DEP/DUA/1/35/26 (Transcript version)

Peggy Fulton

1784

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Peggy Fulton July 2^d. 1784

In hist of this patients case many sympt enum.

And these in general not [much] connected with each other

While at same time many of most distress occurr in various affec.

Such for example as depress of spirits, vertigo, headach &e.

But of all affect in which these occurr, none more common than febrile compl.

And with these we are told our patient pecul affectd during the night.

At which time subj also to profuse sweats.

With these howevr some other sympt also occur which but seldom at least concom of febrile state

Such for example as swelling of legs & arms.

When consid that these dimin towards morning gives indic of being of dropsic kind.

But if this the case are not at least connected with any great dimin of disch.

And never to such a degree as to make what can be clld a perm dropsic affect.

But besides these subj also to other sympt. of still more alarm nature viz bloody expector.

Of this we are told has seldom been entirely free, for consid time past.

For space of near 15 months upon coughing, has very gener. expect a mattr tinged with blood.

But on partic occas this disch. has gone to much greater height.

And has been expect. under form of pure blood to very consid extent.

In this then have unquest. the most import & alarm effect to which patient subj.

And if to give name to disease should consider it as better entit to appellat of Haemopt. than any other.

Nay to this not improbab that some of other sympt, such for examp as sweatings during night, to be referrd.

But at same time sever of symp which probab. little if any imm connect. with it.

Yet even these I think, reason to presume connected with it in second way.

And inclind to think that here haemoptys. as well as all othr sympt, derive origin from one common cause.

Irregul viz of menst. disch.

This you will obs. is patients own conject concern nature & cause of her affect.

And this conject I am inclind to consid, as by no means improb.

At least from irregul, diffic or obst. menstr, very numerous complic & anomal affect are every day obs. to arise.

Is at least therfore no improb suppos, that such the case with pres patient.

And with this view of nature, name perhaps immattr.

But as [illegible] bloody expect most alarm & danger sympt, best [named] from that

And would therefore consider it as example of Haemoptys. Catamen.

With this view of nature of disease, may give more fav progn. than could in almost any other case of Haemopt.

For no doubt that as sympt of obstructed or irregul menst. this disease less fatal than from almost any other cause whatever.

Is in but very rare inst indeed, that proves fatal from mere quant of disch.

And when from this cause, but seldom that has termin in state of supurat. the most comm fatal conclus of this affect.

Besides this, always chance of complete & radic cure, from restorat of menst. disch.

An event sometimes to be accomp by interpos of art sometimes even where least expect it, by operat of syst itself.

Here then on such an occas. have chance of success & speedy termin, of all compl.

But at same time after obst. for 15 months, chance of recov. now much less than if affect of earlier date.

And may here be disapointed in restorat either by natural or artific means.

Especially as from circum of patient, are naturally precluded from some of most effect modes of cure.

Such for example as employm of electric, to which haemoptysis an object.

Also to be obs. that although bloody expect. from Dymenorr. rarely termin in Phthisis yet cannot be said that this never case.

And unquest much more to be apreh. when that state of expect. constant, than when occurs only as [vicar] to menst. disch. & at time when these should flow.

Hence then though not without hopes yet can by no means repres case, as without danger.

If restor of menst. flux accompl. either by nature or art, may I think look for compl. recov.

If hamopt. contin, have reason to dread suppurat in the lungs.

[Thus] then neither ground to be surprized at either a speedy fav. termin, or the contrary.

But before strong presumpt of either event this case may afford us opport for trial of diff pract.

Here as have already obs. Hamopt with tend to degen into purulent state may be consid as most alarm sympt.

But at same time irregular & scanty menstr. as being cause of this perhaps not less an obj of attent.

To these two then thought [that] endeav were here first to be directed

And was with this intent, that put patient on powders consist of equal parts of Rubia Tinct, & Crem of Tart.

First of these artic solely intended with view to affect of [menst] discharge.

Rubia a vegetab. root evid [poss]. some degree of acrimony.

And reason to presume that this of pecul. & penet nature.

Or at least unquest evid that some parts of plant, penetrate even to [finest] & most inacess [vessels]

This abund app. from tinge which colouring part gives to firmest & hardest of bones.

While however from these presumpt of action on extreme capillaries, from observ of facts in pract. alledged to operate as powerful emmen.

And while operates as a geneal stimul at remote vessels, has been supp. to have pecul infu on syst. of uterus.

How far any foundat for this is in my opin mattr of great doubt

And must own also inclind to think that operat as [emmn], has been much over rated.

Yet at same time from many concurring obs. reason to presum that has effect in some cases.

And in this view thought it here well entit to trial.

Imag. however that from imm action on stom, might have some influ as acceler. circulat.

Was with view therfore of counterac this effect, & of operat as corrigens, that conj. it with Crem. of Tart. with influence of which, as refrig well known pract. long well [aqcua]

But besides this from Cream of Tart. expected also some benef with view to Hamopt.

For well known that in this [comp.] often empl. with advant.

And useful both as dimin [impet] of circulat, & from operat as laxat.

On these grounds then expect benef from this combin.

And if nothing shall occurr to alter plan is intent to persist in use for some length of time

To this however may occas [superadd] such pract. as from partic occurr. may seem requis.

Accord when after use for space of week found that bloody expect still contin, directed at the sam time, use of an astring.

Spt. Vitriol ten. viz. still farther diluted, with mucil of G. Arab.

On these med pat has now contin for some time.

And as app. from last report bloody expect. almost gone.

While sympt in other respects much dimin.

Hence then so far at least a change for better.

But at same time shall I own entert no very great hopes till free & copious menst disch.

Of this however can hardly be able to judge till next, perhaps even succeed period.

And during that time, if nothing partic occurs shall persist in pres. course.

If this fails with circum [much] in situat which now [are], have thoughts of trying Cicuta.

If circum change must [adap] treatm to occur. then taking place.