DEP/DUA/1/43/48 (Normalised version)

Mary Wallace

(1787-1788)

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Mary Wallace at 17. N^o35

Of disease of this patient formerly offered conjectures at some length.

And upon whole disposed to consider it as most probable that was Case of Amenorrhea.

And of that species distinguished by [title] of Amenorrhea Eman.

Since came under care nothing has occurred either to confirm or invalidate that conjecture.

And still remain in same state of doubt as before.

If however conjecture well founded cure must principally at least be affected by operation of nature.

And what chiefly to be done is with view of obviating such urgent [symptoms] as may occur.

Here however little done, even with this view.

And practice chiefly directed to promoting natural tendency to menstrual.

Was with this intention, that first prescribed for her, the Aloetic Pill.

This article need hardly observe operates as purgative chiefly from affecting rectum.

And stimulation thus produced propagated to neighbouring vessels.

Hence tends to augment circulation through uterus.

And accordingly to give rise to that [accession] of blood, which a necessary condition to menstrual discharge.

Here more used with this intention, than that of moving belly.

At same time imagined that by free discharge dyspeptic symptoms at least, might be somewhat alleviated.

In way of purgative had rather more effect than could have wished.

For although taken to extent only of grains V in general produced two or three loose stools.

But notwithstanding this discharge, no diminishment of swellings.

While at same time other symptoms continued as before.

[Irreg]. however, that in short time influence as purgative might cease.

And that by persisting in use, effects expected might yet be obtained.

While however directed continuation of pills, ordered also another medicine.

The root viz of Rhubarb Tincture united with Cream of Tartar.

First of these articles, need hardly observe, possesses very wonderful power of penetrating whole system.

In so much, that [colouring] matter, well known to give complete tinge even to firmest & hardest of bones. Has been supposed that among other parts, [influence] communicated to uterus.

And that from stimulation that [organ], operates as an emmenagogue.

In my own practice cannot say that have met with any decided proof of efficacy.

But am convinced, that may be tried with most perfect safety.

And from observations of others, even consider it as deserving trial.

Addition of Cream of Tartar principally to give form & division of parts.

But hoped also, that might have some influence, in tending to remove swelling of legs, from operation as gentle diuretic.

From these powders, had at least no inconvenience.

But pills, operated so severely, that obliged to intermit use.

And upon this discharge by belly returned to natural state.

Still however all symptoms continued nearly as before

And while continued powder unwilling to lose chance of success which pills afforded.

Hence directed repetition one however being taken every second night only.

And at end of week somewhat easier. Soon after however swelling not only increased but more painful.

In this situation had recourse to friction with Camphor oil.

And seemed at least to be attended with desired effect.

For soon after both pain & swelling of legs very much diminished.

In so much, that in no long time, directed oil to be intermitted.

And other symptoms at least not very urgent.

In this situation, have thought it sufficient to persist, in plan begun.

And not without hopes that may in some degree aid operation of nature.

For by this alone, that proper evolution of uterus, & due discharge to be obtained.

To nature then, cure here to be principally trusted.

But besides medicine directed, can be no doubt that her operation also, aided by gentle [exercise] in open air, & by generous diet.

For where no [small] [conformation] of [parts], by these, more than by all other medicines put together, [ amem] Eman overcome.