DEP/DUA/1/12/06 (Normalised version)

Grizel Craig

(1776-1777)

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Grizel Craig.

A patient last summer under care in Royal Infirmary¹.

Complaints then in some respects different from what are at present.

At that time affected with no inconsiderable dropsical complaint.

Then however also subjected to complaint for which at present came under care viz Amenorrhea.

For little hesitation in considering this to be principle part of patients disease.

Was however as have just observed an attendant of former affection.

And at that time disposed to consider too as not unconnected

Then I own inclined to believe that the obstruction of menses cause of dropsical affection.

And that from this circumstance dropsy would probably be more obstinate.

How far affections really connected may yet perhaps matter of doubt.

But dropsy in no long time entirely removed

And as I apprehend in good measure from affect of elaterium a medicine of which had lately occasion to speak.

After dropsy removed did nothing for restoration of menses but by endeavouring to strengthen system.

And as measure used in house with this view ineffectual thought it improper to keep her longer in the hospital.

Was dismissed therefore in hopes that flux might be restored by still farther recovery in [countenance]

And by more regular exercise & freer air than to be had in an hospital.

Now appears however that these also insufficient for purpose.

And besides this had for some months [introduced] many different medicines.

Which although such as might readily have been supposed most serviceable yet ineffectual.

In this situation again came under care.

To be observed however that at this time as formerly Amenorrhea not only complaint.

Had for some weeks been affected with troublesome cough accompanied with difficult & scanty expectoration.

This ascribed probably with justice to accidental cold

And may be considered as totally unconnected with Amenorrhea

menstrual evacuation now wanting about 20 months

And had little hesitation in referring to this impaired appetite listlessness oppression at praecordia & headache of which patient complains.

Was I own disposed from first view of this case to form different ideas of what would be termination.

In catarrhal affection unless from continuation saw nothing of threatening appearance.

Hoped therefore that might soon be removed or even of itself cease.

Amenorrhea however conjected would be more obstinate.

And as had already resisted several of most powerful remedies had I own but little hopes of cure.

This therefore considered to be great objective of attention in practice.

Now concluded that renewal of discharge not to be looked for from restoration of general health.

For patient now no symptoms of dropsical tendencies or marks of inanity.

On contrary affected with symptoms of fullness at menstrual period.

And from these had often obtained relief by bleeding.

Concluded therefore that due accumulation in uterus not wanting.

Suspected indeed that might proceed from obstruction in passages through which ought to pass.

But if of this kind could not depend on slight or transitory cause example Spasmodic affection.

And if from fixed local cause could not look for removal.

Concluded therefore that chief hopes of recovery from restoration of that action of uterus which suppose necessary to menstrual evacuation.

And with this view resolved to make present case subject of trial of electricity.

A remedy in many of most obstinate cases lately found successful.

And operation of which is I apprehend totally to be referred to action on living fibre.

Well known how much does in restoring sensibility & power of motion to other parts.

May therefore restore menstrual flux in two ways

Either by immediately acting on moving fibres as inducing that contraction which suppose necessary.

Or by restoration capable of action at regular period.

In former case cure instant affect of operation

In latter will not occur till some time.

Sometimes even after electricity intermitted.

On these general principles then resolved to give it full trial in present case

And while persisted in use gradually to increase both number & strength of shocks.

Flow of menses did not here appear on first exhibition of electricity

Although in hopes of exciting immediate action had directed that shocks should pass through region of uterus.

In this however was not I own much disappointed

For after so long obstructed though might have taken place yet was hardly to be expected.

Resolved therefore still to persist in use.

But in this unexpectedly interrupted from an accident to our machine.

And after patient [three] electrifications had it not in our power to exhibit it farther.

Directed however continuation of electricity in hopes of having machine soon mended.

And that might not in mean time seem inactive ordered have an ounce of Elixir Sacred or as now called Elixir ex Al & Rheo.

This medicine continued without the electricity for four nights

At end of that time menses appeared.

As she imagined from medicine then taken.

But when consider that not to be viewed as of very active powers & that never even operated as producing purging little reason for supposing that was capable of removing an instance so obstinate.

And must own that should rather be inclined to ascribe it to preceding electricity.

For where no other medicine used cases affected by electricity on some occasions have not taken place till few days after intermitting.

Consider therefore electricity in this instance as having restored disposition to action of uterus.

Flow happening at period when this action as regulated by laws of Nervous system naturally occurred.

Would not however pretend to allege that elixir had no influence.

From action on intestines particularly rectum may have had some share as inducing & supporting discharge

Although can by no means imagine it capable of removing obstruction which has subsisted for so long a period & had before resisted influence of most active medicines.

Especially when consider small extent to which was here given.

Even admitting this reasoning however affords no certain proof of its being affect of electricity.

By no means impossible that restoration may have depended on circumstances totally different.

With which patient herself either unacquainted

Or at least of which did not choose to inform us.

Cannot therefore pretend to speak in very positive manner

Yet from all circumstances taken together must imagine that restoration of menstrual discharge was affect of Electricity.

Considering having proceeded from this source next occurs as question of some importance how far can look upon it as radical cure.

Whether viz necessary to do nothing farther for securing regularity of menses.

Or whether can be considered as obtained only for single period.

Must own that with respect to this particular extremely doubtful.

Rather however disposed to hope favourably as otherwise

Was intention therefore, without doing anything farther with view to menses to wait till usual term of discharge.

And if then appears will consider nothing farther as necessary.

If do not shall again have recourse to Electricity.

And prosecute plan which at first intended.

If induces discharge a second time shall be contented with directing repetition for a day or two previous to period when menses expected.

And hope that such a measure may prove affective in securing regularity.

If electricity entirely fails may yet expect that discharge may at times occur

Yet must own will have little hope that shall ever become regular

At same time other emmenagogues which may yet be tried.

And with this view shall probably put patient on use of the Rubia.

Failing that may have recourse to trial of Tincture of Black Hellebore.

Pushing to as great extent as think can be done with safety or prudence.

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Explanatory notes:

1) The Royal Infirmary of Edinburgh, established in 1729.