DEP/DUA/1/37/04 (Transcript version)

Rachael Drummond

(1785)

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Rachael Drummond

Disease to which this patient subj when came under our care very distinctly marked.

Consisted of swelling affecting the infer extrem & bearing impress of finger on press.

This swelling while grad encr. through the day very much dimin from horiz post. during night.

From these diff partic their could be no doubt in consid it as depend on water.

And as afford ex of Anasarca.

And indeed besides these charact sympt. had here also other comm attend of the disease.

Respirat indeed we are told free

And must be allowed that in inveter cases of Anasarc. almost [alway] in some degree affected.

But often in begining of disease as with this pat. entirely wanting.

And here had, which a much more common sympt. of the disease, an affect of the excret. partic of watery.

For while belly during course of the affect was bound, urine also scanty

Upon whole then no doubt resp. nature of affect.

And although pat herself not sensib of any partic cause to which could be attrib, yet prob. that had proceed from obst. of perspir, by cold or like.

For this often has affect where not obs. And rather to be susp. from [comm] about [face]

And here no evid of any fixd affect of any kind

From this conj as to cause as well as from being but of recent date, had reason to hope, that would not prove obstin.

But must at same time acknol. that when came under care did not expect so speedy fav termin, as has taken place.

For in cases even app. very sligh sometimes diffic, in remov. of water.

Still more in preven of return, after once removed.

Did not therefore expect, that in space of forthnight, would have been entirely free from affect.

This recov. however am by no means disp entirely to ascribe to pract here empl.

For will obs. that prior to applic at the Disp, a spont diarrh had occurred.

Had for space of some days to extent of six watery stools in 24 hours

Such a critic evac as it may be calld cannot be repres as very rare in dropsy.

Sometimes even is means of recov in most desper. cases.

And that too after artif means of cure have been tried in vain.

Indeed perhaps few diseases, when by spont. evac, whether in way of catharsis or diuresis, more unexp. cures have taken place.

As occurring spont remarkd to have much more influ, than when artic induced.

Prob. because in former case, disch always affect of prev absorp whereas in latter, is affect of stimul med taken, which may have influ whether stagn [serum] absorbd or not.

Hence then understand why in one case, more certainly accomp. with remov of swelling than in other.

To looseness then here occurring can have no doubt in ascrib very consid share in evac of water.

And this at least first step in comb. affect of drop kind.

Consid diarrh. as tenden to natur recov could have no doubt that would have been very imprud to check it.

Espec as had not taken place to extent in any degree alarm or even distressing.

Seemd therefore more prop to encourage & support it.

But here could not with prop. have empl. those brisk cathart to which recourse is often had in dropsic cases.

Where belly bound brisk stimul cathart. Jallap & like, directed both as means of induc disch and encreas absorpt

From these however, in circum of pres pat. some danger of [hypercath].

And form tempor. great evac, chance even of checking after salut disch.

Hence then here obj, merely to prom cathars, in slight manner.

But while aimd at encr. disch in this manner, thought it might also be of serv, to augm disch of urine.

Had therefore recourse to a med, which has tend to operate in both ways

The use viz of Crem of Tart.

Even in most obstin drop. cases & where greatest evac requird, this conj with stim cathart, prod of best affect.

And from addit of a prop of Jallap, Gamb., or like, can obt from it, full affect even of most drast. cathart.

Here any such addit unnecess.

From consid influ however which has on stom as a refrig, consid some corrigens as necess. proper

And accord. added to Crem of Tart, a prop of Cort Cassiae

Which from essent oil it contains hold to be one of most powerful, & grateful of aromat cordials.

And indeed except in artic of price, nothing infer to Cinnam. the bark of anoth spec of same genus.

The one Laurus Cinnam other Laur. Cass.

From this formula then, expected suffic effect in open belly, & some influ also as diuret.

But as still farther means of promot that disch. directed also a small quant of squills.

These empl under form of Pil Scillit made with powder of dry root which hold to be most effic prepar. both as diuret & expect.

In operat of these med were not disapp.

For though looseness not encr. from Cream of Tart, yet contin to extent of sever stools in day.

And at same time urine very consid augm.

Under these disch as might nat. have expected, from circum of pat. swellings soon much dimin

In this situat, at second report though some swelling still remaind, seemd advis to have recourse to pract with view of prev. return.

By some indeed has been supp. that tonics not to be had recourse to till swellings compl. gone.

For that by use prev to this, disch apt to be checked, & thus remov of swelling retarded.

In my own pract however, have not seen any such affect.

And am convin, that in many cases, evac & tonics may be united, not only without prejud, but even with advant.

In inst before us, as far as [pract] could be ground for any concl, that observat confirmd.

For under use, remain swelling soon disapp.

And in very short time, dismissd free from all her sympt.