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Mr: Thomas French aged 47. Complains of a dullness & heaviness,
Sickness at the stomach, accompanied with very great distension,
Belching of Wind & total want of appetite. Frequently a Vomi¬
ting of Insipid phlegm or Bile, but sometimes without this Symp¬
tom. The patient is generally seized early in the morning after
his first sleep, from which time till he gets up, he is Oppressed with
frequent short disturbed sleeps, with a little sweating & sleight shi¬
vering upon the acession of cold air. These Complaints general¬
ly continue for two or at most three days, when the Patient gets
well & enjoys a pretty good state of health & spirits for eight
or ten days, sometimes a longer, sometimes a shorter Interval
tho of late they recur more frequently than formerly. This Course
hath been observed ever since May last tho the Patient hath
always had what is called a Weak Stomach.

No Hardness nor swelling of either the Hypochondriæ can be felt,
/ except a general distension of the whole abdomen, evidently from
air during the paroxysm / Belly regular, rather inclining to
be lax than otherwise. Stools of a natural appearance -
urine in proper quantity, at the beginning pale Coloured
towards the End is higher Coloured, & deposits a lateritious
Sediment. No Swelling of the Legs. Pulse variable,
while the disorder continues is generally feeble & from 80 to 90 -
Eyes dull & heavy - face higher coloured than ordinary –
He hath at times complained of cramp pains in the Achilles Ten¬
don & muscles of the Feet, & he hath also sometimes felt a
High pain in the Ball of his great Toe, but these Symptoms
are by no means constant Attendants. –––

Queritus 1st. Are we to consider this disease as a true Dyspepsia
Idiopathica of which it hath the greatest part of the Pathogno¬
monic Symptoms? or

2d. Are we to consider it as Symptomatic of an Obstruction in
any of the Glandular Abdominal Viscera? or

3d. Are we to consider it as any way connected with the Atonic Gout.
This last Supposition, tho' at least probable, yet the pains about
the feet have always been very slight & so often absent en¬
tirely, that joined to other Considerations it never hath been more
attended to, than just to make me on the Look out, in case it
should Appear that Nature was attempting a Critical deposition
on the Extremities.

As to Obstructions in any of the Glandular Viscera, The absence
of pain & hardness, joined to a regular Belly, with stools of a
Yellow Colour, & Legs in good order have always made me
reject that Supposition –– My Patient had some how or other
got it into his head that his Liver was unsound.

I have therefore always considered & treated it as a Dyspepsia
brought on by an easy full Living, with little Exercise, & probably
encreased by his Smoaking Tobacco. –

In the Cure Vomits were Employed at the beginning with some
advantage, but on this Patient Vomiting is particularly severe
they therefore have not been much used of late.

Purgatives had also been used at first, but as his Belly is al¬
ways so regular they did not seem to be much indicated, &
their repetition might weaken still more the tone of the
stomach, they have been therefore laid aside.

Of the Class of Tonics several have been tried, or to speak
more properly have been attempted to be tried, for from a
particular Idiosyncrasy this Patients stomach rejects almost
every thing that hath the name & appearance of a Medicine.
Bark in Substance & Cold Infusion, is immediately thrown
up, in Tincture however is retained.

He hath been tried with pills of Asafœtida & Extract of Gentian
but are hardly swallowed when they are thrown back again
& various preparations have been met with the same fate.
Infusions of Aromatics & Bitters in Spirits, both seperately
& Conjoined are used, & indeed the only Medicines I have ever
got his stomach to retain. Neither the Columba nor
Fava Sancti Ignatii have yet been tried.

I got him a few bottles of Harrogate Water, but its disa¬
greeable taste prevents him from taking any quantity
perhaps Pyrmont Water might answer better.

As to regimen he is to exchange his tea for a trial of Cocoa.
He eats few Vegetables especially such as contain much fixed
air. His Drink is Porter, Spirits & Water, or a Glass of Wine
ocassionally ––––––– & he rides out every good Day