DEP/DUA/1/22/06 (Normalised version)

Isabel Moore

(1779-1780)

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Isabel Moore

Case in many respects similar to that of William Erskine.

After what said therefore of former little to be added of present.

Disease consists also in severe pain affecting different parts of body.

And can entertain no other supposition but that either of Rheumatic or Gouty kind

Here however little doubt that of former kind.

That Rheumatism may be inferred from age of patient 24.

From sex – a female.

From situation in life by which excluded from all luxury.

From places attacked, larger joints

From obvious cause by which induced action viz of cold & fatigue.

And lastly from existing with severity in many different joints at same time.

In short whatever grounds for doubt in some cases here no room for ambiguity.

And while pronounce case Rheumatism must also consider it as example of affection in simple & uncommon state

In last lecture pointed out at some length different stages of Rheumatism

And shall soon again have occasion to make some observations on them in practical course.

Here then many only observe that consider this patient as well as Erskine as in stage of irritability.

That inflammatory stage past was led to infer from state of pulse & want of other febrile symptoms.

That had not reached atonic concluded from pains being aggravated on warmth of bed.

From this state of complaint then as well as from general nature of disease had expectation of favourable termination.

And some grounds at least for presuming that has already taken place

If this really the case may with propriety attribute a good deal to articles employed.

Here as in former case had recourse also to Siberian remedy the Rhododendron Chrysanthemum

To observations so lately offered on it nothing now to be added.

As evidencing however how far [virtues] [extracted] both by Spirit & watery menstruum leave here for examination a preparation of each kind.

These formed of ℥ii of leaves & stalk to pound i. of menstruum.

And to both menstruums evidently yields very strong impregnation.

Here however for same reason as in former case had recourse to it in substance.

And although employed in equal dose to what given in case of Erskine yet had not same affect on stomach.

Was neither affected with sickness nor vomiting nor did it produce any change on state of discharge by belly.

But as mentioned in Siberian account had here very soon affect of exciting peculiar [sensation] in parts most pained.

And when consider how soon followed exhibition of medicine presumption that to be accounted for from influence as affecting stomach.

From all trials, [well] ascertained to be a plant of narcotic kind.

Thus then action of stomach will affect whole nervous system.

And by this means can readily conceive how peculiar sensation should come to be referred to extremities of nerves in diseased condition.

With this obvious operation in whatever way to be explained patient sensible also of another affect from medicine.

Succeeded to profuse sweating particularly in joints most pained.

And under these operations pains very greatly diminished.

That this change for better to be ascribed to medicine employed if not certainly at least highly probable.

In this situation then could have no hesitation in directing continuation

And from success in former case was in hopes that here also might be means of complete cure.

Since repetition however have seen nothing more of patient in this place.

And as have had no opportunity of seeing her at own habitation cannot with certainty say what has been termination.

At same time from state in which was when last visited us reckon it more probable that [desertion] has proceeded from having no farther occasion for assistance than from any other cause.

Consider this therefore as affording fresh example of efficacy of Rhododendron in Rheumatism in state of irritability.

And whatever may be case at other stages am inclined to consider it as well suited to this.