DEP/DUA/1/17/09 (Transcript version)

Christian Campbell

(1778)

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Christian Campbell.

Disease to which this patient subj. a very simple affect.

And can have little doubt in consid all other sympt to be connected with most obvious morbid affect appear condition

That is disch of white fluid from Vagin

This however the princip sympt of two diff. morbid affect viz Leucorrhoea & Gonnor.

And often extremely diff. to disting between the two.

Especially where reason for doubting verac of patient.

For by concealing some circum & misrepr. others diagn. rendered even imposs.

If however take pres. case as repres. to us little room for doubt.

In first place may be observed that othr sympt here pres such as unif. affect of Leucorrhoea.

Or at least such as very generally occur when pres to any grear degree.

Of all sympt attending Leucorrhoea [most] freq is pain of back.

And with our patient this the most distressing sympt.

Commonly also though not always remark that Leucorrh connected with morbid condit in menst. disch.

Perhaps in even greatest part of cases disch in Leucorr. from same vessels furn menst flux.

And hence it is that when disch not con constant is sometimes observd to precede, more freq. to follow menst.

And when is const at these times, partic the latter very gener remarkd most abund.

While this the case may naturally be concluded that what prod morbid state in one will give rise also to affect of other.

Thus with Leucorrhea there often also occurrs Menorrhagia.

And while menst flux regul to periods yet cont also yet for great uncom length of time.

In other cases more freq. return than usual.

And in many inst subj to irregul. either from very triffling causes or even without any obv. cause.

Accord to acct given, in case before us menst disch not subj to any remark augm

Yet liable to very consid irregul with respect to return.

And while in Gonorrhea never affected, at least as sympt of the disease, with our patient sometimes even returns at interv of forthnight, sometimes susp. for unus. period

These however only sympt with which accord to repres of patient disch here [accom]

And in these while no appear of Gonnr have evid indic of Leucorrhea.

But while sympt of latter pres. those commonly attend formr also absent.

No ardor urinae, no external inflam.

No ulcerat about labia pudendi.

These indeed sympt all of which not unfreq. occurr in Leucorrhoea.

But while sometimes attend of that affect almost never absent in Gonnor.

Hence then although but little to be drawn from pres. yet absence, with white coloured disch from vagina strong test of Leucorrhoea.

And especially after that has subsisted for consid length of time.

This howevr to very great degree the case with our patient.

For has now been more or less affectd with compl. for space even of 20 years

This however may be mentiond as [farther] argt in support of Leucorrhea.

And occurrs indeed as almost unsurm obj to suppos of Leucorrhea Gonnorhea that has cont for so long a period.

Partic without occurr of other veneral sym

And indeed at any rate hardly any inst to be met with in which Gonnor has cont for as many months in place of as many years.

If therefore reliance to be put on this [acct] is alone suff. foundat for pron judgem resp nature of the disease.

And when taken with others even where acct not absol. to be relied upon gives, at least strong presumpt.

To all these partic may add cause to which affect attrib.

Accord to acct of patient encrease of affec at least the conseq. of greif & of hard labour.

Circum which while can never give rise to gonnor well known both to induce & to augm Leucorrhea.

Hold therfore that in pres inst little doubt as to nature of affect.

And unless patient has misrep. comp with uncommon art must consid. her to be subj to Gonnorh. Leucorhea.

Here however may observe that every affect included under that gener. denom not of same nature.

Partic may arise either with or without any pecul local affect.

Thus for ex often conseq. of ulcer, of fungous tum, of schirrus, cancer or like.

When this however the case besides other sympt generally disting by local pain & sense of burning heat.

While [arder] urinae & in gener. [strang] affect almost never absent.

No ground then for suspicion of disease being here sympt, of such morbid affect.

But even where affect may be consid as idiopath that is as proceeding from laxity of vessels disch may either be from those of uterus or vagina.

And according as princip from one or other sympt somewhat varied.

Often howevr in some degree takes place from both at same time.

And here from irregul of menst on one hand & from long cont & const of disease on other should susp. this to be case.

This then opin respect. nature of affection in case before us.

After these remarks on disease little need be said as to sentim respecting terminat.

After affect of so long contin can be no means look for exped cure

And must own am very doubtful [whether] shall be able to effect complete recov.

Yet equally little reason to dread fatal termin.

For sympt yet induced indic general affect of the habit.

And of these which have taken place none which can give appreh of danger. tend.

Nor at same time even even any indicat of a cause support affect of such a nature that can be [consid] as irremov.

Would not therefore consider it as an extraord recov. if patient should entirely get rid of affect.

Yet from long contin of the affect a diff terminat is at least of the two the most [prob.]

And besides duration some othr circum also unfav.

Thus for ex advanced period of life at which patient has arrived

Has not now at least chance of recov. from some changes which may be induced in condit of uter by some circum to which exposed.

But partic from pregnancy.

One period however at which even natural recov. may still perhaps be expected.

That is when Mens entirely cease.

And this, at least accord to what happen with major of women, may presume will take place within few years.

But during time that may cont under our care recov. from this source not to be expected.

While at same time rather unfav as otherwise that has resisted med already empl.

Am therefore upon the whole disp to think that may dismiss patient with sympt somewhat allev.

But do not expect complete cure.

Remed however to which would [prin] be led from view to allev., are at the same time such, as may cheifly [expect] to prod radic cure.

For both one & other must be conseq. of restoring to debilit [part] due deg of vig.

For is in conseq. of want of prop tone that escape that serous or mucous fluid [thus] allowd to escape.

In this respect then cure must turn on two partic.

First on employm of such meas. as tend to give addit tone either to syst in general or to uterus in partic.

And secondly on removal of all circum tending either to dimin tone or to support determ to uterus.

Besides these however partic occurrences will sometime take place requiring to be partic obviated.

And in pres. inst some meas already taken with view to allev of these.

But unless what done with this intent diff parts of pract directed with on two [form] views.

Of these then next proceed to speak as well as of meas which may hereafter be be employed if pres abort.

Began patient with use of diff. med of tribe of absorb.

Of these first employd the Lime water long a remedy in this affect.

And indeed generally supposed to operate as an astring.

Effects in this way however, in all prob. are princip if not only conseq. of abs. power.

As by this means powerful in remov a [illegible] debilit tone viz Acid in [Pr] [viae]

Is also on same princip that suppose [other] absorb. to act.

Partic the [Oc] [Cancor] a remed much celeb & given to great extent in this affect by an emmin Dutch pract.

How far cont of this course would have succeeded cannot pretend to say.

But to all extent to which here used had no affect in dimin disch.

And from influ as binding belly was obliged to discont it.

While at same time urgen of pains led me to use of opiate.

To counteract bad affects howevr comb. it with an astring the Elix Vitriol. & a purgat part of same nature the Vin. [Rheu]

While from these however some dimin of disch & allev of pain no influ [as] as moving bely.

By this led to drop the Vin [Rheu] & to use as gentle laxat. the Crem of Tart.

On this course patient at pres. cont.

If however can be avoided is not my intent to persist in use of Laud.

But to cont with Elix. of Vitriol alone.

And to try, how far pushd to consid extent, will in this case be attended with good affect.

Before desert. use may conj with most powerful veget tonic viz Peruv. Bar

Or may give this united with Vitriol acid in diff form that is powder of [alum]

Should these fail many other tonics which may be recom. both to be applied general & partial.

Such for exampl as cold bathing

As cold or astring applic to affected parts.

But before recom. these may prob have [illegible] what effects to be derived try what effects to be derivd from med operating on a diff [prin]

Use for example of stimul partic acting on parts in neighb of uterus

But especialy of Tinct of [illegible] externally internally & of blist externally.

[From] [these] howevr more probab. [that] shall not find it necss to have recourse

And inclind to hope that from [remedies] already mentiond shall derive all relief [which] expect in pres. case