DEP/DUA/1/43/12 (Transcript version)

Euphan Smith

(1787-1788)

---

N^o17 Euphan Smith at 36

In hist of this patient compl. charact of sever diff. diseases.

In [anoxr]. nausea & vomiting [have] ordin. sympt of Dyspep.

And the rather as these accomp. with flatul. & pain at stom.

In cough & dysp again have catarrhal sympt.

But these even least distress part of affect.

What always has & still cont. to give her most uneas. is sense of ball rising from stom to oesoph.

And there inducing sense of suffocat.

This I need hardly obs. is [evidently] the glob. hyster.

A sympt so freq occurring in that disease as to have derived name from it.

And indeed by many consid as pathognom.

In so much that allow no case to be hyster where is not pres.

And consid every case as Hyster, whatever other sympt may be, where occurs.

This however an opin which [illegible] own can by no means adopt.

Yet have no doubt in consid it as one of strongest char. of hyster.

And here as comb. with depress & fluctuat of spir evid demonst. pres of that affect.

Accord when formerly spoke of case, repres it as an ex of hyst

And indeed to Hyster am inclind in great meas to [referr] sympt already mentiond.

For while these very numer. well known also, to feign many other diseases.

And among these none more com than cough.

In so much that very few of those subj to it, who are not at times affec with what calld Hyster or nerv. cough

Seldom also that funct of stom undisturbed. Even these therefore may be entirely from this cause

Hence however though view it as prin would not consid it as sole disease.

And inclind to think that comp at least with some degree of Dysp.

But besides these anoth part which it may be thought also here deserves ment.

The absence viz of Menst disch. Patient though only in 36^th year has seen nothing of this evac for four years past.

Well known however that from want of these, many & var. sympt arise.

At least when this want not consq of what may be calld natur termin.

And age of thirty two, a period of life when this could not be natur expected.

But besides this obstr. then we are told effect of partic accid.

Influ viz of Anger.

A cause which as well as other pass of mind, well known to have great influ in prod affect of that disch

Hence then, may look upon obstr. as not natur, but accid.

Still however am not inclind to look upon it, as in any degree conn. with pres. affect.

For if any effect in this way, would have been soon after obst.

And after menses wanting for sever years without inconv. could not suppose that at end of that period, prod of any sympt.

Think it much more prob. that notwith period of life, will never see more of this flux.

And that altog. unconn. with any future affect to which may be subj.

When formerly spoke of case, was inclind to entert. favour hopes of termin.

Partic as no remedies had before been empl. & as affect but of short contin.

Hitherto however must acknowl. progr to recov. has not been great.

[But] this in part to be attrib to patient herself.

For attend has never been regul.

Accord no opp of giving fair trial to med directed for pat.

Nor of empl. those formerly sugg. provided first trials unsuccess.

Here as already obs. consid affect chiefly claiming attent to be Hyster

And this I suppose to depend on pecul tend in moving fibres to inord action, partic in alim canal.

The effect of pecul. mobilit in nerv. power.

Hence to be comb. by restor moving fibre & nerv. energy to natur state

But by accompl. this end, also reason to hope, that might in some degree comb. dyspept affect.

For little doubt that irritab & atonia of stom the prin morbid cond taking place in that disease.

Or at least, though state of secret altered, yet cannot act immed upon it

And is only by restor proper tone to secret vessels, & of course due [state] of action that can expect natural & prop secret will be obt

With view of answ. these intent to Valer. root & Peruv Bark

Both these artic so well known that unnecss to say much with resp to either.

In Peruv bark a vessel comb. bitterness with aroma, have not only a powerful antisep but also one of best tonics.

And while [as] taken into stom has this effect on syst. in gener. more esp. exerts influ on alim canal.

Indeed is prob. from influ exertd on alim canal that encr of tone over other parts of syst is obt.

But whatever mode of operat. no doubt that first & prin effect on alim canal.

In valer. again one of those artic long referrd to tribe of nerv or antisp

That is exert effect as allaying tenden to inord action, from pecul influ on nerv. power.

And that is possessd of such a prop. for my own part little doubt.

And For although in but few inst, that can expect from it, radic cure in cases of Epilep. yet have often I think witnessd effects as allaying tend to inordin action.

From comb. influ of the two then might look for good conseq. both as allaying irritab. & restor tone.

And thus useful in counteracting both Hyster & Dyspep affect.

This combin have often before empl in simil cases.

Or at least in cases where have susp. simil morbid condit.

And have I think seen best conseq. result from use.

But these effects not to be immed expected.

For remov. of irritab. & still more restor of tone in some degree work of time.

Seemd therefore advis to do something with view of giving more immed relif

And partic. as giving disch of flat. For very prob that by this not only distens of stom induced, but also, that inord action giving glob & occas dysp.

Was with this intent that had recourse to assafoet.

An artic than which nothing perhaps more powerful in giving free disch of flatus.

Partic when retaind by inord. action. Here however did not seem necess to do any thing with view of mov. belly.

For disch in this way suff. free & regul.

Hence indeed under form of Pil Foetid [simp].

That is equal parts of Assaf. & [Soap]. From these med at first seemed to derive consid benef.

Pills as might have been exp. no operat in mov. belly.

But neither from these nor the powd. any uneas. at stom.

And after short contin became much less affect with sense of ball rising to throat.

While othr sympt very consid relivd. Relief however thus obt not perman. For as you will observe from report of Janr 5^th became again much affected with sense of ball in throat.

This however was inclind in some degree to consid as effect of irregl attend.

And of course may inferr of irreg use of med.

For quant with which supp. no no more than calcul to last till succeeding report.

This aggrav therefore consid as no reason for altering plan.

And the rather induced to contin as in other respects thought sympt easier.

After this however not more regul than before.

For from 5^th of Janr saw [nothin] of her again till 19^th.

Then learnt, that had for some time entirely omitted powders.

As susp. that had effect of bindg belly.

Found however that most of sympt partic affect of stom cont. easier.

Was therefore desirous of persuad her to give fair trial to course begun.

And although still at times affectd, both with sense of ball in throat & depr of spirits yet trusted, that by due persev these would be removed.

Hence recommended her [persist] in plan begun.

But since that have seen nothing more of her at this place.

And after absent herself for space of a month not now prob. that will again return.

Unnecess. therefore to say any thing of pract which might have been emp. had this faild.

And although cannot say that here any great progr to recov. yet as far as med any effect was evid benef.

And prob. I think that would have been more so, if fair trial given them in way of regul contin