DEP/DUA/1/23/03 (Transcript version)

Helen Young

(1780)

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Helen Young.

Disease of this patient an obv. local affect.

And if pres suspic are not ill founded of most danger tendency.

Consists if not entirely at least prin in fungous [excress] or tumour on [right] angle of mouth.

From even appear of this alone very strong reason I think for presum that is of Scroph Cancer. nature.

This suspic corrob by severe pains shooting to other parts.

But still more by enlargem of lymphat glands about fauces.

For little reason to doubt that these affected in conseq of absorpt from this tumour.

And now univ admitted that affect of neighb lymph glands one of strongest marks disting tum of schirr. cancr from those of [simple] schirrous nature.

Is rather in favour of this suppos. as otherways that patient knows no cause to which compl. to be attrib.

Upon whole therefore, although has not yet proceeded to prop ulcerated state, yet may with some degree of confid venture to pron it an example of cancer.

Here indeed but fair to ment. one circum which may be supp to create some doubt.

That is scroph taint which seems to have been origin in pat. constit.

Are informd that even from infan some marks of such an affect.

May therefore be matter of doubt whether enlarged submaxil. glands be not of this kind.

But even admit this to be case cannot I think suppose it with regard to affect of mouth.

Appear, pain & every other sympt, much more in fav of cancer than of scrophul.

While at same time well known that angle of mouth seldom seat of scroph, freq of cancer.

And upon whole greater probab that gland swellings are as already suggs from absorpt of cancer virus, than from any other cause.

Taking it for granted then that affect is cancer. prognos cannot be fav.

Although far from consid it as entirely incurab. yet must admit that in every case a danger disease & in greater part even fatal.

And this especially case whether either from situat of affect. from determin of patient, or other circum cannot admit of artif removal.

From this circum consider dangr in pres case, as very much encreasd

While at same time not less to be dreaded from progr which has already made.

Has not it is true either arisen to great size or yet degener. to ulcerated state.

But to be observd that only two months since first appear.

A period which for a cancer. affect is proport. very short.

Even during this period however has already proceeded so far as to create very great pain.

And if susp well founded to give affect of other parts from absorpt of cancer virus.

To all this to be added that at pres in such a state as to have even manif encrease.

And Am therefore dispos to fear that all efforts to stop progress will be ineffect.

And that patient will at length fall victim to the affect.

Begin treatm therefore without any high expectat.

Yet still case may at least afford us opportun for trial of diff med.

And if any found to succeed will afford stronger inst of effic.

In treatment of cancer in general many meas may be taken with view of allev. sympt.

But radic cure in gener to be aimd at on one of two princip.

The restorat viz total removal of diseased part.

Or the restorat of it to sound state

First of these to be effected only by mechanic means

That is either by operat or caustic.

Prop. both of one & other have among diff pract. been much subj of [debate]

And this has partic been case with regard to extirp by operat.

For where size consid caust. [tota] in applic.

Into controv. however how far in any case is or is not advis. would here be [improp] to enter

May only observe that for my own part, consider operat which is admiss or where patient will subm to it, as being the pract of all other promising greatest success.

And notwith unfav situat in pres case as well as deform which must necess give, should still [illegible] it for interest of [pat.] to subm to extirpat

Of this however whatever may afterwards be case at pres no prob.

And in mean time at least other meas not to be neglected.

In restorat of part to sound state where cannot be removed, two obj to be accompl.

1 The restoring a prop condit to vessels

2 The restoring due state of action to vessels.

Is I appreh on these princip that to acct for effect which sometimes at least has been derivd from certain med, where affect even manif cancer.

Partic from those vegetab. [comb] with narcot power that also of pecul stim.

Of these none more used than the Cicuta.

Of introd of this vegetab. against cancer, or of pres charact. need offer no observat.

May only remark that notwith [disered] into which has of late fallen am fully satisf. that have in many cases seen remark effects from it.

From this consid then determ to give pres patient that chance which it affords.

And for this purp have begun here with intern use of it.

Is intent to employ it for some time by itself only & in this form alone.

But if thus incap of stopping progress of affect shall use it extern as well as intern

And in both ways mean to comb. it with mercury.

Extern with a solut of corros. subl & internally with Calomel.

From such addit am inclind to think that in some inst have seen powers encreasd.

At same time will be no more than I already dread if in pres. inst shall in end be found unsuccess

If this case besides attempts to allev. sympt. may try also other meas.

Partic if shall be able to [proc] them the verucae Equinae or Horse warts.

But as after meas must be regul by the then state of disease as well as inclin of patient at pres unnecess to say any thing resp. them.