DEP/DUA/1/33/32 (Transcript version)

Nelly Spalding

(1783-1784)

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Nelly Spalding. Janr 24

Disease of this patient when came under our care consisted entirely in affect of left mamma.

And there app. under form of indur & irregul swelling.

From progr of this affect. from contin & various other sympt could only be one doubt with respect to it.

Whether viz were to view it as [shirrous] & cancer. affect.

These indeed I must own, for my own part hold to be but diff stages of the same disease

Look upon occult cancer as being as it were medium between open [canc] on one hand & schirrus on other

And am inclind to think that as much connected with latter as former.

Still however even suppos them progress stages of same affect yet in these Prognos at least much varied.

And in proport to advances danger very much encr.

In case before us disease cannot yet be consid as having all charact of occult cancer.

And in partic no app of any virus absorbd affect neighb. glands as induc swellings under axilla or the like.

This indeed, I must own, I hold to be strongest sympt, of affect having degener. from [shirous] to cancer. state.

But by no means only mark

And in case before us two partic occurr which are also strong indic.

The one is the state of integum above the part.

Skin of mamma we are told [rugou] app & pursed up like [scorched] leather

This state of integ in gener [preceds] those [chaps] & fissures which consid as first state of open cancer.

And indeed argue occult cancer being even far adv

Accordingly this state of skin, was held by late emmin Dr Hunter one of first anatom of age as certain [mark] between schirr & cancr.

Another partic also disting two is cancin. pains.

These seldom if ever attend of mere shirros. but one of most distress sympt in Cancer.

With pres. patient however when came under our care were become very freq.

From these therfore as well as from state of skin could have no doubt in consid affect as examp. of cancr.

And from this view of disease will readily concl. that must be very appreh of conclus.

Though some recov from cancr yet in by much greatest number of cases fatal termin.

And that too even where app. has been for some time flattering.

Hence therfore, must not rashly conclude from allev. which has taken place, that affect will go on with [uninterrupt] progress to recov.

Would not be at all surpr. if should again take turn for worse, & even in end prove fatal.

At same time, advant already obt, give at least hopes of fav. concl.

And these advant, I must own, cannot help being disp. in great meas at least, to referr to pract here employd.

First pract here empl. were you will obs. extern friction with Camphor. oil & the intern use of [Cicu]

That first of these inadeq. to removal of Cancer is indeed true.

But at same time, can be no doubt, that both from penet. nature of Camph, & from influ which [impr] made on superf vessels of part, have on those deeper seated, has very consid effects as tending to remove obstruct & renew circul. though indur. tum.

Here therefore expected at least that might in some degree coop with remed taken internally.

And on that I own, expect of success were chiefly founded.

Cicuta the intern remed here used, was given united with Pulv. Cretac merely for prop. form.

And was from Cicuta alone that good effects were expected.

This narcot vegetab. need not obs. first introd against Cancer by Dr Stork of Vienna.

And since much empl. by others, very diff ideas formed with respect to it.

Some consid it even as altogeth effic.

And that not adeq to cure of every case of Cancer no one will deny.

For my own part however am very much persuad that have often seen good effects from it.

And where no other conseq. has at least very gener. influ in obviat those urgent pains with which Cancer attended.

This effect seems to have had to remark degree in pres. inst

For from time that began use pains much allev.

And by contin have now we may say almost entirely left her.

For during course of Cicuta tumour has not only become more moveab but also accord to her own acct. both dimin. in size & softer to the feel.

During use of Cicuta, belly became bound.

A circum. which on sev accts was necess to obviate

And with this intent. had recourse to Aloet Pill.

An artic, where merely wish to obviate costiv, very gener. attended with best effects.

But here could not be supposed to have influ in any other way.

To Cicuta therefore may I appreh with justice attrib greatest part of relief that pat. has obt.

Of late indeed in place of Camph. oil have empl anoth very active mode of cure.

The drawing viz Elect sparks from the tumour.

This pract with pain of which pat. compl. was I own at first affraid to empl.

Because from encr. action of vessels some chance that may have converted ocult into open cancer.

But hold it to be one of most powerful means of [renewing] circulat.

And hence of [discuss] or resolv indol. tumours

After therfore disease had taken fav. turn & pain almost gone imag that might be had recourse to both with safety & advant

Since employm has at least been attended with no bad effect

On contrary progr in dimin of tum rather more consid.

And from contin some ground to hope even for complete resolut.

Is with intent of trying how far will have this effect by itself that have given up use of Cicut.

And mean unless circum indic other pract shall occurr to persist with use of Electric alone.

If under contin of use, resolut shall be effected will I own consider it as strong proof of benef of Electric.

But if pains shall return will again have recourse to Cicut.

And I hope with same effect of obtaining mitig.

But whether that shall be case or not cannot help thinking, that what have already witnessed in this case affords evid of benef of Cicuta at least in some cases of Cancer.