DEP/DUA/1/35/34 (Transcript version)

Margaret Drummond

1784

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Margt Drummond July 19

With regard to disease of this patient must acknowl. myself very much at loss both with resp. to name & nature.

Had indeed some sympt which might be consid as distinctly [charac] partic affections.

Such for example as uneas. of throat.

In this may be consid, as having a partic modif at least, of cynanche.

But at same time, when attend to progr. & course of disease, modif it must be allowed very pecul.

For app. we are told, for consid time, merely under form of pain & heaviness in thorax.

And from thence propag [along] course of stern into throat.

But whatever might be singul in course that when she came undr care, parts compl of, subj to disease, could admit of no doubt.

For disease obv. on exam both externally & internally

[Hence] then must at least adm exist of pecul modif of cynanche.

But that was very pecul modif, app. not only from progr. but also from contin & app.

For had subsisted without any matterial change, for space even of sever. weeks.

And during that time, notwith long contin, still rather under form of [rawness] merely, than of ulcer.

But although pecul cynanche constit consid part of affect, yet this not only disease to which was subjected.

For can hardly suppose, that with this, excess menst. to which subj has any connect.

This indeed, she herself attrib. & probab. with just, to a miscarriag.

But at same time, from early period of pregn. at which was sup. to take place, can have no cert. with regard to it.

Whether however depend on this, or any other cause, no doubt that induced sever of sympt.

Partic excess weakness, tendency to Syncope, & even deject of spts.

For although these may have been in part affect of grief, yet well known also, that induced by by causes of exhaust.

Upon whole then though cannot speak with great cert. respecting affect, yet disp to view it as of complic [nature]

And to consider most if not all sympt as referable either to pecul modif of cynanche or to effects of excess menstruat.

On this ground cannot speak with any great confid, as to termin

And Conject however as to prognosis, the less necess, as patient for some time past, has given up attend here.

And more than probab. that unless from some partic accid, shall see learn nothing farther with respect to her

At same time, if am not much mistaken, have of late seen her on street, walking about app in good health

Probab. therfore that desertion has proceeded from having no farther occas for assist.

And indeed nothing in case which should lead us to think this an improb. event.

But in pres uncert. as to [situat] farther conject would be improp.

And from same reason also, restraind in obs. with respect to Practice.

Here however remed empl. direct with view to both affections.

Against compl of throat, had recourse to an astring gargle formd of Infus Rosar with Mucil.

And with view to strength syst as well as to prev of returns of Menorrhagia, empl. the Peruv Bark.

On use of these med was regul kept, as long as attend here contin.

And during that time at least affect consid allev.

At first indeed though [throt] somewhat easier, yet still compl. of weakness.

But under contin of Bark, with this also came to be less affected.

And at least presumpt that attendanc discontin from having no farther occas for assist.