DEP/DUA/1/42/25 (Normalised version)

Ann Kennoway

(1787-1788)

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N^o25. Ann Kennoway at 56

Chief disease to which this patient subjected an affection of Mamma.

And can have no doubt in considering it as an example of Cancer.

Still indeed in [occult] state.

And has made no great progress.

For skin above neither discoloured nor corrugated.

But that has passed state of scirrhous evident from sense of burning heat.

Still more from affection of glands in axilla, in consequence of tumour in breast.

For no doubt that this an enlargement of lymph gland in consequence of absorption from mamma.

Thus appears that even more danger of affection of system than if marks even of much greater disease in mamma

Of prognosis after what formerly said of another case of Cancer almost unnecessary to express appearance of danger

Hold it to be a disease which unless by timely operation will very generally be found to be incurable.

And to this patient at present at least not disposed to submit.

How far even operation would now succeed will not pretend to say.

Would certainly require removal of auxillary gland as well as of tumour in mamma.

And not impossible even that has already made its way still farther into system.

In such a situation then would hardly be prudent to urge it much on patient contrary to inclination.

And for us remains only to attempt cure by other means.

With this view in present case as well as in that last treated of mean to make trial of Belladonna.

But in order to increase chance of recovery mean at same time to employ also Cicuta.

In which as a useful article of Materia Medica¹ must own have some confidence.

The rather as from activity of Belladonna cannot venture to push it suddenly to great extent.

With these medicines in order to procure rest during the night have also conjoined Opium.

And to avoid many different forms this united with the Belladonna.

The dose is my intention gradually to increase as find patient can bear it.

And besides giving the Belladonna in conjunction with Opium may perhaps also add it to Cicuta.

Besides internal use could [here] also wish to try it externally.

But at this season of year doubt how far shall be able to obtain sufficient quantity.

Of practice however reserve observations till afterwards.

Shall only add, that if decidedly product of good effects in this case will be strong example of efficacy in Cancer.

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Explanatory notes:

1) Latin term referring to the body of collected knowledge about the therapeutic properties of any substance used for healing (i.e., medicines).