DEP/DUA/1/12/11 (Transcript version)

Jean Massey

(1776-1777)

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Jean Massey disease of this patient would not seem to be of very comp. nature.

And some sympt such as character. of a partic affection.

Yet a case respecting which questions may be stated admitting of doubtful [answ]

Here no hesitat that one of princip morbid affections to which patient subj. is disch from Vagina.

This disch we are told is of whitish mattr

And so little doubt respecting nature of it, that in case pronoun. Leucorrhoea.

Must however observe that this judgemt given merely on presumpt of patients integ.

For after what lately occas to observe say of simil. of disch in Leucorr. & Gonnor. will be sensib that more necess in Diagnos.

Yet must at same time observe that know no circum to create suspicion with regard to this patients compl.

Unless [acct] given be true can expect no benef. here.

For with us neithr maintained nor lodged.

And except releif from disease has nothng else here to look for.

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Besides acct of nature of running [corresp] with every othr part of story.

But especially with cont. of it.

Have little doubt therfore in admitting this part of patients assertion

But next a question how far Leucorrhoea cause of othr sympt.

Or whether to consider it as symptom of preceding affection.

Cheif othr sympt are affect of alim canal.

Partic Nausea, Flatulen, & Globus hyster

All such sympt well known to be freq conseq of Leucorrhea.

And some others as pain of back, dimin of appetite &e well known const. attend.

Only diff. therfore from durat. of formr symp

For are told that with glob. hysteric has been affected near four years.

If in this accur. cannot considr it to be prod of fluor albus.

But patient with regard to its duration may be mistaken.

Or may have been origin of irritab hysteric habit.

But at any rate, suppos. this not conseq. of Leucorrhoea, cannot consider it as cause

And of two by much least matter. affect.

Must therefore adopt suppos of patient that Leucorrhea here the affect of labor. deliv.

A cause by which, especially when succeedd by large haemorrhaging, often known to be induced.

And indeed a circum which [must] have great chance of pecul. affect state of uterus.

But admitting this cause of fluor albus yet still with respect to nature other quest.

In treating of this affect in practic lecture observd that under term compreh. two [cases] diff from each other.

In one disch merely from vagina uterus in othr from uterus itself merely from Vagina.

In one case disch connected with menst flux, in othr is not.

In one disch for most part, at least at begining, consid intermissions in othr const.

Little reason to doubt disch from vessels of uterus itself in inst now before us

Even since came under care has had consid intermiss.

Such also before observd to have occurrd

Cause probab inducing it such as would in partic affect uterus.

And seems to have even evid connect with menst. discharge.

But to be observd that [connect.] somewhat [partic.]

In by much greatr [number] of cases Leucorrh. succeeds menst flux.

In some although rare inst. observd to precede it.

And pres. case would seem to be of this kind.

At least did not follow last menst. evac.

And has again appeared nearly at time when menses may be expectd.

Here likewise another pecul.

With most women labouring under Leucorr menst. evac partic great.

But with our patient very scanty.

And at that time subjected to affections shew shewing great disorder of whole system.

Partic a certain degree of delirium.

From all circum taken together pres a case of which cannot form very fav opin.

Reason even to presume that supported by some local affect of uterus.

And phaenom even lead to contrary indicat.

Scanty menst disch. would seem to require encreased determ to uterus.

While on othr hand Leucorr. would seem to require that determ which has already taken place should be restraind.

In this situat must own somwhat at loss what to do.

And have by this been led to adopt at diff. times contrary meas.

Was here affraid to have recourse to employm of astring

At least of very powerful nature.

As an absorb. howevr here ordered the Lime water

And as a tonic the Peruv. bark in small quantit.

Am at loss to say whethr in any degree from use of these treat Leucorrhoea soon dimin.

Or whether was to be consid. as one of those remiss. which had often before [obtaind].

In this situat unwilling to push it farther

And with view to uneasiness at stomach varied it for a cordial stim.

Was with this intent that employd the Tinct. Arom.

But patient had taken very little of it when menses appeard.

And these as usual in small quantit & with ordin affections.

In this situat had recourse to med which thought might prom. menst. disch.

An aloet purgat vizr intended cheifly to act as stim to rectum.

Had here two intent in adding to it a prop. of Laud.

First imagind that something might be [expec] from the anod as promot. menst. by removing spm spasm

And secondly with ticklish state of patients stomach thought that less chance of its excit. vom

Not improb that in lattr way had some influence.

At least found that patient retaind it [withou] any inconven.

But neither from aloet nor anod. any affect on menst. disch.

Sympt. howevr excited at menst period soon subsided.

And patient imagind that med used some affect as releiving compl. of head.

On this acct. therfore cont. use till Leucor again returnd.

But then consid it as med which might rather aggrav disease as otherwise.

And in place of it had again recourse to Lime water

Now howevr employ it without bark.

And with view to stomach compl. conj. with propor. of milk.

In all this howevr will be sensib that have done little else than comb. sympt as they occurrd.

And own that very doubtful how far shall here be able to do any more.

At least as far as go will be able to proceed merely on conject ground.

Have some idea howevr that in pres affec radic cure must depend on restor menst flux.

If therfore at next period same appear as formerly shall at least make trial with this view.

And have thoughts of ordering for pres. patient use of Rubia [Tinctur]

If find that does not augm Leucorrh may cont. during greatr part of interval.

If does shall conf. it more partic to period at which menses expected.

But probab. after all cheif endeav in this case merly employd in mitig. sympt.