DEP/DUA/1/19/20 (Transcript version)

Cecily Kinnaird

(1778-1779)

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Cecily Kinnaird.

Had this patient been able to give regul attend. case might have been consid as exhib to us ex of an affect, both in nature import & not without singul.

Affect to which subj. consisted alm entirly in one sympt.

Disch of blood viz from vagin.

For can be little doubt that to this other compl. debilit viz & even pain to be attrib.

Here could have no reason to doubt that blood disch was evac from uterus.

Or in other words that disease [Menorr]

Mennorh. however very general least consists of encrease merely of [Mat] [evac]

And while this bloody disch occurs at shorter interv & to greater extent than natural is yet by no means without interm.

Especially at comment.

That is still has cont for months or even for years.

With our patient however but of recent date.

First commen only two months ago.

But since that time are told that has contin unif without any interm.

And even accord to observat of patient encreas in quantity.

In this then unquest singul.

But perhaps no less in cause from which derivd origine.

Commen. we are told from a miscar.

A circum which by no means unfreq gives rise to Maenorrh.

But certainly very rare to find fem subj to miscarr. at 50^th year of age.

This however period to which accord to inform

Singul in this respect probab to be in some meas expl. from cause.

Derivd origin from a miscarriage.

An accid which well known very freq to give rise to it.

And although most gener prod it in common form yet more ready to induce it in state of mere passive haemorr. than most other causes.

For either from causes giving produc the miscarriage abortion, or from separ affected between vessels of uterus & placent. consid rupt. may occurr.

From such rupt however should naturally look for disch being greater at first.

As rupt vessels even when tone very much dimin must still be [sups] to retain some tenden to contract.

And may naturally imagine that from [illegible] of coag. blood some addit obst. given even without [contract].

Here therefore may concl. that haemorr in some meas supportd by determ to uterus or by action of that viscus.

Yet still inclind to suspect that as it was at commen, at contin to be princip of passive kind.

On this footing then imagind that chief obj in cure was the giving addit resist at bleeding vessels.

For this purpose meas unquest the most effect are the diff astring.

And for this purpose of this kind know none better than Pulv. Styp. of Ednr Pharm.

Under this title no formul in Lond Phar

But has had place in five success edn of that of Ednr

In all formr ones a combin of Alum with Sanguis Dracon.

Effic of former of these artic as a powerful astring univ known.

As is indeed case with every combin of vitriol acid where in such [illegible] that capab of exert. effects.

With respect however to other artic Sanguis Dracon as has been [absurdly] calld for in reality a prod of veget kingdom more doubt.

Especially in state in which here directed to be given viz in substance

This vegetab resion subst. does [indeed] show marks of astring as acted upon by a Spirit menst.

But in all watery fluids & probab in these found in stomach totally [in]

May concl. therfore that will pass off without any action whatever.

And although may have virtues as acted upon by Spt. yet these not ascert. probab not consid.

Hence then inclind to think that little injury done to Mat Med of Ednr Coll from being expung from list.

But whether this with prop. or not can be no doubt that Pulv. Stypt [imp] by change in last edit.

When to Sang. Dracon. have subst an artic still giving med its former app viz the Gum Kino

That this veget subst both solub in fluids & exerts astring to consid [degree] fully ascertaind.

Although at same time as well as formr more of resin than Gummy nature

With alterat of artic comb with alum propor of ingred also changed.

Now more purely alum than formerly

In so much that G. Kino may be consid as intended for little other [purp.] than colouring.

Cannot help thinking howevr that with alum artic might be united acting both as corrigen & [illegible].

And for this purpose have often employ with advant, not only larger propor of veget astring, but also, small addit of arom as Cinn. or Nutmeg.

Am of opin also that some object occurs to G. Kino in solid form as well as Sang. Dracon.

For former also at least most [readily] acted upon by Spt. menst.

And cannot help thinking that have better Pulv. Styp than either in combin of Alum with Succus Japn

But especially in purif. state.

Such a powder either with or without addit of aromat have often employd. in inst of Maenorrh with best effects

Here however directed med at first in estab. form of shops.

And hoped that might be found [attend] with good effect.

While howevr advant expectd here from med given constrict of vessels must also observe that effects greatly aided by avoiding all causes augm form tend to expuls of blood.

Hence then in passive haemorr in gener. great advant from avoiding any stimul cause.

But partic motion.

Than which no circum perhaps which has more influ as giving rise to renewals of Haemmor. in Mennor.

Cannot help thinking then that pres. patient judged better by conf herself to home than by cont. attend.

And indeed [during] motion to which this must have necess. sub. her. med by no means most fav opport of prod full affect.

Less therefore to be [regretted] that attend so soon discont. as to depriv of opport of knowing affect of praescrip.