DEP/DUA/1/42/39 (Transcript version)

Betty Culbert

(1787-1788)

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N^o7^th Betty Culbert at 15.

Formerly obs. that sympt in case of this pat. such as occur in many diff diseases.

And that could form no decided opin of nature.

Gave it however as conject that chief affect prob. conseq of menst. disch not occuring at natural period.

Patient having now arrived at age to which comm. ocurs.

Nothing has since taken place to lead to alterat of this opin.

And still think it not improb. that from want of natur. menst disch chief sympt have origin.

But must be allowed that since pat came under care affect has put on more app of Hyster.

But this in place of affording obj to suppos rather in fav of it.

For well known that Hyster. affect often connected with condit of this viscus.

And indeed suppos. that such an affect const. took place has even given name to disease.

With respect to termin now not less doubtful than formerly.

Have even reason to appreh grea obstin.

For well known that Hyster under whatever modif occurs, though not a immed danger. disease yet often pat obstin.

And even suppos it to origin from obstr. menst. yet does not follow, that by occurr of natur. disch would be removed.

At same time even from period of life alone at which pat. has arrived many chances of recover.

For well known that with arrival at full stature, & occurr of menst disch many changes induced in female [cons]

And chance [thence] arising may at least be encr. by use of prop. remed.

Partic those tending to remove morb irritab. of syst.

When came first under our care [many] of chief sympt. affect of alim canal.

Such for example as impaird app. & freq. reject of food by vomiting.

To this also thought that headach on one hand & pains of side & bowels on other not a little to be referrd.

For these by no means of fixed or const. nature.

And pain of side in partic in place of being aggrav by motion alw relievd by it.

Hence concl. that if not from flatul or spasm, was least a nerv. affect

This therefore naturally indic use of some med tend to strengthen tone of stomach.

And of course tone of syst in gener

For from this, chiefly reason to hope, that tend to menst. would be encr.

As stomach directed here what we call Mist. Tinct. Aromat.

Formd of equal parts of Tinct Arom Tinct Amar & Water.

Of first of these Tinct. the basis Cinnam & Cardam. among best & most grateful of veget aromat.

Of second which has also name of Stom Elix as useful in such affect the basis Gentian

One of purest & strongest of veget bitters.

In both these Tinct. menst empl. not rectif. but merely proof spt.

Still however taken to any extent with those not accust. to spirit liquors apt to make strong impress on stom.

And in some inst obs. to give rise even to intoxicat.

Hence some farther dilut often adv.

And with this view water here added.

To this formula in diff stomach ailm. have often had recourse.

And I think with advant.

Partic as tending both to mend app. & to promote digest

In conjunct with this med directed also use of an aloet pill at bed time

This chiefly empl. with view of obt regul disch. by belly.

For in affect of stom in gener. regul & easy passage of utmost conseq.

Seldom fail to be much aggrav by extremes either of constit or loosness.

While regul. disch at least aids operat of other med.

But besides this in direct aloes here, had also anoth view.

These well known to exert stimul effects pecul on rectum.

And reason to think that influ in this way extended to contig parts

In this manner presumpt that often affects uterus itself.

And thus supp. frequently useful both as tending to induce & to support menstrual disch.

Aloet pill directed to be taken to extent of gr V at bed time

In this when reflect that consists of equal parts of aloes & extr of Gent. formed into mass of syrup may concl. that not more than too gr of Aloes.

And gent in no degree an artic of cathart. qualit.

Could not therefore reason expect more than that would gently move belly.

This effect however as readily prod as even larger quantit.

And indeed have formerly remarkd of aloes that operat by no means prop. to quantit taken.

While from few grains belly gently moved, yet no brisk cathar from much larger quantit.

Here therfore no [appreh] of [affect] any viol operat

But contr. to expectat excited very severe looseness.

From this besides immed incon. had reason to appreh after bad conseq.

Necess. led therefore to interm use.

And affords examp. of remark influ of pecul of habit.

For nothing in case of pres patient to have led to susp. of such powerful operat.

And of 100 patients with 99 would have had no such effect.

From Stomach mixture no partic effect.

And although hitherto little allev of sympt. yet had reason to expect this from contin

Hence directed that should persist in employmn.

But now compl. still more than ever of pain in side.

And as susp. that might be at least in part musc. directed friction with Ungt. Tereb. cum Opio.

Whether to this should ascribe any good effect or not am I own uncert.

But after friction was at least [consd] mitig.

While from time that pills omittd no more returns of looseness.

Now however disease put on in some respects diff. app.

Became affected with freq. fainting attended with streching & yawning.

This well known one of many forms which hyster affect put on.

And although more alarm app. than former sympt yet in reality not more to be dreaded.

And in no degree indic change in nature of affect.

Hence directd contin of former remed

Thought however that might be of conseq. to anticip fits.

And with that intent directed small quant of Aether to be taken on threat of fit.

Of all artic having this effect from impress made on nerves of stomach know none more powerful.

And accordingly in this inst seemd at least to be attended with good effect.

For thought that had at least effect of mitig & shortening fits

Still however these contin to recur freq.

Seemd necess therfore to employ some meas with view of remov. disp to these.

And with this intent nothing seemd to promise more adv. than use of Zinc.

This artic under form of Flowers or Calx, taken internally, introd some years ago in Holl. by an Emp. of name of Luddeman as remed for Epilep.

And strongly recomm to attent of pract by Dr Gaub in his Adver.

Since that time have in my own pract used it very freq.

And much mist if in some inst even of Epilep have not seen manif benef from use.

But still more freq. have found it serviceable in Hyster.

Partic as given in combin with root of Valer.

To this therefore had here recourse

While empl. this med however did not think it advis to cont. others before directed.

As pain of side easier Ungt Tereb cum Opio seemd now no longer indic.

And imagind that aromat mixt might interfere with influ of Zinc on stom.

For prob. is entirely by action on nerves there that exerts effect on syst.

With Zinc however directed as occas might require repet of Aether.

For from anticip of fits, reason to hope that influ on syst. would be encr.

Since began use of Zinc has had no return of fits and in other respects easier.

Am far however from imag. that this state will be perman.

And I own look for return of affec under former or some other form.

But relief obt. at least some [encour] to persist in Zinc till full & fair trial