DEP/DUA/1/46/40 (Transcript version)

John Keith

(1789)

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N^o13. John Keith at 38.

Had no hesit in formerly giving it as my opin that disease to which this patient subj an ex of Dyspep.

And although often an obstin compl. yet expressed hopes of fav termin.

In this partic prognos now [illegible]

For patient some weeks ago dismissd from attend free from affect.

And this I own am disp not a little to attrib to pract here empl.

Although sympt [consist] dyspep. may arise from diff morb. affect. yet was here inclind to attrib them to dimin tone of musc fibres of stom.

From this were to expl. distens from flatul. & pains evid result. from that cause.

And prob. also the vomit with which was often affected.

For well known that with [dimin] tone a pecul irritab often conn.

Here then first & prin obj was to restore due state of vigour to stom.

Seemd however also to be of import to produce immed action for expuls of flatul.

For from disch in any way had at least tempor allev of compl.

And While from remov of distens, removed a circum tending to dimin tone

And thus both to support & aggrav the disease.

Was then on these grounds that had here recourse to mixt of bitter & aromat. tinct.

First of these has for basis some of strongest & purest of veget. bitters partic Gentian.

Is especially suited to act as restor. tone to the stom.

And indeed so much empl. against affect of this viscus, that for long time known under title of stom elix.

Term indeed now changed.

But not from idea, that virtues formerly attrib to it were groundless.

Is I believe by pract in general held in same esteem in stom action as before.

But artic in gener. much better [denom] either from constit parts or sensib qual.

And this accord done in pres inst.

Same also case, with other artic here empl, the Aromat Tinct.

This again has for basis two of most powerful & grateful of veget arom Cinnam & Cardam.

This qualit depend on an essent oil they readily yeild to a spir. [mens].

In conseq of this act of as powerful stimul to stom & intest canal, in way of carmin.

That is both encr action for expuls of flatus, & remov spasm strict by which retaind.

Here therfore while expected that would somewhat aid tonic power of bitter tinct, imag also that might relieve sever other urg. sympt to which was subj.

Partic viol pains in course of alim canal.

For little doubt that these, as well as swelling, were affects of flat.

But besides these, was occas also subj to two other sympt.

Vomiting viz & looseness.

These consid as being chiefly affects of pecul irrit.

And therefore perhaps ultim to be removed by restorat of tone.

But affect in this way only work of some time.

And here thought it necess to employ some means of more imm allaying irrit at least for time.

As otherwise reason to fear that disapp. of affects of med from immed reject.

On this acct added to the mixt a proport of Tinct. Theb.

From ℥i in ℥VI mixt. would take five or six drops in each dose.

By this hoped that med both more readily retained on stom, & tend to vomiting & looseness somewhat dimn.

Whether had these affects or not would not posit pret to say.

But may at least venture to say that had no bad affect.

For from time that med begun sympt very evid dimin.

Was not indeed immed freed from all returns of pains.

But was soon sensib of being less distressd with swelling from flatul.

Continued also free from any return of vomiting.

While at same time disch by belly nearly in natur state.

Circum at least encr. presump. that add of opiate here servic.

In this situat were naturally encour to contin of med.

And under use had almost unif progress to recov.

A circum perhaps rather surp. when consid how easily stomach ailm are aggrav by any accid occur.

For not only, partic liab to be affected by every irregul with respect to diet, but by many other alm unavoid occurr.

From these can hardly imagine that our pat was altog exempt.

But would app. that stomach had soon so far recov tone, as to be able to resist them.

A circum from which may with some degree of probab. inferr, that recov not a little owing, to operat of syst itself.

At same time from almost immed relief which med afforded as well as from obv change induced, can I apprehend be little doubt, that affords ex of benef to be derived from bitters & aromat, or what commonly calld stomach med in such ailments