DEP/DUA/1/40/36 (Normalised version)

Ailsion Denham

(1786-1787)

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[Ailsion] Denham at 4¹

In case of this patient an affection in some degree of complicated nature

But at same time affection chiefly distressing to her & what chiefly led to apply for our assistance very violent tenesmus

And this as I am disposed to conject the consequence of preceding obstinate [constitution].

By this means mucus cover [already] leaving extremity of intestines in bare & highly [sensitive] state.

At same time not improbable that in some degree also connected with another circumstance.

Excessive menstrual discharge viz to which had been subjected.

But whatever cause this most distressing part of complaint has already altogether ceased

And that as almost immediate consequence of an opiate.

Cannot however from this [consider] disease as completely overcome.

And improper to pronounce radical cure, till at least see consequences of next menstrual discharge.

While at same time care to be taken to prevent recurrence by keeping belly gently open

If however from persisting in this manner no return at next menstrual period, shall reckon farther attend unnecessary.

[Unless] perhaps direct few doses of Peruvian Bark with view to recovery of Strength.

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Explanatory notes:

1) While the case note states the patient is 4 years old references to gynaecological problems would suggest this is an error.