DEP/DUA/1/33/32 (Normalised version)

Nelly Spalding

(1783-1784)

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Nelly Spalding. January 24

Disease of this patient when came under our care consisted entirely in affection of left mamma.

And there appeared under form of indurated & irregular swelling.

From progress of this affection from continuation & various other symptoms could only be one doubt with respect to it.

Whether viz were to view it as scirrhous [&] cancerous affection.

These indeed I must own, for my own part hold to be but different stages of the same disease

Look upon occult cancer as being as it were medium between open cancer on one hand & scirrhous on other

And am inclined to think that as much connected with latter as former.

Still however even supposing them progressive stages of same affection yet in these Prognoses at least much varied.

And in proportion to advances danger very much increased.

In case before us disease cannot yet be considered as having all characteristics of occult cancer.

And in particular no appearance of any virus absorbed affecting neighbouring glands as inducing swellings under axilla or the like.

This indeed, I must own, I hold to be strongest symptom, of affection having degenerated from scirrhous to cancerous state.

But by no means only mark

And in case before us two particulars occurring which are also strong indications.

The one is the state of integumentary above the part.

Skin of mamma we are told [rugose] appearance & pursed up like [scorched] leather

This state of integumentary in general [precedes] those [chaps] & fissures which considered as first state of open cancer.

And indeed argue occult cancer being even far advanced

Accordingly this state of skin, was held by late eminent Dr Hunter one of first anatomists of age as certain [mark] between scirrhous & cancer.

Another particular also distinguishing two is [ cancin]. pains.

These seldom if ever attendants of mere scirrhous but one of most distressing symptoms in Cancer.

With present patient however when came under our care were becoming very frequent.

From these therefore as well as from state of skin could have no doubt in considering affection as example of cancer.

And from this view of disease will readily conclude that must be very apprehensive of conclusion.

Though some recover from cancer yet in by much greatest number of cases fatal termination.

And that too even where appearance has been for some time flattering.

Hence therefore, must not rashly conclude from alleviation which has taken place, that affection will go on with [uninterrupted] progress to recovery.

Would not be at all surprised if should again take turn for worse, & even in end prove fatal.

At same time, advantage already obtained, gives at least hopes of favourable conclusion.

And these advantages, I must own, cannot help being disposed in great measure at least, to refer to practices here employed.

First practices here employed were you will observe external friction with Camphorated oil & the internal use of Cicuta

That first of these inadequate to removal of Cancer is indeed true.

But at same time, can be no doubt, that both from penetrating nature of Camphor, & from influence which [impression] made on superficial vessels of part, have on those deeper seated, has very considerable effects as tending to remove obstruction & renew circulation though indurated tumour.

Here therefore expected at least that might in some degree cooperate with remedy taken internally.

And on that I own, expectations of success were chiefly founded.

Cicuta the internal remedy here used, was given united with Pulveris Cretacea merely for proper form.

And was from Cicuta alone that good effects were expected.

This narcotic vegetable need not observe first introduced against Cancer by Dr Stork of Vienna.

And since much employed by others, very different ideas formed with respect to it.

Some consider it even as altogether [inefficacious].

And that not adequate to cure of every case of Cancer no one will deny.

For my own part however am very much persuaded that have often seen good effects from it.

And where no other consequence has at least very general influence in obviating those urgent pains with which Cancer attended.

This effect seems to have had to remarkable degree in present instance

For from time that began use pains much alleviated.

And by continuation have now we may say almost entirely left her.

For during course of Cicuta tumour has not only become more moveable but also according to her own account both diminished in size & softer to the feel.

During use of Cicuta, belly became bound.

A circumstance which on several accounts was necessary to obviate

And with this intention had recourse to Aloetic Pill.

An article, where merely wish to obviate costiveness, very generally attended with best effects.

But here could not be supposed to have influence in any other way.

To Cicuta therefore may I apprehend with justice attribute greatest part of relief that patient has obtained.

Of late indeed in place of Camphor oil have employed another very active mode of cure.

The drawing viz Electrical sparks from the tumour.

This practice with pain of which patient complained was I own at first afraid to employ.

Because from increased action of vessels some chance that may have converted occult into open cancer.

But hold it to be one of most powerful means of [renewing] circulation.

And hence of [discuss] or resolving indolent tumours

After therefore disease had taken favourable turn & pain almost gone imagined that might be had recourse to both with safety & advantage

Since employment has at least been attended with no bad effects

On contrary progress in diminishment of tumour rather more considerable.

And from continuation some grounds to hope even for complete resolution.

Is with intention of trying how far will have this effect by itself that have given up use of Cicuta.

And mean unless circumstances indicating other practices shall occur to persist with use of Electricity alone.

If under continuation of use, resolution shall be effected will I own consider it as strong proof of benefits of Electricity.

But if pains shall return will again have recourse to Cicuta.

And I hope with same effect of obtaining mitigation.

But whether that shall be case or not cannot help thinking, that what have already witnessed in this case affords evidence of benefit of Cicuta at least in some cases of Cancer.