DEP/DUA/1/44/29 (Normalised version)

Margaret Wilson

(1788)

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N^o5^th Margaret Wilson. at 25.

Concerning case of this patient little to add to few observations formerly offered.

For while case turned out to be but of little importance was also but a short time only under care.

Obstruction of menstrual discharge to which subjected consider as merely symptom of state of constitution at the time.

And to be restored by recovery of health & vigour, which when came under our care had not regained after fever.

Consider her therefore as chiefly our patient for affection of Ear.

Affection here entirely confined to one Ear viz right.

This however subjected to repeated [infection] & suppuration.

This as well as want of menstrual discharge consider also as sequel of fever.

While fever often operates as cure of preceding affection so many others also which induces.

And indeed hard to say under what variety of forms these may appear.

Among others however inflammation & suppuration of different parts very frequent occurrence.

Sometimes, particularly when gives rise to Scrofula these appear on many different parts & extremely difficult to cure.

In other cases & these more common gives rise to ordinary phlegmatic suppuration & [heating] mildly.

But when affects a very delicate organ of sense as Ear, at least less chance of this.

Particularly after repeated returns.

In some instances has not only given rise to incurable deafness but has even proved fatal.

For by repeated suppuration structure of organ entirely destroyed.

And from erosion of bones, suppuration makes way into brain itself.

When this however case, fatal termination not to be wondered at.

Did not therefore I own expect that speedy favourable termination which has here occurred.

And must also add that this entirely operation of system itself & in no degree effect of medicine here employed.

When patient first appeared for assistance chief distress arose from pain of ear & tinnitus aurium.

These after formerly existing with great violence had ceased on discharge of suppurated matter from Ear.

And had again returned on discharge ceasing.

From this therefore reason to suspect that fresh suppuration was going on.

And this if could be accomplished was an objective to prevent.

If not was yet desirous at least to moderate suppuration & to mitigate pain & other urgent symptoms.

With this intention it was that directed for our patient a mixture of Camphor oil & Thebaic Tincture.

In each ingredient of this combination need hardly add that have a very powerful topical application.

Camphor well known to be a [substance] which from topical action of a very [penetrating] nature.

And often successfully employed with view of [discuss] tumour threatening suppuration.

Often also very useful in affections of Ears.

Particularly where depraved state of sensibility giving uneasy sensation as tinnitus aurium.

And under no form better [appearance] [particularly] to Ear than under that of Camphor oil.

Here then on different views seemed a very proper application.

But Camphor however active has much less influence in allaying pain than Opium.

And here the obtaining that end seemed at least to be a matter of importance.

Besides from Opium as well as Camphor had reason to hope, that suppuration rather prevented than otherwise.

In these expectations however disappointed.

For notwithstanding regular use neither any considerable mitigation of pain nor prevention of suppuration.

Or at utmost had affect only of [rendering] suppuration less considerable than might otherwise have been case.

But whether this effect or not in no long time, abscess formed was subjected to spontaneous rupture.

And in consequence of this, ear as may naturally be supposed much relieved.

For till, discharge of matter distension alone a sufficient cause for [supporting] pain.

But this on rupture entirely removed.

Still however was subjected to considerable pain in different parts of head.

From this led not only to direct continuation of oil, with view to prevention of return of fresh suppuration but also to application of blister.

And that might more readily [secure] determination from head, [illegible] blister to be [converted] into issue.

After these practices however directed saw nothing of this patient for a [considerable] length of time.

And then met with her only accidentally.

Found however that from period of last purulent discharge had been entirely free from former symptoms.

That in short time discharge ceased.

But that upon this, there was not as formerly any return of pain.

And that was now in every other respect in good health.

Hence then marked her in our list as dismissed.

And may justly consider cure as solely the effect, of operation of nature not of any practice here employed.

Still however termination gives countenance to idea given of nature of disease, that viz. whole a sequela of Fever.