DEP/DUA/1/22/02 (Transcript version)

Mary Monro

(1779-1780)

---

Mary Monro.

Case by no means without diffic

If acct indeed to be dep on dist markd.

And an affect by no means uncom.

Disease accord to repres from fright by burning of neighb house.

At that time menses flowed

By this suddenly stopt.

To obst. thus occurr. all other sympt referd.

These princip. Naus. sickness at stom vomiting, headach vertigo.

Accid well known freq. conseq of [obstr]

To same source also may referr other symp

Such for ex as Borborig. Flatus & foetid [crust]

These indeed less freq from obst.

But sometimes also from this cause

And indeed hardly any sympt from which may not arise.

These latter indeed may more [illegible ] proceed from constip.

A condition here occurring & well known freq to prod them

But even thus also prob [return] from amenorrhoea.

If therefore repres well founded may consider case as simple & [uncom] inst of that affect.

But with regard to Ammen. repres often not to be dep. on.

Idiopath obstr often pretended when effect of Pregn.

And here all sympt occurring such as pregnan often induces.

Till therefore diagnos cert. estab rest from pract with freedom or confid.

Here indeed durat of affect may seem to afford such.

Said before under our care of ten month standing

If realy the case no room for doubt.

But if deceived in other part. may also in this.

And compl may in reality be of much later date.

Suggest this however merly as possib case.

And princip as no certain indicat of idiopath Amm

But on other hand no partic reason for doubting verac of patient.

And acct given us nothing [improb.]

Hence then with respect both to prognos & [pract] may proceed on supp of truth

And here with respect to termin could not confid expect speedy cure.

Affect arose from cause influ of which very great.

And often indeed remarkd to induce still more threat affect.

Cause acted at time when influ most powerful.

For during menst flux pecul irritab.

From these circum reason to presum that effect consid.

And from facts in reality case

For before came under our care had subsisted 10 month.

During that time many med empl.

And these too prob most powerful.

But without effect either of restor disch or even of allev. sympt.

Now less reason to look for benef.

For syst of uterus long without period revolut.

Speedy cure therefore hardly to be [expec]

If it occurd to be consid as indic effect of powerful med.

If however appear of ted case no ground for appreh of great danger.

Such indeed often conseq of Ammen.

And with our pat. sympt encreasing in violence.

In so much that when came undr care more sever than ever

Still however none of alarm nature

And when such occurr, comm soon after obstr.

At pres. advan. period therefore less reason for appreh.

And even without restor of disch, from obv. some sympt. reason to hope that others would decline.

In so much that without restorat of menses complete recov of health.

Not indeed near age when Mens. disapp

But in conseq of diseas [illegible ] at early [per]

Upon whole therefore not appreh of dang

Yet dreaded tedious affect.

Here consid disease as idiopath Amm still at loss with regard to pract.

For success very much dep on meas being accom to cause of obst.

And in diff cases cured even by opp. [means]

Here reason to presume that first cause of obstr. uncom resist to passage through uterine vessels.

And that this conseq of Sp. from [fright]

Could not howevr suppose this cause to have unif oper. for 10 months.

And must concl. that from [spasm] change induced in uterus itself.

And that Ammen supported either by want of due accum of blood in viscer uterus

Or by want of due dispos to action in that viscerus

Or perhaps both conjoind

In this case then, 1^st object restorat of due accum in uter. vessels.

And if this insuff restor of due dispos of action.

Is prin with these intent that meas hitherto directed for this patient intendd.

Although indeed also in view obv. symp

This however will more fully app from observ on partic pract.

Began with pill Gummos.

An artic of pharm of which have [alr] spoken oftener than once

Though Myrrh. Galb & Ol. Succin enter [compos.] yet effic cheifly from [Assa]

An artic not suited for every constit.

Yet where can be borne stim & antisp effects very consid.

Assafoetid long estemd as emmen.

Cheifly indeed in recent cases.

And where obstr. immed effect of spasm

Better [calcul] for pres. therfore, long before, than when came under our care

But has farther powerf influ as stim to alim canal

No doubt that effect even xtends to rectum

And thus at least in second [way] to [Uter]

Thus then expect that might prom accum

But besides this intend also for relief of sym

Stim indeed to intest not powerf as cath.

Or at least requires large doses.

Yet in this way some effect.

And with partic constit even in small quantity

Hoped therfore that pills to extent of gr X in day means of obv. costiv.

And that thus some relief of affect of alim canal.

Partic foetid eructat disagreab taste in mouth nausea & like.

Hoped also that would thus even counteract borborygm & flatul.

But in this way expectd still more from antisp. power.

And as remov. strict retain flatul one of most powerf means expl. from al. can

But after contin for some time almost totaly disapp.

No appear of return of menses or even signs of dispos to them

Flatul. partic as indic by disten of stomach still to same degree as before.

And had not even influence of movin belly.

As thus ineffect. led to think of anoth med.

And to pil Gum. substit pil foetid cum Aloe.

Formd of equal parts of Alo. Assafoetd & Soap

Effects therefore as dep. on assafoetid not less than pil Gum.

While from aloes higher degree of purgat power.

From this therefore hoped for same conseq formerly expected.

Relief of sympt & determ to uterus.

How far latter effect cannot [pretend] to say

But in obv. operat at least not disap

And effect in obv. one sympt costiv.

Not however with any very great degree of viol.

For seldom effect of more than one loose stool in the day.

And that too without any inconven.

While thus moved belly, some reason to think that stim prop to uterus.

And that thus more free circul.

From this then some ground to hope for necess accumul.

Still however no appear of return of menses.

And although flatul somewhat relievd other stom compl. somewhat still distress.

This however imagined might occurr not less readily that accum of blood in uterus had taken place.

And thought therefore of meas with view giving due action of this visc.

For this purpose nothing equally effect as electric.

Now for consid time celeb. formula in Ammen.

And every day more freq employd in pract & with greatest success.

Where prev accumul of blood disch often instant effect.

[Where] accum not pres. can restore [only] dispos to action.

Thus only occurs after accum return.

And thus perhaps not till used for some time

Or even till after intermitted

Our patient however either disp to put little confid in it, or what more likely much affraid of it.

For not so far a famil operat that terror removed.

And patients in gener. much more affraid of it than of pract more distress.

Whether from this or any othr cause cannot tell but have seen nothing more of patient since ordered.

And even first effects never tried.

Notwith obstin of case had I own expect from use of it.

And if attend contin, should have been anx to give fair trial.

As has now desertd us howev almost unnecss to suggest any farther [meas].

Or to ment what had thoughts of having recourse to if electric had faild

May only mention that in this event was intent to have given full & fair trial to Rubia.

Had it faild in a cure where elect ineffect should not have concl. that void of [activ].

Had it succeeded would I own have given me high opin of power.

And should have concluded that success dep. on penet. nature [affording] stim to uterus.

And that too stim of pecul nature

If these unsuccess, no other artic of tribe of stimul. from which any expect except Mercury.

At same time after electric unsucc had faild no stimul from which should entert any great expectat.

And if disease then curab. to be brought about by other means.

Partic by such as have tendency to restore vigour to syst in gener.

And on this prin take it to be, that even in most obstin cases, success often obt. from chalyb. cold bathing & exercise.

But as little prosp of witness effect either of these or any other pract in pres case, need say nothing farther with regard to it.