DEP/DUA/1/11/21 (Normalised version)

Sarah Mills

(1776-1777)

---

Another patient lately dismissed from attendance Sarah Mills.

Of her disease already spoken & after what already said very little now to be observed.

For during whole course no reason to alter either opinion or practice.

Formerly no difficulty in pronouncing that disease of Rheumatic kind.

And if no symptom has since occurred to confirm opinion as few to create any doubt.

Symptoms with which has been affected during continuation under care could indicate no other complaint.

And indeed except slight ulceration of legs has merely had continuation of symptoms mentioned in case.

These merely superficial, and indeed hardly an object meriting any attention.

Pains not entirely without temporary increase of severity.

Yet upon whole more regular progression to recovery than here expected.

Prediction therefore that in no long time would enjoy tolerable health has at least been fulfilled

How far assertion, that might again be subjected to renewal of complaint well founded yet remains to be determined.

Shall not be displeased to learn that in this respect fears be found groundless.

If contrary happens not improbable that may again apply for assistance.

After former observations on plan of cure nothing now to be added.

Viewed case as one in which, with atonic state, still some remains of inflamed diathesis

Neither consider it therefore as on one hand proper for Peruvian Bark & Cold bathing.

Nor on other for bleeding & sweating.

Was on this account that thought of a medicine at once stimulant & evacuant.

And with this intention had recourse to elixir of Guaiacum.

Then observed that since publication of Dr Dawsons have on several occasions employed this remedy

And I think with good effects.

In no instance however have I seen it product of so good effects as in present.

At time medicine begun pain to such degree particularly on one side that unable either to stand or walk.

And from increase which pain suffered on going to bed often deprived of rest.

In this case situation such that for some time after case introduced into register¹ could not attend us.

Began her with elixir of Guaiacum to extent of table spoonful for dose.

Which in common may reckon more than half an ounce.

To this extent continued medicine for some weeks

And that might be more certain of affects had recourse to no other.

By that time entirely free from excruciating pains at bed time

And in other respects so far recovered that could walk without much inconvenience.

In this situation reckoned it unnecessary to continue medicine to same extent as before.

And therefore directed it in form of mixture with mucilage & syrup in which for each dose took only half quantity of Guaiacum which had done formerly.

From this diminishment reason to suspect that some inconvenience arose.

For at next report told that pain of back during night somewhat aggravated.

Still however continues to retain power of walking

And as probable that aggravation of pain may have been affect of accidental cold as of any other circumstance.

Persisted therefore in use of former prescription

And during use of it became so easy that reckoned it unnecessary for her to continue attendance here.

Was accordingly dismissed after exhibiting to us, in my opinion, no weak proof of affects of Guaiacum in this formula against Rheumatism at least in a particular state.

In this case as had formerly occasion to observe employed formula of Dr Dawson.

But should another similar case present mean somewhat to vary prescription.

And to use in place of Volatile the simple elixir.

As best means of determining how far powers are to be ascribed to Guaiacum itself.

For must observe that consider large doses of present formula as liable to some objections

From heat of menstruum cannot venture to employ them undiluted.

And from any addition a [prescription] of the Guaiacum is necessary consequence.

Is therefore at any rate inelegant in point of appearance.

And if mixture allowed to remain any time adheres so much to sides of phial that proportion of Guaiacum intended, not taken.

With simple elixir menstruum, which rectifies spirit, would not require dilution.

---

Explanatory notes:

1) References are made throughout the case notes to a dispensary patient register. However, no evidence has been found that this register survives.