DEP/DUA/1/19/23 (Normalised version)

Barbara Stodart

(1778-1779)

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Barbara Stodart.

Case of this patient manifestly of complicated nature

But in affections to which she is subjected have no uncommon occurrences.

And even combination which here takes place by no means rare.

Can have little doubt that pain with which affected of Rheumatic kind.

Situation indeed somewhat peculiar.

For at least principally in sides

Seated either in intercostal muscles or in [tendin] parts by which attached.

But by no means confined to that situation.

Extended also to inferior extremities.

And not only in thighs but also in larger joints particularly knees.

In this then evidence of affection in most common situation.

But while affection intercostal, seems also to have seat in abdominal muscles.

At least there also considerable pain.

But in some measure doubtful whether this be not consequence of another affection.

Cough viz to which subjected.

At least told that by cough aggravated.

And not infrequent that pains in abdominal [integumentary] induced by mere agitation from cough.

At same time more probable that in present case merely aggravated.

But whatever may be case with respect to this circumstance, no doubt that to Rheumatic affection cough super [added]

And when consider continuation for four months with state of expectoration must naturally conclude that has already acquired condition of [illegible] [effect]

In these two diseases then Rheumatic affection, conjoined with chronic catarrh have complications to which patient subjected.

And while neither uncommon this even a very frequent conjunction

Nor indeed surprising, when consider that both readily originate from [same] cause

Of all circumstances most frequently from cold.

And from such may here present [originate]

Patient indeed ignorant of any cause

But act of cold a cause to which much exposed.

And may often have effect when [changes] [observed].

With this idea of affection progress not favourable.

No reason indeed for great alarm.

Yet of neither affection to expect [sup.] [cure]

And remedies accommodated for both by no means the same.

Patient also rather advanced in life as otherwise

And has appearance of being older in constitution than in years.

If therefore can palliate affection is utmost that expect.

Of this however prospect at least [augmented] from season of year.

And by warmth alone even without medicine considerable remission may be obtained.

While under our care however measures at least to be tried with view of [forwarding] recovery.

And here consider Rheumatism from being most urgent as chiefly claiming attention.

Was with view to this that directed as topical application to pained parts the Unguent Vitriol.

A remedy action of which depends on Vitriol Acid

Having powers however restrained by unctuous matter

This application in many instances of Rheumatic affections have used with success.

And hoped that might here have good affects.

But here did not wish to trust to it alone

And began by conjoining it with calomel a medicine of affects of which in Rheumatism have already oftener than once has occasion to speak.

With present patient however several circumstances occurred as objections to giving very long trial.

And as had not speedy affects [substituted] to it the Volatile Elixir of Guaiacum.

Of this article also power in Rheumatic cases oftener than once subject of observations

And for own part look upon it as being in many cases efficacious remedy.

Whether proved such in present case cannot positively pretend to say.

But to patient, taste & sense of hearing which excited not agreeable.

And very soon tired of employment.

Under this course however according to [illegible] at least pains much easier.

And much less affected also by cough to which formerly subjected

In this situation then thought it unnecessary to continue practice to which patient herself averse.

As at least considerable chance that would not be carefully executed.

Have now therefore put her on use of purgative pills Pill ex Colcoynth merely with intention of obviating costiveness.

And if find her continuing to enjoy same ease as at last report shall take opportunity of dismissing her.

At same time am far from expecting that will not be again subjected to returns of complaint.

In this case however know no measures more advisable than those already tried, to which cannot I imagine expect [compliance] of patient.

Shall therefore be better placed to have it in power to dismiss her even with alleviation of affection.

With these [observations] conclude remarks on present case

And this day [illegible] propose to [illegible] this part of present winter course.