DEP/DUA/1/41/36 (Normalised version)

Isabel Milne

(1786-1787)

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Isabel Milne. April 20.

Here no doubt that most urgent part of patients complaint pain of back.

And although [concerning] nature of this different conjectures might have been formed, yet to me seemed most probable that patients own opinion best founded.

And that in reality a [muscular] affection originating from over exertion.

This rendered probable from being able to date them [from] particular accident.

From situation which occupied.

And from length of time for which had continued.

For that this should have been case particularly with a woman advanced in life by no means surprising.

To this pain was I own disposed to attribute all other symptoms mentioned in case.

A natural conclusion from observing that these only supervened after pain became severe.

While at same time well known that pain product of various symptoms.

Of none however more readily than of such affection of stomach as here took place.

Often also of urine.

Especially when seated in parts contiguous to the secreting organ.

With this view of disease progress more favourable than perhaps any other.

Could not indeed perhaps expect that pain would yield more readily than if of rheumatic kind.

But supposing affection of stomach & urinary organs merely symptoms, less to be apprehended than if idiopathic ischuria or dyspepsia.

For in that case reason to hope that by mitigation of pain both would be removed.

And this I think some reason to conject has really been case.

At same time as not altogether certain as to termination of affection can speak only as probability.

And perhaps still more grounds for uncertainty whether supposing favourable conclusion are to consider it as effect of practice employed.

On idea mentioned however treatment of case conducted.

As means of alleviating all [symptoms] seemed first objective to mitigate pain.

And with this intention, considering affection as local had recourse to topical application of anodyne balsam.

A formula I need hardly remark often thus product of best effects.

And indeed not surprising when [consider] active articles it contains.

Particularly Camphor one of most [penetrating] substances with which yet acquainted.

But still more Opium.

Effects of which as allaying pain when applied to [sensible] nerves, undeniably proved by daily observation.

With this intention used under various forms.

But under none more frequently than that here employed.

And particularly where pain arises from sprains.

Here then expected that would be product of [wanted] effects.

And that relief of other symptoms would be consequence.

Was however inclined to think that state of urine deserved some attention

And at least that would in no degree interrupt relief from anodyne balsam that gentle diuretic at same time employed.

As such had recourse to Cream of Tartar.

For besides increased urine expected benefits from it also in other ways.

As gently moving belly imagined that might in some degree tend to obviate stomach ailment.

And from acidity might [quench] thirst.

Cannot however say that these medicines in every respect answered expectations.

In effect indeed of anodyne balsam were not disappointed.

For as immediate consequence of application considerable relief of pain of back.

And that this affect of medicine, clearly apparent from consequence of omission.

For, happenening to have none of it for some days, pain again returned.

And on recurrence to use same [relief] as before.

With this relief of pain had also considerable mitigation of other symptoms.

Particularly of stomach ailment.

This however could not ascribe to Cream of Tartar.

For from use no obvious operation ensued.

Hence then consider it as solely effect of mitigation of pain.

And as corroborating opinion formerly stated as to nature of case.

Might therefore have expected [cure] by persisting in Balsam alone.

But as urine still scanty same reason which led me to first [use] of Cream of Tartar induced to continue & increase quantity.

Should also naturally have thought of persisting in Balsam till completely recovered.

But a circumstance occurred as objection.

An eruption viz over affected part from which considerable discharge.

This viewed as consequence of friction.

And of acrid nature of [compost] particularly from [illegible] & essential oil.

But whether this conjecture well founded or not, this condition of [patient] prevents farther trial at least for time.

And now so far free from pain, that much less necessary.

Directed therefore that should continue with Cream of Tartar alone.

But since that has never again visited us here.

An event, which, though cannot speak with certainty, am I own disposed to attribute, to having no farther occasion for assistance.