DEP/DUA/1/34/18 (Transcript version)

Christian Stuart

(1783-1784)

---

Christian Stuart March 13

Concerning disease of this patient am I own very much at loss.

And that perhaps not more from nature of affect, than from indistinct acct. which patient gives.

From being always accust to speak Erse probab. neither underst. what said to her in English, nor capab of giving answ. in that lang when does understand it.

As far however as are capab of judging by what can learn from her, is subj to many diff sympt.

Partic affect of breathing, cough, pains of back & abdomen, & general debility.

But above all a period disch from the vagin of a whitish coloured fluid.

With this circum reason I think to presume that all other compl are connected.

At least ground for entert this suspicion, with regard to some of them, from varieties here said to [occur].

For with regard to affect of Resp & cough, are told that these subj to period remiss, for some time before app of menses.

And that after that period is passed again return with former viol.

With regard to pain of back, this also, well known to be an almost const attend of fluor Albus.

And here both this & [pain] of abdom also, obs. to be partic severe immed preceding disch from vagin.

But in place of usual menst. disch have fluid of whitish colour merely streakd with blood.

Consid disease then as chiefly [char] by this white disch would give it name of Leucorrhoea.

At same time must be allowed that is a Leucorhoea with very pecul circumst.

But of these, in a case where have already expressd so much [uncer] as to data on which proceed, would be improp to offer any conject.

And may natur be supposed, that can as little say any thing with regard to termin, as with respect to disease itself.

May only obs. that my expect of being of any service to this patien are by no means great.

And am very appreh that shall dismiss her in no better [situ] than when came undr care.

May however add that as far as can learn of hist of case, was formerly in more distress situat than at pres.

For then in place of menst. Haematom occurred.

A circum though less danger. in that case than others, yet [alw] giving some ground for alarm.

And as sympt of themselves [have] abated in viol, may here expect even natural cure.

Partic at that period when menses should naturally cease.

And from circum of this patien as well as age to which she is adv that probab not now very far distant.

Notwith decline of health therefore yet still if repres of case not erron may look for such [termination]

And on idea given of disease diff. remed which promise at least being of some advant.

This partic to be lookd for from those artic which tend to brace & strengthen syst.

For from restor of vigour in pres. case if return of menses to be brough about, chiefly to be expected.

On this plan, pract hitherto emp. have been chiefly at least directed.

Began indeed you will obs. by ordering for this pat an Emet.

Chiefly that by thorough evac of the stomach the Peruv. Bark [which] at same time prescr. might have more effect.

On this remed our patient cont. for space of week

But without deriving from it at least any consid immed advant

For although disch of white fluid from vagina ceased, yet as much as before compl of uneas at stom & pain of back.

Concl. therefore that was only from long contin that much to be expected.

And hence judged it necess to subs. for the bark a cheaper med.

To this foreign artic many, which are prod of our own country nearly [at] least app in sensib qual.

And though none it must be allowed equally success. yet from some, good effects in diff diseases obt.

This partic the case from the diff. bitters & aromat.

And indeed is at least the most [gen] received opin. that on a combin of bitterness & aroma, the virtues of bark depend.

Of all the vegetab. bitters one of purest & strongest is Gent.

Root however of such spungy text that does not readily admit of being reduced to state of powder.

But this less to be regreted as freely imparts qualit. to watery ment.

And accordingly Gent. employd as active basis, of the Infus Amar. of our Pharm. one of bitters most freq. in use.

In that formula besides bitter some aromat also enter.

For is solely with view of impart aroma that addit is made of small proport of Orange skins & Corriand seed.

While again proport of Spt which enters the menst. merely [intended], merely intended for preservat for prop length of time.

In this formula have one of most agreable bitters & best subst. for bark [with] which have for my own part at least any exper.

Have sometimes even by means of it cured interm.

Still more freq. have found it useful in prev. return, after remov. by bark.

On this then here put patient.

And is intent to contin use for some length of time

At least till shall have again period return of the disch.

And by that time shall [perhap] be better able to judge how far pres idea of disease well founded or not.

According to idea however [which] then have, future pract if necess must be directed