DEP/DUA/1/25/02 (Transcript version)

Katherine Duff

(1780-1781)

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Kath Duff.

Disease prin stomach compl.

But affected also with pains & swelln partic in ancles.

But if these most distress sympt anoth not less import.

State viz of Menst. disch.

Obst. for some time before came under our care.

[Prev.] to that irregul & scanty.

At least such acct. of patient.

Regul. of this disch. much com. with hea health

When obst. howev. cannot alway pron it cause of disease.

Often a conseq of affect of syst.

In other cases howevr prod of an alm infin numb of appear.

Perhaps no sympt to which may not give rise

And to none more freq than those in pres. case.

There then first quest. whether an idiopath or sympt.

Or rather whether subj to Ammen or to any othr disease.

Is somewat in fav of [depend] on other affect that no obv. cause giving obst.

But ammen by no means unfreq [with] obv. cause.

And still stronger arg. that idiopth

For no preceding disease by which can be induced.

If acct. to be credited occurd as [first] sympt

Cannot indeed put abs. depend on these

Yet as little reason for doubt them.

And sympt such as Ammen well known to induce.

Cannot therfore consid Amen. then as sympt of any other affect.

But besides disease anoth cause often giving obstr.

And that too connected with health

That is pregnant state

Here often very great diffic.

Obst. freq. pretended as means of obt abort.

And this may have been cause in pres. case

This in many cases if patient [afflict] imposs. to discov.

And must always be a good deal [determ] by opin of integ of patient.

At first here very doubtful.

But from all inquir no reason to quest. veracity.

And in fav of patient that ascribd no partic cause for obst.

For when pregn to be [concernd] some other cause alledged.

Still more in fav. Length of time.

Now accord to acct three years.

And no reason to doubt integ.

Upon whole then, after suff opport for exam concl idiopath Ammenorr

Of prognos. after patient already dismissd observ. superseded.

Have at least obt. tempor. cure.

And little doubt that to be attrib. to pract. empl.

Would not howevr assert that permanent

And shall not be surp. to find that afterwards both irregul & scanty.

In that case may again expect return of form sympt.

But at pres. at least free from all affect.

And in this situat dismissd.

Here little doubt in asserting that this in good meas conseq of treatm

Treatm of Ammen on very diff prin.

A natural conseq of depend on diff caus

These however variously viewd [accord] to idea of cause menstruat.

And of this as had occas to observe in theoret lect great diver of opin.

Am however inclind to think that always refer to one of three causes.

Want of due accumul.

Want of due action

Obstruct to natural passage

Often both from first & last.

Yet want of due action most freq.

And this supposed case in pres inst.

Treatm therefore to be directed with that view.

But at commen from doubts [unwilling] to use strong remed

Partic from doubts respect. pregn.

Began therefore with gentle meas.

Directed only common aloet. pill.

Not here indic by bound belly.

But by free disch epectd mitig of stomach compl.

Had princip in view howevr operat as stimul to rectum

By this often happens that influ so far commun as to operate as stimul to Uterus

And thus from renew action prod disch.

Not indeed powerful.

But even in cases of pregn. safe.

And was intent to employ it till more cert. that no pregnan.

Conj. howevr infus of veget bitt. & [Am]

Mixt of Infus Amar & Tinct. [Aromat]

In this also double intent.

The mitig viz of stomach compl. first object.

Well known that with this intent often useful

Partic as expelling wind.

And this reason to pres. [concerned] from swelling of stomach & belly.

But while thus relief useful also against Ammen

Not indeed means of immed excite action.

But from operat as tonic gives that condit to uterus necess for action.

Thus when accumul prod & cause excit [action] returns that action more forcib.

On this course pat contin for some weeks.

And seemd to have some [influ] as mitig stom compl.

Had however no effect in restor. [illegible].

Consid it therfore as inadeq to affect.

And now concl. that obst. not from pregnan.

In this situat then vent to have recourse to more powerf remed.

Use viz of Electric.

This hold to operate entirely as affect state of action in uterus.

In this way operates on double princip.

Is efficac as restor disp. to action where wanting or impaired

Is effic as immed induc action

Infl. in both ways demonst by effects in other diseases

In first way exempl in use in [Paral]

In last in [affects] when [actioning] on [moving] fibres out of body or on [animal] body newly killd.

In lattr case electric shock [contr] of all musc. after infl of mechan stim has entirely ceased.

This I appr. operate as immed excit disch.

And in some inst flow app [while] patient on wheel.

But can only happen where prev accumul.

And more freq operates as giving disp to action.

Thus menses at natur. period of employm of electr for some time

These then sentim as to operat of electric in Ammen.

But whethr right or not that a most effic remedy not to be doubted.

This abund proved by late expr.

Partic by cases pub. by Mr [Birch] of London.

And in many inst in my own pract. have seen it prod of effect after other had faild.

Here not disapp.

For in short time, flow restord & patient dismissd cured.