DEP/DUA/1/36/37 (Normalised version)

Ann Runciman

1785

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Ann Runciman. January 22^d 1785

From history of this patients case appeared that when applied for assistance, here was subjected to complication of affections.

Of these the first & what shall probably also find most obstinate, part of disease is pain of back.

To this we are told had been subjected for period of 15 years.

And then originated from spraining in consequence of violent exertion.

A cause well known frequently to give rise to such complaints.

And often even inducing such a state, that continues for life

Or at least though subjected to temporary remission returning on slightest accident.

And this so much case with our patient, that renewed not only from attempts to lift weight but even from bending body, or position in bed.

This however not entirely from first accident

To this height had arisen in consequence we are told of last delivery.

And this which of itself often a cause sufficient to induce these pains, might readily suppose capable of aggravating them.

Here then would appear, that very weak, & irritated state, induced in these parts.

But though this first, perhaps may also add most distressing & most obstinate part of affection, yet by no means only disease.

Affected also to considerable degree with Fluor albus.

Which although in greatest quantity immediately after menstrual, yet had now arisen to such height, as not to be absent during whole interval.

With this discharge, well known that affection of system in different ways often connected.

And particularly not only frequently attended with disorders in alimentary canal, flatulence & like, but also with pain of back.

To this therefore not improbable, that in part urgency of other complaints to be attributed.

But when consider period of commencement & of increase can by no means ascribe it altogether to that cause.

And indeed not less probable that injury to back in some degree cause of Fluor albus.

But still more should I be disposed to ascribe this latter disease, to change to which uterus subjected, during last pregnancy.

For while frequently marked to be [induced] from this, to be observed that almost first commencement dated from that period.

May then upon whole consider these two parts of affection, pain of back, & Leucorrhoea, as having but little [connection]

But if this the case with regard to these two, still less reason for suspecting that either connected with third complaint.

Discharge viz of Ascarides.

Had remarked that worms of this kind, had been discharged by anus, for space of near ten years.

And although do not seem to have been product of any great inconvenience, yet were at least a morbid affection which was desirable to remove.

And one too from which reason to apprehend, that greater distress might soon arise.

Upon whole then, patient may be considered as subjected to these different affections.

viz. Pain of back, Leucorrhoea, & Ascarides.

To enter fully into prognosis here would be requisite that should make some observations respecting each.

But without descending to particulars, may only in general remark, that with regard to none of them, any grounds for alarm.

And have even reason to hope, that of all, may be able to produce, if not radical, at least temporary cure.

Must however be allowed, that from very trifling accidents, will be apt to recur.

And this particularly to be apprehended, both with regard to Fluor albus, & pain of back.

As patient thus subjected to complication of diseases, particular practices might be concluded to be necessary, with regard to each.

And this accordingly case in practice here directed for patient.

Began treatment by directing the Infusion Amarum, to be taken by mouth & injection of lime water to be thrown into rectum.

The former of these remedies have often I think seen, attended with good consequences, in instances of Leucorrhoea.

The latter, one of most powerful means with which I am acquainted, of removing ascarides.

While at same time, perfectly safe, & innocent.

In case before us, reason to presume that both remedies attended, with desired affect.

For from time that she began use of infusion, Fluor Albus considerably diminished

And from very first injection, a large number of ascarides brought away

While during several succeeding ones none observed.

Soon therefore became unnecessary to continue use, & to this remedy can have no hesitation in attributing removal.

Have even been inclined to suspect that also serviceable in another particular

That has viz a share in removal of Fluor albus.

For ceased in shorter period, than should have expected from bitter infusion alone.

And reason I think for presuming that an article of the astringent power of Lime water, may extend influence from rectum to uterus.

What has happened therefore in this case will lead me to make trial of injection of Lime water in other instances of Leucorrhoea

But whether had any influence or not this complaint for time at least has ceased

And at last report only remaining affection was pain of back.

For this now employed friction with anodyne balsam.

And hope that by means of it at least temporary ease may be obtained.

If this however not the case is intention to direct here, drawing electrical sparks from pained part.

For in a former instance where back similarly affected from being overstrained was able by means of electricity to affect complete cure after many other remedies tried in vain

Hope therefore that may here be product of same effect.

And that in no long time, may be able to dismiss patient free from all affections.

While however pain may baffle utmost efforts should not also be surprised at recurrence of former complaints.

Particularly of Leucorrhoea at succeeding menstrual period.

But even supposing this to happen have reason to hope that may again yield to repetition of measures already employed.