DEP/DUA/1/43/28 (Normalised version)

Ann Kennoway

(1787-1788)

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Ann Kennoway, at 56 N^o 25.

When formerly spoke of case pronounced it a decided example of Cancer in Mamma.

And from evident affection of axilla gland so far advanced that even danger of introduction of Cancer [virus] into system.

And when consider nature of disease could not be viewed as without immediate danger.

Still however not in such a state as altogether to preclude hopes of recovery.

For still in condition of occult cancer. And skin over surface had not even obtained [pained] or corrigent state indicating progress to open cancer.

Since came under care no reason to alter opinion either of nature of affection or of prognosis.

And if then some faint hopes of recovery now I think in place of being diminished may rather be increased.

For whether affect of medicine or not, under use at least, symptoms somewhat diminished

This however will more particularly appear from short view of practice.

With regard to practice may again report as formerly observed that patient’s best chance of complete recovery from removal of Mamma & axilla glands.

But her own objection to this which it must be allowed always a dangerous operation left us only to attempt cure by other means.

When patient first appeared to us directed you will observe equal parts of Cicuta & Glycyrrhiza.

In this need hardly observe that only active article the Cicuta.

The Liquorice used merely to cover taste & give form.

And powder taken to such extent that at each dose about ten grains of Cicuta.

This article long employed in medicine of late years particularly celebrated for cure of Cancer, by Dr Stork of Vienna.

And although has by no means [answered] expectations raised by him, yet for my own part inclined to consider it as not without use.

Sometimes at least tends to [resolution] of tumours evidently tending to Cancer.

And where no other effect at least in general alleviates pain.

Here however with view to alleviation of pain thought something farther necessary.

And accordingly at bed time had recourse to opium under form of Pill Thebaic with view of securing easy nights.

From these medicines felt at least no inconvenience.

And from commencement of use answered in particular the end of giving better rest.

Was only however from long continuation that could here expect much manifest benefit.

And after found that these borne with ease resolved to try to hasten progress by means of another article.

The use viz of Belladonna.

Of this article had in a former case occasion to offer a few observations.

And for more full account of use may refer you to treatise then alluded to writer by Dr Munch.

Has now had place in two successive editions of Edinburgh Pharmacopoeia¹.

But London College² have not given place to it in edition of their work lately published.

An omission in my opinion much to be regretted.

As in consequence of this will not be generally kept in shops of apothecaries

Hence practitioners disappointed of opportunity of trial even in cases which from no other remedy hopes of service.

Its being in list would not oblige anybody to use it & could be product of no inconvenience.

While would furnish practitioners with an active agent with which under prudent management as have repeatedly seen in present course may be employed with safety.

Here did not wish to multiply medicines on patient.

And accordingly to avoid new formula conjoined Belladonna with Opium.

Taken to extent of grain at bed time had at least no effect in preventing influence of pills as procuring sleep.

This continued to enjoy much better than before.

But on beginning new pills from mistaken directions given she omitted [powder] of Cicuta.

And upon this observed that became affected through day with same pain in Mamma as formerly.

A circumstance giving at least presumption that by use of Cicuta had been mitigated.

And this presumption increased from relief which received on return to use.

While at same time was also observed that on future accidental omission renewal of pain took place.

After short use of Belladonna wished gradually to increase dose.

And that rather by giving it frequently than by large dose at a time.

Hence [added] a portion of it to powder as well as to pills.

And under these medicines continued with tolerable ease for some weeks.

At least when compared with state in which formerly was.

Still however no evidence of disease yielding by any change on swelling.

Lead therefore to conjoin with these practices still another mode of cure

Use viz of electricity under form of sparks drawn from Mamma.

This need hardly observe one of most powerful agents with which are acquainted both as renewing circulation & promoting [obstruction].

In both ways promised some use in removal of tumours.

And what of still more consequence has in some cases at least been attended with desired effect.

On these grounds then employed it in present instance.

Only obvious operation that for about quarter hour after use found sense of heat in breast.

But in other respects even from commencement no inconvenience.

This therefore encouragement to continue.

With this was wish to increase Belladonna & at same time to omit Cicuta.

And in hopes that return of pain might be prevented by Opium given with Belladonna both morning & evening.

Accordingly directed two pills for dose at each of these periods.

And under this course not only relief from pain but some diminishment of swelling.

During course however an accidental looseness supervened.

This probably would soon of itself have terminated naturally.

But to aid termination had recourse to a mixture with Electuary Japonica.

And whether medicine any effect or not soon so swelled that farther continuation [illegible]

Now therefore goes on again with Belladonna & Electricity.

And while appears that both may be used with perfect safety, here have given at least some hopes of success from diminishment both of pain & swelling.

Is only however from long continual course that can expect much.

And after all no sanguine hopes of complete cure

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Explanatory notes:

1) An official publication containing a list of medicinal drugs with their effects and directions for their use. The Royal College of Physicians of Edinburgh's Pharmacopoeia was first published in 1699.

2) The Royal College of Physicians of London.