DEP/DUA/1/47/29 (Transcript version)

Mathew Steele

(1789)

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N^o19 Mathew Steele.

This case I formerly remarkd thoug attended with some pecul was disp to consid as an ex of Dyspep.

And have since had no reason to alter opin either with regard to nature or termin of disease.

Now indeed more manif than before app that pain not from any fixd cause as schirr or like.

For has freq had consid interv entir free from it.

And no doubt that when has occur, has been conseq. of viol action & distens, induced by flatul.

Prin if not entirely conseq of weakned tone in stom.

With regard to prognos formerly expressd hope that in no long time might be able to comb. the aff.

And although in this have not altog succeeded yet little doubt that upon whole at pres much easier.

And perhaps may even add [that] would have obt. still greater benef if attend had been more regul.

For as from nature of our pract is a very freq occur. did not attend us when thought himself rest to health.

And by this means med for some time interrup.

On idea that disease chiefly depended, on relaxed & aton state of stom, began by directing for pat mixt with aromat tinct.

This consist of equal parts of Tinct. Aromat. Tinct. Amar & simple water.

And is as I have already oftener than once obs, an excell. stom.

For besides tend to restore tone & prom action has also effect of expell flatul.

And thus tend both to radic cure of disease & relief of sympt.

Here therefore had reason to hope that might have influ as reliev pain

But as this sympt. more severe than in most inst of Dyspep. though something farther necess with view of allev.

And as most effect artic with which are yet acq for this purp had recourse to Opium.

Opium from whatever cause pain may arise has tend to allay it, from rend sentit prin less suscept of painful impress.

And indeed when carried to great height provd such state of Torpor that no impress whatever has any influ.

When proves fatal [well] known to operate in way of inducing apopl. insensib.

But even in doses infer to these prod sleep gives rise to renders influ of painful impress less powerful.

Besides however gener affect in this mannr, in partic inst tends also to allev pain on other grounds.

Thus when [acts] on extrem of nerve from which pain arises renders them less sensib at least for the time.

Here then as introd into stom might expect at least some benef in this way.

But in pres inst expected still more in anoth way.

For pain here as already obs. viewd prin as being effect of [inod] action.

And well known that nothing more powerful in allaying action than opium.

On all these grounds then here exp. to obt benef from use.

But while thus hoped for advant. had in anoth respect some reason to appreh inconv from use.

For need hardly remark that has a very great tend to bind belly.

A conseq necess resulting indeed from influ as allaying action.

This however a circum well known to be extrem unfav to [illegible ].

And partic where are subj to much pain from flatul.

Nothing indeed more pernic to them than strong evac.

And although from emet & purgat sometimes immed relief, yet in end never fail to encr. the affect.

But at same time a state of [illegible ] equally to be avoided.

And here to be obs. prev to opium tend rather to bound state than other

To counteract this therefore, rarely failing in operat.

Pil ex colocynth cum Aloe to extent of ten grains.

But though this very powerful in moving belly seld operates as inducing any consid catharsis.

And here directed it not to be regul cont, but to be had recourse to only when occas required.

By this artic effect wanted was fully accompl.

For while prod free disch by the belly was at same time without Cath.

While this the case however had also very consid relief from pain.

An effect prob prin to be ascribd to the Theb. pill.

In this situat thought himself so easy that for some time negl. med altogth.

But conseq soon was an aggrav of his affect.

A circum afford at least addit presumpt that these the cause of former relief.

Could therefore have little hesit in direct repet.

And again exper former relief from pain.

Found however, that unless from freq use of purgat pills, belly still disp to be bound.

Wishd therefore to try how far would he cont easy without opiate

As thus hoped that at least less freq repet of purgat pill would be necess.

And accord under Mixt & occas use of purgat pills cont tolerab easy for space of forthnig.

But then on anoth interm of all med had fresh aggrav of his compl.

On resumpt again relievd.

But even this not suff to secure future regul.

For as well obs by report of 6^th of Febr. after being alm entirely free from compl. for some time had anoth return on discont med.

Since that has contin med without any interm.

And sympt upon whole very much relievd.

Can therefore be little doubt that has been consid benef by pract here empl.

And would prob have been more so, had he been more atten in following direct given.

Here however must be allowed that interm of med not only cause giving aggrav of affect.

For obs also that subj to some returns if feet [allowed] to be very cold.

A circum by no means wonderf. when consider infl. when consid influ. which coldness of extrem has on whole system.

And by no means rare with dyspept pat.

To this cause of aggrav therefore is to be hoped that pat will afterw also pay attent.

And trust that benef already obt may soon be rend both more consid & more perman.

At the same time dyspept apt to be aggrav by so many diff accid, that can by no means be surprizd at some returns of uneasiness.