DEP/DUA/1/42/45 (Transcript version)

Elizabeth Clark

(1787-1788)

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N^o10^th Eliz. Clark at 59.

When formerly spoke of case of this pat repres it as compl. & in some resp. doubtful affect.

Most distress affect headach, conj to be of Rheum kind.

To this opin led from seat which occup course of coron nature.

From stricking down towards ears.

But above all from sever on first becom warm in bed.

All these well known to be more comm occur in Rheum than any other headach.

While at same time from Rheum a very consid major of headach arise

But notwith these presumpt am now inclind to think this suppos erron

Besides headach had also a variet of stomach ailm.

Or at least affect of alim canal from wind.

For to this cause was disp. to attrib pain both in stomach & side as well as sickness & vomiting.

Formerly remarkd that from impr on alim canal, headach often arises.

And notwith presumpt of Rheum some ground for suppos this in pres case.

Partic as headach most severe when stom most distend.

Hence then conj. that had at least consid influ in aggrav affect

Would now app. that influen much greater than then imag.

And from total remov of headach which has followed allev. of stomach ail would inferr that sole cause.

Accord has not been necess. as form sups. might be case, to have recour to any remed, with view to headach alone.

For from begining thought it most advis to comm attempts to cure by endeav to comb. stom ailm

And partic to obv pains, by prom disch by belly both of wind & foeces.

With this intent had recourse to Pil. Foetid cum Aloe.

Consists of p. a Assaf. Al. & Soap.

In former of these have a vegetab. gummi-resin exud, possess. very great antispas. [powers].

At same time comb. with stim qualit.

And partic useful as prom expuls of wind from alim canal.

In Assaf. itself there resides [somew] of purgat power.

But to inconsid degree only.

And if of good qualit, for induc. cathars, more requird than stom can in general bear without vom.

Hence where with flatul. belly bound someth possess. more power cathar stim in gener. requis.

And what here wanting fully supp. by Aloes.

For of these very few grains suff. to give at least one or two easy stools.

And this utm in any such cases to be wishd for.

For from consid [cathters]. affect always aggrav.

Hence even where constip very obst. is always prop. to try first to move belly by gentle means.

In effect exp. from these pills were not disapp.

For while gently opend belly occas consid disch of wind.

And with this, all her sympt but partic headach much relievd.

A circum giving addit strength to suppos, that headach entirely sympt of affect of alim canal.

In this situat nothing farther seemd necess. than contin of pills.

And reason even to hope that by persisting in these alone [affect] might be removed.

But although use persisted in, did not contin to have all former effect.

For although a stool every day yet rather bound

And with this both much uneas from wind & aggrav. of headach.

A circum afford addit evid of [cons].

In this situat seemd less necess to do any thing farther to open belly than to correct flatul.

While therefore with former intent reckond it suff. to cont. pills, with latter had recourse to mixt of bitter & arom. tinct.

Of this combin as useful in stom compl. have already had occas to treat.

Consists of most pleas & active vegetab. bitters & aromat.

This united with prop of Pepp. M water.

Than which as expelling wind have few med more immed in [effect] or more active.

While at same time serves to dilute ard. spt in Tinct.

Cannot however say that here attended with all benef. exp.

For still cont to be much affectd both with wind in bowels, & severe headach.

This however was disp. to attrib, to pills now ceas. to have form. affect.

For notwith empl. belly cont very bound.

This might be merely return of former condit.

For not unfreq. happens, that purgat. stimul, by habit loses influ.

Or might be conseq, of some accid cause of constip

Such for ex as artic in diet, want of exercise or like.

But whatever cause seemd part necess that should be obv.

Still however by a med not purging violently.

And partic by one which could be contin with some regul.

Accord to Pil. Foetid cum Aloe, subst. Pil ex Colocynth cum Aloe, Pil. Cociae, as formerly calld.

A formula oper. still more powerf than aloes alone.

For purgat power encr. by [Scamm] & Colocynth.

This pill to quant even of gr V in gener. oper. as ob costive, if belly not very bound.

Here however to secure effect ord to extent of gr X.

But these to be repeated only every second night.

Purgat pills had rather more effect than could have wishd.

For from every dose, two or three loose stools prod.

But with this, consid allev of some of sympt.

Still indeed contin to be at times affected with pain in stom & bowels.

But headach became consid easier.

This therefore suff. encouragm to contin.

And partic as from what had happ. with regard to former pills, imagind that would soon have less effect.

While trusted that tone of stom & intest, would be grad rest, by use of mixt.

And thus regener of flatul prev.

In these expect not altog. disapp.

For at succeed report, though still at times compl. of pain yet flatul much less consid than before

And although pills not now purg to same degree as before, yet headach cont. much easier.

In these circum then could hav no inducem to alter course.

And accord directed contin

Under use, became still more easy.

And in this situat seemd [unnec] to persist farther in any med.

Have accord dismissd pat from attend at least free from headach.

And for pres. at least with very little of stom ailm.

Am very far however from repres. patient as entirely rid of disease.

For need hardly remark that few compl. more apt to return, than stom ailm.

Nor can this seem strange when consid how much exposed to action of [cause] induc them

For stom acted upon by every thing taken in way of alim.

And that not merely both from quant & qualit but also from [temp]

For by this last circum, am conv. that are often both induced & aggrav.

And partic apt to be renewed with those once subj to them.

For to be obs. that what will have little infl. on a vigorous stom will have great effect on one that has once been weak.

Is only therefore by great degree of attent on part of pat. that can ever ex to remain toler. easy.

But from what have seen in this case app. by what means tempor relief [might] at least may be effected.

And affords also ex. of headach entirely dep. on affect of stomach although app. attended with symp. which might have led to susp. of being of Rheum kind.

While at same time shows prop. in cases where headach & stomach compl. are compl. of at least endeav in first inst to obt. relieve of former by mitig of latter.