DEP/DUA/1/11/04 (Transcript version)

Janet Brown

(1776-1777)

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Janet Brown

Seems to lab. under complic of affections

And of these some which if not fatal shall I am affraid find very obstin.

Of all her compl most distinctly markd is circum. tumour in right Epig. Reg.

And is in all probab. cause of some of most troublesome sympts.

While from progress already made still farther danger to be appreh.

What nature of this tumor cannot posit. say.

High probab. however that depends upon enlargement of some of abdom. [viscr.]

And indeed little room to doubt that is an affect of the liver.

A bowel well known to be freq. affected with swelling, schirrus & its conseq.

From this would acct for painful tumour

And from pressure on diaph probab. prevents easy respir during night.

While consider this however as most matter part of compl would by no mean view it as only part.

Is also distressed with affections of stom.

And that these unconnected with tumour may certainly be inferrd from being of much earlier date.

At same time by no means improb. that may now be aggrav from affect of Livr.

As cannot fail to have remarkable effect on state of circulat.

Must however observe that are not told of this having been the case.

From which may draw addit [argt] as to being unconnected.

But besides both these is also freq. troubled with another compl. viz severe headachs.

This also imagine totally indep. of tumour in abdom.

Would not howevr say that has no connex with dyspeptic affection.

Well known that sympathy between head & stomach very great.

And that morbid condit. alternately affect each other.

Notwith. this however have some suspicion that headach in pres. inst. of a diff. nature.

This cheifly led to suspect from seat of it.

And from not being observed to be most severe when stomach compl most urgent.

Reckon it therfore as probab. that is of that kind of headach which depends on Rheumat affect of chronic kind nature

And these, except perhaps purely nervous headachs, take to be of all others the most common.

From this idea of patients disease then would consid her as lab. under three affections.

In this case will not wonder that should be somewhat puzled both with respect to prognos & cure.

With complaints of head & stomach must own that am not much alarmd.

At same time suspect that shall find both to be obstin.

But with affection of liver not merly reason to dread an obstin compl.

Here also great reason to appreh that affection will be danger.

True indeed often schirrus affect of liver without proving fatal by themselves.

Thus for example freq. induce dropsic affections.

But even then disease can often be [palliat] for consid time.

And other instances where still less consid conseq.

Often when product of acute disease remains for life in station condit without any inconven.

Thus for examp. is a freq. occurrence in fenny countries as conseq. of interm fever.

These famil known under appellat of ague cake.

And those affected with it pay little regard to it.

Seems however in pres. instance to be much more serious affection.

And disposed to think that unif, &, comparat speaking, speedy encrease threatn. greatest danger.

What will be mode of termin reckon very doubtful.

Appreh. however that greatest reason to dread will at last land in suppur.

And that patient may fall victim to hectic fever induced from absorpt. of pus.

What gener. disting by name of Tabes hepatica.

Though this however most serious yet often will not be most urgent part of compl.

Hence in practice will not altogeth engage attent.

Especially as must own am much at loss to think how to be overcome.

While contin in pres. state however some attempts to be made to radic cure.

For if suspicions well founded may in short time be in situat to be desp. of.

Here must acknowl. that know no remed. capab. of remov. schirrus or cancer of intern viscer.

Of late indeed cicuta & some other of tribe of poisons introd as infallib [against] this affect.

Yet greater part of practit already convin that by no means entit to charact that has been given of them.

And am myself one of those who reck that wherever operat possib never from any expect from these to be a [momen] delayed.

Yet far from looking on Cicuta as a med perfectly ineffic.

And wherever operat inadmissib, think that at least merits trial.

On this acct have thoughts of trying it in pres. instance.

From other compl. however am very appreh. that shall not be able to persist unif. in use for any length of time

And without such cannot be reckond to have fair trial.

In admin of cicuta some caution necessary

Is one of those remed strength of which varies very consid.

And some patients able to bear much greater quantit than others without inconv.

From narcot powers howevr requisite in every case that should be begun with small doses.

And only be gradual encrease that can fix proper dose.

Used also in diff. prepar.

Princip however powder & extract.

Here have prescribd conjunct of both in form of pills.

And have directed extract of seeds [which] manif more powerful perhaps also more certain than leaves.

At least is unquest so with respect to Narcot. effects.

If other sympt. will admitt of use of this med. mean to give it fair trial.

If not have thoughts of attempting radical cure by means of Mercury.

And with this view shall wish to [illegible] it into system in least acrid state.

That is not in saline form but merly as rendered active by trit. or calcinat.

With both of these may probab. [conjoin] friction with camphorated oil.

Not indeed that expect very great [effect] from it.

Yet must observe that look upon camphor to be one of most penetrat topic applic with which acquainted.

And am inclind to think that often serviceable as removing tumour in conseq of restor circul from stimul.

To this however if have recourse to mercur internally may perhaps [subst.] mercul. unction externally.

Besides these still anoth med which am desirous of try in obstin tumours.

Although must observe that consider pres. to be unfav. case for [such] trial.

For in such state of progr. that could not with certainty determ affects.

Medicine to which I allude is Electric.

Is one indeed of which in such cases have had no experience.

But lately favourd with history by an ingen Gent in Ireland of a lady cured of an obstin tumour of breast by accid stroke of thunder.

This acct have had confirmd in such manner that cannot be smallest [reason] to doubt accurr of observ.

And a priori disp. to think that remedy has great chance of answering.

But perhaps very unnecess. to plan out so many schemes for attempt [remv] of this tumor.

For if progr. be not soon stopt shall probab. have it in powr to try but few of them.

And at any rate will be necess. to bestow great part of atten on other complaints.

On presumpt that headach from cause mentiond will be most effect allev. by guarding against exciting causes as cold.

And by support. drain from neighbourh.

Is with this view that have ordered blister

And wish to keep up drain for some time by epispast. ointment.

Stomach complaints cheifly to be allev. by counteracting acid when occurrs

And by obviating costiveness.

These views will explain to you intent in prescribe magnes.

And in ordering aloet pill.

Should these prove ineffect may [employ] other means of palliat compl. both of head & alim canal.

Yet with regard to either allev. of sympt must be object princip in view.

And cannot expect to restore patient to health without remov. tumour.

This as already observed consider to be by much most matter part of compl.

Hence in all remed employd with other intent is constantly to be had in view.