DEP/DUA/1/39/38 (Transcript version)

Helen Spalding

(1785-1786)

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Helen Spalding. April. 15

When formerly spoke of this pat. case, pron. it to be distinct markd inst of Anasar.

And expr. hopes, that in no long time, might be brought to fav concl.

During pat. attend here, no circm occurrd, giving least reason to alter opin.

And some time since dismissd from attend, entirely free from all compl.

Event therefore, has so far at least, conf. prognos. formerly given.

In this indeed, as in other drop. it is true, that app remov of affec, least part of cure.

For few diseases more apt to have recurr.

And much more diffic matter to prev return than to remove affec.

But should this even occur. after interv which pat. has now had, rather to be consid, as fresh inst of Drop, than any thing else.

Here however, would even flatter myself with hopes, that have obt compl. & perm cure.

And this indeed, should in som degree inferr from circum of case [itself].

For in these, many partic highly fav.

Cannot indeed say, that swellings slight & inconsid.

But still entirely of anasar. kind.

And no reason to susp. depos in any other cav than cellul. memb.

No farther swelling of belly, than what merely from enlargm of legum.

And no fluctuat discov

Had indeed it is true some cough dyspn & pain of breast.

But these merely from what might be calld anas. of lungs or slight accid catarrh.

For no sympt in case, which common attend of hydroth, as sense of strict in breast, frightful [drem] start in sleep or like.

While again, disease of very short contin, & ascrib. merely, prob. with just, to action of cold.

Might perhaps also reckon it even among fav. circum, that urine disch.

For in that case, at least greater chance of benef, on restor. of free disch.

While however circum thus fav., still nothing in case, which seemd to indic tend to natur. cure.

Is indeed true, that such often suddenly & unexp. affected.

Partic on encr. disch either by urine or surface.

But at same time, in gener. of cases, unless removed by artif means, contin grad to encr in viol.

And the longer it contin, the more diff. the cure.

Here as to gener. grounds on which cure to be attempt, almost all pract are agreed.

Cheif obj are, to remove water alr. effused, in cellul. membr., & to prev [return]

Where water can be remov. by natur passag., unquest much pref to inst artif.

Only natur outletts howevr [illegible] cellul. membr, are absorb.

Hence then, becomes first & prin obj, to encr. their action.

And indeed to me seems probab. that from morb. dimin of their [action] a great [major] of inst of anas. arise.

Action of Lymph however, well known to be much encr. by [demand] made by syst, in conseq of encr of serous disch.

And as here urine remark dimin seemd natur to indic, prop of attemp to encr. absorpt, & disch water by augm. it.

From this therefore, determ to have recourse to diuret.

And as such here resolvd to [make] trial of Nicot.

This artic lately recomm to attent of pract by Dr Fowl. of Staff.

In a short treatise, lately pub. entit Med. Reports of affects of Tobb has given, many cases, afford very strong proof of effic.

From his treatise app, that may be success exhib, under diff formulae.

Has given it in subs, & as acted upon both, by spirit, & watery menst

But of all his formulae, am a priori at least, inclind to think, that Vin Nicot, prom to be most useful.

For no doubt, that this subst, derives activ. both from an oily, & saline impregn.

Hence mixt of water & spt, which have in wine, prefer. to either separ.

From this then, led to direct Vin Nicot, to pres pat.

At first gave it, to extent only of [gt]. XX, bis indies.

But even from this quant, some slight sickness.

Had however, at same time, affect of prod consid augm of urine.

And what a still more agreeab occurr, this followed by corresp. dimin of swelling.

While however swellings fell in other parts of body, that of legs, rather augm.

And at same time cough cont severe.

A circum to be consid as indicat, that still depos in lungs.

Seemd therfore necess, that some partic meas, should be directed to [this]

For as already sickness from [drop] Nicotian could not with prop, encr. them.

But with contin of these, directed you will obs., two Emet, & frict of legs with Camph oil, to which added small prop of Vol. Alk.

Need hardly obs. that this introd to stim to action, lymph in these in partic

For while leads to more [illegible] & regul contin of rubbing, is at same time, a powerful & penet stim.

And am inclind to think that have often seen consid benef from it.

From emet again had in [view] the prom absorp from syst in gen.

And espec. from lungs while exp. also from benef both as reliev cough & dyspn from prom expect.

[These] med had every app at least of answ ends intended.

For while not disapp. in obv. op. found her at succeeding report entirely free from cough & dysp. & swellings almost totally gone.

In this situat. still however though it advis to support disch of Urine by contin of Vin Nicot.

While as means of strength syst had recourse to Cort. Querc, with Cassia

And whether any affect, or not, yet patient soon in such situat that farther attend unnecess.

& Dismissd in good health