DEP/DUA/1/13/01 (Transcript version)

Mary Kennedy

(1777)

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Mary Kennedy.

With compl. of this patient must own have very great diffic doubts.

And here first perhaps also princip diffic with respect to name of disease.

For besides that from situat of patien & other partic in an affect distressing is in state which must give diffic in practice, till nature ascertained can expect to do nothing to purpose in cure.

Conject entertaind by patient herself is that lab. under Vener. disease.

And that this commun to her by child that suckled about nine months ago.

That L. V. often then commun can admit of no doubt.

And that pres. patient was affected little reason to question.

But for this affection subj. to a mode of treatment which very gener. at least has affect of remov. it.

And was supposed to have done so in inst before us.

Comes first then to be quest. of some import. how far any part of this affect still remains.

On one hand to be observed that Lues an insid compl.

Often lurks in constit when thought to be completely erad.

And after disapp. for some time is again evinced by incontest. marks.

In this therefore must be allowed that some foundat at least for pres. suppos. of patient.

Or at least for entert. appreh.

But on other hand to be observd that this a disease with regard to which people often fearful beyond meas.

And many whom impossib. to convince by any argt that they are cured.

Mere suppos. of patient therfore no ground for inferring disease

And must form conclus. entirely from sympt.

In pres. case must own that see nothing to confirm suppos. of Ven. affection

Is indeed not free from complaints.

And these at least of such a nature as to have some resemb. to Ven. taint.

Are cheifly if not entirely of two kinds.

Affections of throat & of genital organs.

Well known that few places in system more freq. suffer in Syphil. than throat.

And in general also conseq. of disease after some contin.

Often first sympt when breaks out after having for some time disapp. & after suppos of compl. cure.

But from all these partic cannot concl. pres. to be a Vener. sore throat.

Here only manif affect. inflammat.

And when this exists no wonder that diffic of swallowing.

Veneral. sore throats howevr very univ with ulcerat.

And with these too of very partic kind.

In so much that a person who has [once] seen them cannot easily be again [mist] with regard to them.

Was then I own disp. to look upon this part of sympt as not vener.

And respecting affection of genital organs was also by no means without doubt

If here any affection was Gonnorhoea.

At least no obvious ulcerat. [indurat] or any other sympt.

Here indeed augmented disch. of mucus matter, at same time accomp. with ardor urinae. Which with females at least chief charact. of Gonnor.

But to be rememb that females subj to a disease which in these respects [agr] with Gonnor.

That is Leucorr. or fluor albus.

And in case itself some circum corrob. this suppos.

Partic general debilit & pain of back

Which at least much more freq sympt in Leucorr. than Gonnor.

To all this may be added that altho Gonnr. a vener. disease yet may [reason] for pres. that in nature essent. diff from Syp

Of this subj. however shall perhaps hereafter take opport. of explan. [suplem] to you more fully.

At pres. may only observe that if this patient, has obt Gonnor. from nurs is first inst. that have ever seen of it.

From all these circum then very doubtf as to nature of affect.

And must own that now rather on whole disp. to think that is not affected with Lues.

At same time as far as treatment can at pres. be ventured upon reckon it now prud to go on this suppos. than any other.

For by this less danger of doing mischief than by treating Lues for another affection.

Before conclud. observat on nature of the disease anoth partic to be mentioned.

Obst. viz of Menst. disch.

When patient came under care had been stopt for 9 weeks.

And during time that has been our pat. no appear of return.

This howevr cannot consid as in any degr a morbid affection.

For from commn suspected obst. to be affect of pregnan

And with regard to this suppos. has now no doubt.

If therefore be not an object requiring means of cure, yet [claims] attent in other respects

And will very much restrain us, in means to be used in practice.

From this circum dare not venture to employ what might otherwise be used with probab. of success.

And which perhaps might serve to determine nature of the affection.

From all circum then taken togethr cannot here entert prospect of speedy & favour termin.

And must own very suspicious that patient may cont. long under [hands] in pres situat

If no other sympt appear shall I own be very shy as to pos more active meas. during pregnan.

And while patients stomach cont in pres. state probab. few which will be able to bear.

If howevr pregnan a little farther advanced stomach may be less ticklish.

And perhaps may then be able to pros. meas. with more success.

Now state of throat no longer an object of attent.

And endeav to cure to be solely directed to disch from Vagin.

Whether this origin from Lues or any other cause may now I appreh. consider it as free from virul.

And must be cheif object to [restrain] it by astring & tonics

With this view in pres. circum of patien should I own consid Per. Bark as prefer. to any other.

And if stomach found to bear it shall at least think of fair trial.

Meanwhile will will endeav to mitig. sympt from dimin acrim of urine.

This will endeav to affect on one hand by encreasing quant, & on other by checking acrimony.