DEP/DUA/1/12/03 (Normalised version)

Mary Dods

(1776-1777)

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Next patient in order of admission.

Mary Dods

In this case symptoms few & affection evidently simple.

Yet nature not altogether without difficulty.

Disease even at present is principally if not entirely situated in left mamma

And here affection equally evident both to sight & touch.

Manifestly indurated tumour can be distinctly felt.

And although surface sometimes ulcerous sometimes not yet skin never [recovered] natural appearance.

Here have not indeed every symptom usually attending cancer.

Yet strong probability that affection rather of this kind than that now to be reckoned scirrhous.

Of Cancerous Nature some probability from disposition to ulcerated condition.

Corroborated by shooting pains with which patient frequently affected.

Still more by tumour under axilla

For this last circumstance may be considered as demonstrative of absorption from breast.

And that too of a matter which in other glands would produce similar affection.

With this sentiment cannot easily in present case pronounce favourable prognosis.

For may unquestionably reckon cancer among most dangerous affections.

Is particularly one of those complaints with which no grounds to hope for natural termination in recovery.

And if cure to be affected must be in great measure if not entirety work of art.

Yet perhaps even with best assistance is recovery in no case to be depended on.

Nor on other hand can any be considered as so desperate as to preclude all trials.

And is merely with such a view that have taken present patient under care.

In such cases as present cure to be expected only on one of two principles.

Either by removing diseased parts

Or by restoring to sound state.

Where complete removal can be affected have no doubts in considering it as preferable method

Am for my own part convinced that affords not only most expedient but also most certain cure.

And am persuaded that many have fallen victims to cancer from its having been neglected.

Some indeed & those too of no inconsiderable note enemies to operation in every case of cancer.

And were we acquainted with any medicine effectively restoring sound state to parts would have no hesitation in agreeing with them.

Observed & indeed with justice that many on whom operation performed with success afterwards die of cancer.

And that too in very great agony.

But to ascribe either return of cancer or pain to operation a very erroneous mode of reasoning.

The allowing cancer to remain at one place no defence against affecting another.

On contrary from this circumstance greater probability of happening.

Hence no evil with justice to be ascribed to removal.

And when find a patient affected with cancer from whom one formerly extirpated only argues that by local operation virus cannot be eradicated from the system.

Which probably even very general affect of operation being delayed.

And if some cases where patient has had recurrence of cancer others where this has not happened.

In some cases then may be considered as means of complete cure.

In others, & these even worst, where situation such as to admit of operation may at least be means of removing urgent symptoms & protracting life of patient sometimes for many years.

From all these considerations then must own that am an advocate for operating in this complaint.

And after the cases lately published in support of this practice by late Mr Hill of Dumfries, very few I apprehend who have seriously considered them will doubt propriety of it

And as he observes of himself were it my fate to be affected with cancer would not delay operation single hour in hopes of cure by other means.

On these principles then had no hesitation in recommending it to this patient, to think of operation & to consult surgeons with respect to it

Found her however totally averse to all thoughts of it.

And must here observe that is an operation attended with such danger that should reckon it improper to go any farther than to give opinion.

As therefore present patient, while resolved against this, desirous of employing any other mode of cure resolved at least to give trial to such.

And at least to attempt what could be done with view of restoring diseased part to sound state.

This I apprehend to be affected by restoring free circulation through the part, and natural action of vessels.

For on obstruction & vitiated action suppose the [genera] of what has been called cancer virus as well as all other symptoms to depend

Consider this as no unfavourable opportunity for trying how far these ends could be obtained by means of electricity.

A practice which had before occasion to mention lately suggested by Dr Eason, a surgeon in the army.

And which he led to propose from an accidental recovery happening to a lady in Ireland, labouring under such a complaint in consequence of a stroke from lightning.

This history as related by him will find in a late number of the Medical Commentaries.

Was with present patient therefore intention to persist in use of this remedy for considerable time

And to carry it to as great height as patient could easily bear it.

At first although even to slight degree seemed to promise some advantage.

And she herself inclined to imagine that both mitigated pain & diminished tumour.

With view therefore of augmenting these advantages ordered both number & severity of shocks to be increased.

Now however am I own somewhat doubtful how far this direction proper.

For after this change pains returned with increased severity & tumour again converted into ulcerated state.

Do not think it clear that these alter the affect of electricity.

Yet where grounds for suspecting this dare not order continuation.

Especially as patient herself became averse to it.

On this account therefore have at least for present discontinued trial.

And put her on course of cicuta.

From which cannot help thinking that in some cases have seen very good affects.

If therefore any apparent advantage shall wish to persist in use.

And after proper trial farther treatment to be regulated by circumstances.

Must however conclude as have always said that neither from this nor any other medicine have high expectations.