DEP/DUA/1/35/34 (Normalised version)

Margaret Drummond

1784

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Margaret Drummond July 19

With regard to disease of this patient must acknowledge myself very much at loss both with respect to name & nature.

Had indeed some symptoms which might be considered as distinctly [characterising] particular affections.

Such for example as unease of throat.

In this may be considered, as having a particular modification at least, of cynanche.

But at same time, when attend to progress & course of disease, modification it must be allowed very peculiar.

For appeared we are told, for considerable time, merely under form of pain & heaviness in thorax.

And from thence propagated [along] course of sternum into throat.

But whatever might be singular in course that when she came under care, parts complained of, subjected to disease, could admit of no doubt.

For disease obvious on examination both externally & internally

[Hence] then must at least admit existence of peculiar modification of cynanche.

But that was very peculiar modification, apparent not only from progress but also from continuation & appearance.

For had subsisted without any material change, for space even of several weeks.

And during that time, notwithstanding long continuation, still rather under form of [rawness] merely, than of ulcer.

But although peculiar cynanche constitutes considerable part of affection, yet this not only disease to which was subjected.

For can hardly suppose, that with this, excessive menstrual to which subjected has any connection.

This indeed, she herself attributes & probably with justice, to a miscarriage.

But at same time, from early period of pregnancy at which was supposed to take place, can have no certainty with regard to it.

Whether however depends on this, or any other cause, no doubt that induced several of symptoms.

Particularly excessive weakness, tendency to Syncope, & even dejection of spirits.

For although these may have been in part affect of grief, yet well known also, that induced by causes of exhaustion.

Upon whole then though cannot speak with great certainty respecting affection, yet disposed to view it as of complicated [nature]

And to consider most if not all symptoms as referable either to peculiar modification of cynanche or to effects of excessive menstrual.

On this ground cannot speak with any great confidence, as to termination

Conjecture however as to prognosis, the less necessary, as patient for some time past, has given up attendance here.

And more than probable that unless from some particular accident, shall learn nothing farther with respect to her

At same time, if am not much mistaken, have of late seen her on street, walking about apparently in good health

Probable therefore that desertion has proceeded from having no farther occasion for assistance.

And indeed nothing in case which should lead us to think this an improbable event.

But in present uncertainty as to [situation] farther conjecture would be improper.

And from same reason also, restrained in observations with respect to Practice.

Here however remedy employed directed with view to both affections.

Against complaint of throat, had recourse to an astringent gargle formed of Infusion Rosarum with Mucilage.

And with view to strengthening system as well as to prevent of returns of Menorrhagia, employed the Peruvian Bark.

On use of these medicines was regularly kept, as long as attendance here continued.

And during that time at least affection considerably alleviated.

At first indeed though throat somewhat easier, yet still complained of weakness.

But under continuation of Bark, with this also came to be less affected.

And at least presumption that attendance discontinued from having no farther occasion for assistance.