DEP/DUA/1/43/10 (Transcript version)

Janet McDougall

(1787-1788)

---

Janet McDougall. at 38.

Formerly pron. disease of this pat an ex of Hyster.

And while contin attend here now no reason for altering opin.

Disease indeed cannot be repres. as by any means corresp. to defin of hyster given by nosol.

But no doubt that this disease app under very great var of forms.

And these often altern with prop hyster fits.

Hence unden. that to be consid as same affect.

Seldom entirely under form of prop hyster fits, without other sympt at time occurring

But often totally consists of what may be calld hystr sympt

And of this have I think ex in case before us.

In pains to which is subj have sympt analog. to what constit the glob Clavus hyster.

And in affect of alim canal have in some degree that inord. action which prop to throat gives glob. hyster.

These it is well known two of most leading & distress. sympt of the disease.

With regard to prognos. formerly obs. that could not flatter ourselves with hopes of compl. recov.

For this disease in general though not very danger yet well known to be very obstin.

And that too even when much less severe & of more recent date than in pres. inst.

Well known that by contin is as it were [rivetted] on constit.

Or at least if removed for a time yet liable as it were to be renewed on slightest accid.

Hence many with whom after once induced remains for whole future course of life.

With our patient however had already subs. for space of 14 years.

And during that time had resist various med.

By some indeed, as for ex Valer, imag. that obt. some [cure].

But this neither consid, nor perm

Did not therefore look for being able to accompl more, than mere allev of sympt.

And if this obt. is it must be acknowl. utmost derivd from med used.

When first app. for assist directed Pil. Foetid cum Aloe.

An artic of which have already oftener than once had occas to sp.

And which as comb. antispas. power of Assafo. with cathart qual of aloes, often useful, often useful where irregul action of alim canal.

Here indeed purgat prop, not partic wanted.

For disch by belly in natur state

But while pains much connected with distens of bowels from wind, had always relief on disch of flat.

Hoped therefore, that by this med disch of wind would be prom.

And that from purgat there would be tend to disch rather under form of flatus than of eructat.

Pills here directed to quant only of gr V, at bed time.

From this as cont little more than [griss] either of aloes or assaf. could not expect much effect.

But with hyster females, action of bowels very irregul.

Judged it therefore prud to begin with small dose.

And as app. from event, this caut not unnecess.

For found at succeeding report that had prod consid looseness.

Perhaps indeed, no more effect, would have resulted from larger dose.

Or at least a comm obs. of aloes, that degree of operat, by no means [prop] to quant.

And while an easy stool from 1 or 2 gr, no more from 10 or 12

But this not strictly applic to that state of bowels, where stim of aloes suff. to induce cathars.

While that the case, reason to think that effect encr. in prop. to quant.

And at least [desirabl], that should be small.

Hence then, though perhaps without suff. reason, had some satisf in think that had not empl. med to greater extent.

From cathars. induced no partic relief was obt.

And although wishd for free & easy disch of foeces yet did not see that any benef to be expected from evac from syst.

Hence then thought it imprud to persist in employm of pills.

And in place of it, subst a med, from which without any purgat power, might exp. disch of wind.

A mixt viz consist of bitter & arom tinct.

This from aromat it cont. oper. very immed as a carmin.

While at same time from bitter tends to strength alim canal & [thus] prev. regener of wind.

Conseq of this med seemd at least to be so far favour.

For in short time after began use sympt much relievd.

And partic nothing affected with pain in stom.

Here however cannot with any confid assert that this effect of her med.

For besides that such relief sometimes spon, was not only artic now empl

Though pills directed to be interm yet pat. who had not used all before given her had recourse to these of herself.

And whether had any effect in contrib to relief or not were at least not now attend with former conseq.

For no cathars result from empl. An evid proof how much action of med varied by state of bowels at the time.

While however got rid of some sympt became affected with others.

A circum perhaps more commn with hyster. than alm any other disease.

Now compl of having been subj to consid uneas. from palpit.

A sympt to which though not ment in hist of case were now [informd] had often before been subj

And which in hyster well known to be a very freq. occur.

For this however did not think it necess. to have recourse to any partic pract.

Often indeed success. obv. by antisp as Aethr. Vol. Alk. Tinct. Fulig. &e

But these little tend to prev return

And imagind, that while might soon again of itself disapp. more to be exp. from course begun.

Merely directed therefore that should persist in empl.

After trial however for some longer time, found that rather augm than otherwise.

And now also anoth app. in some degree morb. had occurd.

Want viz of menstr. disch at usual period

While this a very comm accid with hyster females, imag. might have some influ. as ind palpit.

Or at least that want of disch might supp. it.

At any rate was advis that natural flow, if could easily be effected should be ind.

And this the rather to be hoped, as had been regul at preceding period.

Imag. that might perhaps be accompl. by stim of Aloes to rectum

For little doubt that while these act more espec. on that part of alim canal, effect in some degree propag to rectum.

To obt this however a dose to some extent is requird.

Accord directed them to quant of gr X.

But that might avoid inconv from contin cathars, directed that should be taken only every second night.

Even in this way however did more than could have wishd.

Hence at succeeding report red dose to gr V every second night.

While persisted in use in this manner as informd on 19^th of Janr. though from pat having come late not ment in regist, menstr disch restord.

And with this some allev of sympt.

Since that however have seen nothing more of patient.

And little probab. that will now again return.

This dissert. may perhaps have been conseq. of remaining tolerab. easy.

But as probab. that arises from entert little expect of deriv benef from father attend.

And at any rate though on some occas allev of some sympt. yet cannot consid her as matter benef by any pract here empl.