DEP/DUA/1/47/20 (Transcript version)

Peggy Hog

(1789)

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N^o32. Peggy Hog. at 17.

Respect disease of this patient my opin not altog. decided.

Can however be no doubt, that to be consid as ex either of Hysteria or Epil.

In many cases these two diseases in app. very diff from each other.

For hyster at least appears under variety of forms.

And although less change in app. in hyster. Epilep. yet there also in some cases at least more distinctly markd than in others.

Such for ex. as when fits last for an hour or upw. when attended with total abolit of sense & foam at mouth & when followed by long contin sopor.

In pres case however these marks wanting.

And if really an epilep. is at least so modif as nearly to appr. to Hyster.

Of two affect however must own that most inclind to suppos of latter.

Cannot indeed by said that have all sympt commonly to be met with in Hyster.

Yet no sympt in case of pres pat which is not at least a common occur in that disease.

And in app. nothing at least against the suppos.

Must however be allowd that same may also be said with respect to resemb of fits to Epilep.

And for my own part have always been inclind to think, that in such cases the chief charact mark, is total abolit of sense occur in Epilep.

While again even in long contin hyster fits, patients yet know & recollect every thing done about them during course of affect.

Here then may be thought that app. state of insensib said to occur during fits an argum rather in fav of epilep, than of Hyster.

This however prob. more what may be consid as an hyster faint than any thing else.

And indeed with fits of so short durat as these of pres pat. can hardly have evid of compl. abolit of sense.

And even circum of shortness of fits an argum in support of supp of Hyster.

For although these sometimes very long contin, yet admit of greater variety in app. than Epilep.

And but very rarely that Epil. fits of so short durat as there occurs in pres. case.

But have I think a circum still stronger in fav of hyster, in sense of ball, rising from stom to throat.

This accord to acct given us though not a const. is yet freq anteced of fits.

And from influence in imped deglut & respir, can have no doubt that depends on spas effect of oesoph.

In [fine] that is a distinctly markd example of Glob. Hyster.

This sympt some have consid as even pathogm of the disease.

That is consider every case as hyster where pres. & will not allow any to be Hyster where abs.

This opin however must own am for my own part by no means disp to adopt.

Have seen very distinct markd inst of Hyster where the Glob abs.

And have met with cases which could not be calld hyster where pres.

Partic inst of Dyspep & Flatul. where reason to beleive that merely a sympt of these diseases.

Still however not to be denied that is a freq mark of Hyster.

And in such cases as pres gives strong pres of it.

Might perhaps be imag that same presumpt of Hyster might here by drawn from age & sex of patient.

Well known to be a much more freq affect with females than with males

And here occurs at that period when comm of Hyster most comm.

Must then at least be admitted that in these partic nothing against suppos.

But on other hand epilep also very common with females.

And perhaps even more freq at period of life at which pres patien has arrived than any other.

From these therefore can hardly consider suppos as corrob.

But from circum already enum consid suppos of Hyster as at least the most prob.

Besides fits patient here affected also with some other sympt.

Hoarseness viz attended with Dysp.

And this we are told comm with some degree of diffic deglut.

In all these the ordin marks of [illegible] result from cold.

An affect by no means uncom often very obst.

And although preceded other affect & has hitherto contin during [course] yet presumpt that altog uncon.

While this latter affect seldom danger, in many inst even but little troublesome.

And as freq. yields impercept of itself, as by aid of any med.

Is therefore with view to [fomer] affect that have selected this pat as subj of pract & lect.

And with regard to termin of case must acknowl. myself no less doubtful than with regard to name.

For whether consid it as Hyster or Epilep. both one & other very obt affect.

And shall not be surp. if baffles efforts to cure.

Is however at least, not a little in fav of recov, that disease but of very recent date.

And hope that may derive some benef from Pil e Cupro.

But reserve observat.