DEP/DUA/1/40/64 (Transcript version)

Mary Morison

1787

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Mary Morison. Janr 27^th 87.

Form pron. diseas compl.

No reason since for alter opin.

On contrary compl. rather encr.

For now sympt with which not less affect.

And prob. unconn. with any other part of compl.

When app. for assist compl. most distr. affect of arm.

And this inclind to think of Rhem kind.

Had not occurd in conseq of any partic accid.

Yet chiefly app. under form of pain & swelling.

Well known most comm app in Rheumat.

Espec. as here from situat. sex age & other circum no susp. whatever of gout.

With Rheum however app of some tend to paraly state.

For uncomm weakn of arm

And consid dimin of power & fail of motion indep. of pain occas.

This however very common conseq of Rheumat.

Or rather a stage of that affect.

For consid Rheum in its progr as exhib. four diff states.

viz Inflam. Irrit. Aton. & Paralys

Latter indeed in gener. only conseq of long contin.

But at same time cannot be consid as superv at any determ period.

And prob. more conseq of pecul nature & situat of affect than of contin.

Here then consid Paralyt tend as conseq of Rheum.

Or rather Rheum as verging to state of Paralysis.

But at any rate whether connected or not here same evid of Paraly as of Rheum affect.

For while one indic by pain & swelling other by dimin of power of motion & vigour.

From this part of compl. no [reasn] to appr. danger.

At same time could not confid look for speedy recov.

Rheum affect indeed in acute state a good deal under power of med.

But in aton still more in paraly often obstin.

And partic apt. to be renewed from slight causes.

Here however had not resisted powerful med.

And as far as Paralys. at least but of recent date

Hence enter. hopes that might be able to overcome it.

And from progr made to recov. now still more reason to entr. this opinion.

Cannot however say same with respect to other affect.

For although pain of arm most distress yet was not even at begin. most distress [danger] part of compl.

More reason to be alarmd for pulm affect.

Had long been subj to sever cough

And some reason to doubt whether was not Phithis.

Here some ground of presumpt both from app & age of pat.

Had a good deal of delic look with which Phthis most freq.

And was at 25^th year a period at which Phth. very common

Also often affect with sympt indic some degree of hectic fever.

Cold, hot & sweating fits

And pulse consid above natur stand

Still more susp. circum in having once been affected with bloody expect.

Must be allowed that there alarm.

And that Phth often fatal where disease for long time with fewer symp.

For as have already oftener than onc obs. an insid compl.

And often consid progr. where little suspected.

Or at least where by no means dist. markd.

Hence then here not without appr.

And must own that appreh not yet remov.

But origin inclind to view this part of compl as catarrhal.

And although now more doubtful yet still rather disp to same opin

For if disease [sometim] insid in other inst, much alarm where no Phth.

Many inst of Haemopt where yet compl. recov.

And these pat not afterw. [illegible] from catarh.

When Phthis from Haemopt, in gener follows, as alm imm conseq.

Or at least with recurr. of Haem if form. recov. from it.

In gener. prod Phthis of ulcer kind.

That is vomica of consid size.

Hence fixd pain, const dysp, & inab of sleeping unless in partic posit.

None of these however in pres inst.

Matter expect. app. without any mixt of pus.

Nothing if cleaness of tongue concom even of slight mixt of [illegible].

And in such secret of mucus at lungs suff. cause both for cough, dysp. & other sympt.

From these consid then still incl. to opin of being catarh.

Yet from obs contin now [somew] more [susp.] than formerly.

And would not at all surp. me if at length termin in fatal Phth.

Accord to this have all along had view in treat.

But before speaking of pract. necess to take notice of still anoth occurr.

For to these affect which had when come under care, another app. diff. has superveened.

Our pat. during course of attend from accid. fall receivd hurt on knee.

And from this, though at first little inconv, yet soon consid pain.

These however less distress than two other sympt now super & [atten] to this cause.

Viz. Freq. fainting fits & severe vom.

Of these have not had any very distinct or accur. acct.

And may be much doubted, when whether in any degree connected with cause to which attrib.

But whethr connected or not, am I own, from descript given, disp. to look upon them, as affect of Hyster kind.

As being more alarm than dang.

And as what will prob. termin in no long time.

Of this however, will be better able to judge, after knowing affect of remed prescr.

And after learning more distinc & partic acct of app.

In case thus complic. will natur. be supp. that remed empl. with diff intent.

And this indeed might be inferrd from remed them.

Began by direct Ungt. Terebinth

Basis the Oleum Terebinth a pecul. active & penet. stim.

Here united to Axunge empl. merely as [excip.]

In proport of ℥i of form to ℥i [illegible]

Entirely directed against aff. of arm

And on suppos of Rheum affect promised some advant

At least in such have often I think empl it with consid benef.

Not indeed in inflam stage.

But in that of Atonia.

And here useful in same [measur], as in cases of sprains, after inflam overcome.

For which need hardly remark, long empl, both by Phys & Farrier

After use for week little effect in alev. pain.

But thought that moved fingers more freely.

This however if at all conseq of med, prob. effect merely of [frict].

Although howver had not yet prod much effect, yet nothing to led to discont. use.

Espec. as did not prev. other pract

Accord at succeed report, had recours to electric.

Of reput of this artic in affect of paral. kind need say nothing.

Not indeed success in every case

But under prop. admin where paralys curab. often succeeds.

And perhaps hardly possess a a more powerful or penet. stim.

On this prin often also useful in affect of Rheum kind

Espec. when have degener. to state of atonia.

From this therfore reason to expect still more than from Ungt. Terebinth.

And from conj. hoped for good conseq against affect of arm.

But from neither could any influ be expected on cough.

And this still cont to give great distress.

With view to mitig had recourse to mucil. julep. with prop. of Laud.

Which while prev. action of irrit causes, also rend. effect of irrit less powerful.

Under elect. & ointm soon consid relief from affect of arm.

Not only dimin of pain & swelling but restor of free motion.

From mucil mixt however did not reap equal benef

And with contin of cough belly bound.

For mitig necess to obv. this sympt.

Accord while persisted in mixt [directed] comp. powed of Crem of Tart.

P. ae of Crem of Tart & Sulph.

In gener oper as easy & gentle lax.

But here not attended with des. aff.

And while constip cont. became affect also with vomit.

As means of obv. former had recourse to aloet pill.

While with view to lattr directed mixt of vitriol acid.

An artic from which in such cases have often seen best effect.

Influence of pills as open belly not very consid.

And after accust to them for some days, ceased to have any influ

While at same time, some return of pain of arm.

This was disp. to attrib to want of ointm, ordered to be omitted.

While therfore orderd renewal encr. dose of pills.

But from this quant. thought excited sickness.

And as now no uneasiness from costiv ordered intermiss.

And At that period, was for some time, almost without any compl.

For both arm & cough very much relievd.

But then accid exposed to cold & wet.

And on this fresh aggrav of pneum affect.

From this led to repet of mucil julep.

And now with former prop of Tinct Theb. added equal quant of weak Vitriol acid

A combin to which have often recourse.

And I am inclind to think with adv.

Partic in inst where tend. to vomt.

But cannot say that this here the case.

Had indeed no return at this time of vomit.

But no allev of cough, which partic distress in night.

From this led with contin of mixt to order larger dose of op. at bed [time]

Accord directed ten gr. of Pil Theb. cont. one of Opium.

And app. with good effect.

For at succeed report, found cough much allev.

But now informd subj to pres train of sympt.

Had we are told in conseq of fall receivd hurt on knee.

And although at first, prod of little uneas. yet soon followed by excess consid pain.

And to this followed sympt more alarm.

Partic freq. fainting fits, at same time attended with severe vomit.

These sympt as already obs, inclind to consider, as chiefly of Hyster kind.

For this at least most natur. suppos, with respect to deliq.

Accord directed pract with that [view]

Ordering mixt. with Tinct. Theb. & Vitriol Aether.

At same time must allow that while had seen nothing of these fainting had no such accur. descript, as to enable me to form accur certain judgem

And shall in some degree be guided in opin. by effect result from med as well as by future acct.

And accord to circum will be directed in future pract.

With respect to kneee however not same uncert.

And in hopes that by anody balsam directed for it pain may soon be removed.

And that will likewise cont free from affect of arm in remov of which Ungt Terebint & Electr. seem to have had good effect.

Cannot however say that in comb. other parts of affect, have yet made any great prog.

And in future pract must be very much regul by circum.

Partic by evid that may [hereaf] occur either of Phthis or Hyster.