vomiting.

But if in state of vomiting app not always obs. one still more [rare] in hunger with which affected.

Want of app. one of most comm sympt in Dyspep.

In gener even avers to food.

Probab. from recollect that often remains like load on stom.

Hunger however the natural conseq of an empty stom.

And here to be obs. immed conseq of severe vomit.

Hence would argue that from this vomiting stomach fully emp.

To this then might here perhap without farther inquir refer it.

But to be obs. that something pecul in manner in which allayd.

Best done we are told by a little warm milk or cold water

If however ordin app. should have rather induced dispos for solids.

Hence then view it rathr as pecul craving than natur [hung]

This pecul of stom app also from anoth circum.

Kind of food viz agreeing best with him

These we are told flummery & watery fluids.

This however by no means in gener. case with [dyspept.]

For while often prod of great uneasin. freq also obs. that [degen] less readily than others.

Very commonly least uneasiness from solid food, as beef stake if taken in moder quant.

And often where even this gives uneasin. ready digest if meat highly seasond, salted, or smoked.

Hence circum of diet justly rankd among pecul.

And prob effect of pecul state of stom.

Of other sympt as exhib no singul unnecss to say any thing.

Loss of strength, want of sleep flying pains & bound belly, com sympt of this affect.

And some of them even necess conseq.

With regard to prognos as little need be said.

Or at least nothing to be added to what before obs.

After five years contin could not expect speedy fav termin.

At same time from acct given us affect even of itself on decline.

Greater hopes therefore that from prop remed some allev might be procured.

And this farther reason to expect from relief exper. after began remed here directed.

But after short contin gave up farther attend here.

And Whether this proceeded from farther allev of sympt. or from some other circum cannot pretend to conject.

And prob. no informat on subj as little chance of [seeing] any thing more of patient.

When first began attend here directed use of [Pil] Stomach

Consist chiefly of Rhub. Aloes & Myrrh

These however united with consid prop of Volat. Arom Oil

viz distilld oil of Mint.

May therefore expect that will excit on stom, both stim & tonic power

Not only immed prod action but tend also to encr. power.

While at same time effect of gently moving belly.

Accord. where sympt of flatul with costiv often of great use.

And in this inst may at least venture to say that no bad effect.

For obvious operat that of gently moving belly.

And this, whether cause or not at least attended, with consid allev of sympt.

Still however contin to be affected with freq. vomiting.

And this as already said consid as more effect of pecul irritab. than of any thing else.

Was with this intent that while contin stom pills directd also anoth med for pat.

A mixt viz. consist of weak vitriol acid & Theb. Tinct. diff in water.

From both one & other of these reason to expect good effects.

Of effects of opium as [allayin] inord action unnecess to say any thing.

This exper. not only in stomach but over whole syst.

And that too in conseq of action on stom.

Influ of acid not perhaps so gener.

But with respect at least to inord action of stomach very [grea]

This app in [cheek] which [given] to influ even of emet.

When acid taken, Ipecac has power of excit vomit if not destroyd, at least very much dimin.

App no less in effect as [checkn] hiccough.

This sooner checkd by acids partic Vineg or Vitriol acid than perhaps any other remed yet known.

But though both artic thus promise advant. mixt obj to.

Has been alledged that on destr effect of other.

And partic that by acid power of opium destroyd.

This however at least in [such] mixt as here empl. by no means case.

And indeed as thus empl. does dimin narcot or intox power of opium

And accord thus useful corrig.

For confus of head perhaps nevr wanted.

But from repeated exper. have found, it still to exert sedativ power

Partic effect of allaying action & induc sleep.

In so much that have of late freq empl. it with both intent.

And for allaying vomit acq with no med which in gener answ purp better.

But what effect in this case have not been able to learn as have seen nothing of pat since [first]

And as shall not prob see more of him farther obser. unnecss.