DEP/DUA/1/44/25 (Transcript version)

Mary Millegin

(1788)

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N^o3 Mary Millegin. at 34.

In case of this pat. formerly obs. that two diff. affect occurd.

viz Leucorrhoea & Menorrhagia.

And this conj by no means an uncomm occur.

For although often to be met with sep & distinct, yet still more freq. conj.

And indeed mutually oper as causes of each other.

Or rather both conn with simil cond of uterine vessels.

Charact of formr of these affect Menorr very obv.

And indeed one [respect] which a female can hardly be mist.

For no other disch having resemb to it.

And must be fully sensib both of quantit & contin.

If therefore veracity of acct to be depended on no room for doubt.

And from this circum also are more to form judgem of Leucorrh. than from any other.

For a disch simil to what takes place in Leucorh. occurs also in [illegible]

And where charact susp, & acct not to be depended on, often gives great diff.

For in app of matter disch. no diff. to be discov.

And many other sympt even ardor urinae same in both.

In some inst indeed of Leucorrh. pains of back & general affect of syst partic of alim canal, not occuring in Gonnorh.

But in some cases these entirely wanting.

Then diagnos chiefly from connect of disch with menstr. flux.

For with Leucorh. disch common greatest immed before or after menst.

But ceases during course of menst dis.

In gonnorh on contr. not affected by it.

And even contin during time.

Of this however cannot always easily judge.

For when bloody disch consid other in some degree concl.

Hence where can dep on veracity of patient this one of readiest test.

And account of pat. denying Gonor. at least corrob. [where] conn with [menst]

On this footing then had no doubt in believing acct of pres. patient.

And taking it for granted that lab. under both Leucorrh. & Menorrhag. natur lead to concl. that should find disease obst.

For in that case dare not venture on use of those restring med which might otherwise empl. for counteract. Leucorrh.

These indeed no less indic by Menorh. than by Leucorrh.

But after that disch. as it were hab. a sudden check often attended with worst conseq.

And at least prud [mannag.] seq. in administ of these.

At same time in both as already obs. there exists same morbid cond of uterine vessels.

Nay even strong presumpt. that same vessels at one time furnish excess [disch] of blood, at another give uncom disch of serous or mucag. matter

Hence an import indic in common to both to give addit vig of uterine vessels.

Was with this intent that here directed Peruv bark.

Which of all veget tonics yet disc. is perhaps justly entit to pref.

And although some stom with which does not agree, yet perhaps more gener. sits easily on stom than any other.

From this therefore hoped that might grad accompl. restor of due tone to uterine vessels.

Did not however think it prud to empl it in large doses at first.

As from loading stom might entirely frustr intent.

And indeed where wish for effects of bark as tonic, to be obt rather from long contin action than great quant.

For these reasons directed it only in doses of ℥p.

And these repeated but thrice a day.

From this mode of exhib little dang of overload stom.

And at same time grad action as it were of an infus formd in stom itself.

This I own consid as gener preferab. to an infus prev formd by any menst.

At same time these will sometimes sit upon stom, when bark in subst. even in small quantit, gives much inconv.

Here however patient bore it without any uneasiness.

And for some time after use begun disch a little dimin

But not long after this regul period of menst evac arrived

And had as usual app of being consid.

Was however an obj of conseq. to restr. it as far as could be done with prud.

For while disch itself tend to dimin tone of syst in gener. from partic vessels through which took place these left much more exposed to Leucorrh.

Hence had here recourse to an astring & anod mixt.

A combin viz of diluted vitriol acid & Tinct. of Opium.

The Cassia water, spring water & simple syrup intended merely to give form & from sugar & arom. to render it more palat & grateful to stom.

And was from two former artic [alone] that could look for any consid effects

Both vitriol acid & opium however well known to be med of most [illegible] kind.

In formr one of strong. astring we can empl. for restr. disch. either of ser. or bloody nature.

While in latter the most powerful sedative, as dimin encreased action of vessels by which disch supp & encr.

Am indeed aware that by some combin of these two artic held to be very improp.

And contended that acids in gener. but partic strong miner acids, destroy influ of opium.

For this assert however, partic when empl. to extent here prop. am conv. from much exper. than no found.

And when opium comb. with acid its sedat & [sopor.] effects as certainly obt as without it.

Do not indeed assert. that Vitr acid no effect on opium

On contrary think have seen manif benef from it, as prev. sickness at stom, & even vomit, which with some opium very apt to induce.

And where Laud not retaind alone yet readily done with this add.

Think also have seen manif benef. from it as restr. intoxic or what may be [strickly] calld narcot effects of opium.

These where wish to induce sleep by opium would always wish to avoid.

For often vertigo & confus of head such that entirely disapp. of des. effect.

And accord long a [desid] in med to find prop. corrig.

This with some some constit not to be obt by any addit.

With some however affected by addit of small prop of Volat. Alk spirit.

But with others still more manif by addit of vitriol acid.

And from pretty extens exper. hold it to be best corrigens we can empl.

Although not always success, yet am conv. that by this addit. both as inducing sleep, allev pain & allayin inord action, when otherwise entirely disapp. either from its being rejec. by vomiting or occas distress confus of head.

On these grounds then with view to sedat & astring powers comb. directed it to pres pat.

And that might not multip [exub.] of med directed each dose of bark in dose of this mixture

Under this form of exhib still at least no inconv from med.

And although menstr. disch prof. yet with less pain than formerly.

Hence encour at least to persist in employm & accord directed contin.

And if duly persist in on part of patient, hope that by next menst period, may be able to see good effects both as restr. that disch & as dimin fluor albus during interm period.

But if this not case must think of other meas.

And may employ alum with G Kino, or Lime water with veget bitter

But in select of med, must be determ by circum in which shall find pat & effect of pres pract.