DEP/DUA/1/37/56 (Transcript version)

Elizabeth Ross

1785

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Eliz Ross. April. 23. 85.

As to case of this patient am I own somewhat doubtful.

Can be no quest indeed that princip sympt consist of pector affect.

And that in these a manif & alarm tenden to Phthisis.

For with other sympt, of hectic fever, pulse at 120.

And although no certainty of purul in matter expect, yet as little evid of contrary.

With these pectoral compl. there is here also united obstr. of ment disch.

And this we are told had commenc about same time with other part of her affection.

With one or other of these all symp mentiond in hist of case evid connected.

And here of this disease, two views may I appreh be taken.

No reason to believe that the two compl. altog. unconnected.

But either may consid pectoral compl as origin disease, & want of menst. as sympt of affect of breast.

Or may view ammen as being the primary affect, & pectoral sympt as only arising from this cause.

For cannot be denied, that hardly any affect, to which amenorrh will not sometimes give rise.

In either view however, must still look upon affect, as of very alarm natur

For whether primary disease, or not, still great reason to presume that this Phthisis does exist.

And wherever occurrs whatever origin may be always to be looked upon as of most alarm nature.

At same time although must be allowed that in any view great ground for alarm yet not equal ground for appreh on both footings.

For idiopath Phthis, much more to be dreaded than that arising from obstr. menst.

In latter case, notwith resemb to Phthisis, yet higher probab. that merely catarrhal.

And even suppos that hectic fever, from purul of lungs, which I reckon essent of Phthisis, yet if merly sympt of obstruct menst, much to be hoped for, from restor of that disch.

But if on contrary idiopath Phthisis, danger much more consid than obv.

For this again a very insid disease & has in gener made very consid prog before indic with any certainty.

Besides this, where menses obst in conseq of it, always a bad symp

Hence then, on this view of the disease, prosp. partic unfav.

But at same time, was I own of the two, rather inclind to former opin.

And this the rather probab, as both affect, comm at same time.

For when menses fail, in conseq of Phthisis, is in gener. only, at late periods.

At same time, from these circum no certainty

And even on most fav view, case still to be held, a very danger one.

And I own am inclind to think, that all our efforts will be of no avail.

Still however, measures may be tried not altog without prosp of success

On idea that pectoral affect was conseq of want of menst disch, first obj in cure was restor of natur evac

And for this purp. med at first empl, were here directed.

Began you will obs. by putting patient on course of Emet, repeated at short interv.

While directed to contin in more regul & unif manner, the use of the Rubia.

That from Emet. consid effects should sometimes be obt. as restor menst. disch not surpr. when consider effects, as giving gener [commot] to syst, & induc circulat, through extreme [vessels]

Hoped therefore that might here have some effect, in this way.

But the rather led to use, from hopes that might mitig the cough.

For with this intent need hardly obs. that every day had recourse to both in Phthis & Catarrhal cases.

And although in former, seldom ultim with benefite, yet often prod at least of tempor advant.

Of the Rubia as an Emmen have already in a former case had occas. to speak.

Then obs. & may again repeat that in my own pract have had no decided inst of effic.

Have indeed given it in some inst, where during use menses app.

But this so often effect of accid, partic when in other respects, patient situat changed, as by admiss into hospit or like, that very little [concl] can be drawn from few inst.

While at same time but too much reason to believe that is sole foundat, for alledged virtues of many of boasted Emmen.

In fav of pres. artic however, not a few, & these strongly markd cases, have been ment.

For some such, may partic refer you to inaug dissert of Dr Spens.

And I own from what there mentiond, shall be inclind to trial, till convinced of ineffic from expr.

Here the rather induced to use, from consid as being in even a doubtful case, a safe remed.

For where susp. that Phthis had already taken place, stimul [illegible] as Helleb. Cantharid, or like unsafe

From Rubia howev nothing to be apprehend.

Here therefore directed employ as comb. with Cream of Tar

But cannot say, that use prod of any matter benef.

And after trial for some weeks, sympt upon whole rather aggrav.

Cough & dyspn in partic so sever that thought it necess to have recour to blister.

And with view to determin from breast shall prob. support disch under form of issue.

With this also, as means of allev, may combin mucil. mixt.

And if that obt. must be directed in future meas, by situat of patient.

At pres howevr have some thoughts of trial of Cicuta.