DEP/DUA/1/12/18 (Transcript version)

Mary Thomson

(1776-1777)

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Mary Thomson.

As two patients of this name necess to disting pres by title of elder.

Disease to which this patient subjected when came under care very obv.

May however remark that treatment for this affection soon interrupted by othr [com]

And matter of doubt how far the two [could] be consid as in any degree connected.

At time of this patient admission only compl. an ulcerated sore near hip joint.

This affect before applied to us had cont for nearly space of three years.

Gave therefore strong presumpt that might be consid, if not worse, at least as ulcus mali moris.

Yet in pres. inst few or none of these appear pecul to cancer.

While at same here a circum by which may suppose ulcerat to be supported even although in nature of sore nothing malig.

Part subj to almost const. irritat. & pressure from sitting.

Would howevr seem that patient had been in const. hopes of its healing soon.

And thus had best. on it very little attent

To me howevr I own appeard in diff light.

And did not expect that would have heald so soon speedily as in reality did.

Which at same time must observe consid to have been more work of nature, than of any remed, which we employd.

Did not indeed doubt that in this ulcerat might be suff. dispos. to heal.

And of this even some presumpt from state of surrounding inflam.

For is by certain degree of inflam [alone] that can expect healing.

Perhaps may even say by pecul kind of it.

What has been stiled viz the adhes. influ.

This probab. most nearly allied to [supp]

And from one most ready transit to [other]

Hence well digest pus mark of healing.

This then leads to observe that in pres case some evid that inflam [not] of that kind.

For disch here princip occurring a thin sanies

Swelling Disch. howevr no appear of acrid or corros. nature

Yet this circum seemd to indicate that state of inflam requird change.

And on this cheifly that plan of cure at first begun entirely proceeded.

Change of inflammat princip to be expectd from pecul. stim to part.

And this might be obt either by inter or external exhib.

To latter howev thought that some object from superficial inflam already [exist]

And imagind that what chiefly wanted a change of action in vessels somewhat deeper [seated].

Was with intent of obt this that thought of employing Mezeron.

A vegetab. of the acrid kind respecting powers of which as collected at diff. parts of body after [entering] circul. syst have [alred] had occas to speak.

Have seen strongest inst of [effic] in vener. ulcerat or rather against ulcerat succeeding lues.

And have no doubt that on same prin will also be serviceable in other cases.

Hoped therefore that would have good affect in pres. instance.

And to this was intent to have [almst] totally trustd cure.

Using merely as an extern applic the mildest & most gentle ointment.

And that rather with view of making patient attend to sore & guard it against accid than on any other acct

This then plan of cure at first intended.

May howevr occur that one part of [dises] mentiond in case of which have said nothin.

And to which these meas could be consid as in no degree directed.

That is state of Menses.

Are informed that Menst. disch. had not appeard for space of six weeks.

At which time patient had sufferd an abortion.

This circum evid of much more recent date than other disease

And consid two as totally unconnected.

Was at loss whether to consid obst here as morbid or not

For patient, who was a married woman might again have falln with child.

And at any rate after consid disch by abortion not uncommon to miss a period

For this therfore consid no meas as necess.

Nor did I consid it as a circum from which in least degree to be restraind as to meas. already mentiond.

From these meas howevr must own did not reap desired affect.

Applic of Linim inded as might be expected prod of no inconven.

But after decoct, compl. much of being [affecd] with uneasiness at breast & pains in diff. parts of body.

These I own did not consider as affects of Decoct.

But looked upon them as rather of Rhm kind from some accid expos. to cold.

This howevr imagind would be best [determ] by omitting decoct. cont. merly from [applic] to [same].

At next visit found that pains still cont.

And now more evid markd of Rheum kind from affect knees & wrists.

By this led to have recourse to Elix of Guaiac.

From use of this med howevr pains not immed relievd

But on appear of menst. disch. occurin probab at second [evac] [period] aftr abort, became consid easier.

Not howevr willing immed to return to use of Mezer. which afterwards intended to do.

And as at this time besides ulcerat princip compl. was bound belly thought merely of obv. it by an Aloet. pill.

But from recurr of pains was induced at succeeding visit to give second trial to Guaiac.

In place of relieving howevr patient imag that rendered pains more severe.

And although imagind that in this she was mistaken yet med was not [attend] with any obvious operat.

This therefore led me to use as subst for it the Virginian Snakeroot.

But although taken to mod dose only in place of usual affect prod with this patient sickness & vomiting.

And can hardly ascribe it to this med that pains at next visit so much easier.

For then only compl. of pain in foot where was at same time attended with some evid swelling.

Which soon yielded to gentle [frictn] with volat linim.

During all this course ulcerat cont [grad] to mend.

And now so far heal that reckond it unnecess for her to cont attend any longer.

Have no doubt that in this case recov from affection for which patient came under our care neither to be ascribd to extern. applic nor to intern remed used.

But was merely affect of patient bestow greater attent upon it & [deffending] it [againt] from irritat.

A circum which am persuaded [will] often succeeded where from long cont of ulcerations is presumd that are supported if not by cancerous at least by [cacoethi] state in ulcer itself.

And would upon whole conclude that pres. disease no more an ulcus mali moris than rendered so by irritation.