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

Catherine Menzies

(1778)

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If in case of George Allen an ex of Ascites in that of next patient Cath Menzies a no less manif inst of Anas.

Here from nature of swelling with which patients legs affected can be no doubt respecting cause.

That dep. viz on effus of watery fluid into cellular membrane.

And although not pecul separated in infer. extrem yet more especially making appear there in conseq of free commun of cells & depend situat.

And accord observd that this swelling most consid at night.

A circum if not univ at least very generally happening in Anasarca

And which indeed must be necess [conm] of [erect] post through day.

Unless from influ of action as prom absorpt greater quantity of water [carried] off, than what brought by infl of grav.

This however can only be case either in inst of very slight anasarca or where conval condit has taken place.

Neither howevr the case with our patient.

For although disease by no means very consid yet to be consid as being in encreasing state.

And from this circum togeth with nature of disease preclud from giving fav prognos with great confid.

Nothing indeed in appear mentiond in history of affect which could be lookd upon as very alarming.

Yet none of common sympt of [anas] affect here wanting.

For besides impaird appet for solid food, here there also occurrs encreasd inclin for liquids with manif dimin of quantity of urine.

And what perhaps to be consid as worse than any of these irregul of menstruat.

For inclind to consid this circum not as cause but conseq of the disease.

And look upon it as indicating a state of habit from which affect will have tend to be rendered obstin.

Hence therfore unless in conseq of [illegible] meas. should not be surprisd to learn that affect has in the end a fatal termin.

[Probab.] howevr is that by due medical aid affect may be overcome

And here unquest first object to disch water already effused into cellul. memb

Evac of water however although first by no means most matter part of cause

Is an object of still much greater conseq. to prev return.

This however to be affected rather by regim than by med.

Partic by such diet exercise & air as has tendency to strengthen & brace the syst

Evac may be effected either by means of natural or artif outlets

Latter unquest afford most immed exit. yet besides being subjected to many other [inco] of no farther peman. than length of time for which disch. cont.

Hence unless in most urgent cases prefer very univ given to natural outlets.

From vesicles of cellular memb. now [are] admitted that only outlets as lymph absor

And by these merly depos. in mass of circul. fluids.

Hence then evac by natural outlets to be affected firstly from absorpt

And secondly by augm serous excretions

But more partic by inducing dich of seros from mass of [fluids] either by stool or by urine.

Latter unquest best fitted for habits greatly debilit & where disease of long cont.

But former a more exped means of cure

And at same time a more affect means of promot absorpt.

For while this in some meas [conseq] of evac. arises also to certain degree from stimul of cathart.

Cannot indeed by asserted that all cathart possess stim power.

Yet this a quality at least of many of them

And partic of those cheifly used against dropsies.

Is especially a prop. of Jallap.

This therfore the purgat which here meant to employ.

Directed it however as combind with Crem of Tarter.

From which hoped both that purgat [powe] would be encreased, & that some affect would be prod in way of diuresis.

But as patient did not afterwards attend us had neither opport of prosec course nor indeed of seeing learning effects of first exhib.