[Page 1]

[Page 2]

[Page 3]

[Page 4]

[Page 5]

[Page 6]

[Page 7]

[Page 8]

[Page 9]

[Page 10]

[Page 11]

[Page 12]

Mrs. A. as early as the 12th. year of her age was subject
to pain and a sense of fullness at stomach; before she was
quite thirteen the Catamenia appeared, and continued to
flow regularly, tho' sparingly, or in small quantities, till
the 21st. year of her age. Before their eruption, she was com¬
monly affected with great pain of the lower part of the Back
and Belly, and with a sense of fullness & pain of the stomach
for some time after they ceased to flow. ––

About the age of 14 she tumbled down a very steep declivity
almost a Precipice, and struck her stomach against the stump
of a Tree; this occasioned a considerable swelling, and inflam¬
matory appearance of the external Integuments, over that Or¬
gan, attended with acute pain –– She concealed this accident
for about a Week, but was afterwards bled and used warm fo¬
mentations to the part, which in the course of a few Days en¬
tirely removed the inflamation and likewise the pain in a
great measure. ––

For six or eight months after this, her Complaints at the Men¬
strual period, particularly the pain and sense of fullness at
stomach, were much more troublesome, than they had ever
been before; and by the advice of a skillfull & experienced Phy¬
sician who attended her, she took a variety of Medicines, which
she believes were of the stomachic & deobstruent kind: by the
use of these, by Exercise &ca her Complaints were considerably
relieved; she was still, however subject to returns of them at

This was the state of her case till the 21st year of her age, in
the year 1772, when she was married. From that time she
enjoyed perfect health, menstruated more freely, plenti¬
fully, and without any of the former complaints of the Back, Bel¬
ly, or stomach, for near seven years, that is from the first of Sepr.
1772 to the beginning of the year 1779, when she was about 28
years of age, and was giving suck to her 3d. Child, with the Cata¬
menia and other Evacuations regular; for it is to be observed, that,
in nursing her three first Children the Catamenia flowed regularly
during the whole time from the third period after delivery. ––

In the Month of March 1779 about six Months after her third
delivery, she was again attacked with her stomachic Complaint
more violently than at any former period. She now described
it, as a violent distention of the stomach attended with acute
pain and sense of fullness. It generally, from this time, seized
her about Eleven or Twelve oClock at night and continued till five
or six in the Morning, when it seemed to move into the right
Hypochondrium, and after being felt there for a few hours it went
entirely off. ––

From March 1779 to March 1782 the returns of this Disease were
not very frequent nor were they at any regular periods. They
did not seem to depend on the state of the Menses, nor on any particu¬
lar affection of the Mind, neither could it be observed, that any
particular kind of diet had any effect in producing or aggravating

During the Paroxysm, no quickness or hardness of the Pulse, præ¬
ternatural heat of the skin, or any other symptom denoting Inflam¬
mation could be perceived; neither the state of the Mind, nor of
the secretions seemed to be affected by it. It was considered as spas¬
modic and perhaps flatulent; and Volatiles, Fœtids, and warm cor¬
dials were tried to prevent, to moderate, and to carry off the Pa¬
roxysm, but without any good effects in either case; recourse
was then had to Opium, which given in the beginning of the Fitt,
and in large doses generally gave relief; but it was found inconve¬
nient from the costiveness which it induced; and the great lowness
and debility by which it was succeeded. ––

At this time the Flor: Zinci was recommended, as an Antispasmo¬
dic by a Friend who was consulted in this Case, and was given in the
quantity of two grains, and was afterwards increased pro re nata.
This Medicine had every good effect, that could be wished, it never
failed to shorten or carry off the Paroxysm when exhibited early enough
to be retained on the stomach, that is at it's commencement, or before
the spasm had so far affected the stomach as to render it incapable
of retaining this or any other Medicine ––

In the Month of April 1782 she proved with Child, and for the first
four Months of her pregnancy her stomach Complaint attacked her
more frequently than ever, but still the Zinc given in increased

On the 25th. of December of the same year she was delivered of a
Boy after a short, easy, & natural labour; two Days after, she complain¬
ed of a Pain in the top of her right shoulder, and of a general weak¬
ness of that whole side extending to her Hand and Foot, but these she
attributed to her exertions in supporting herself by the Arm & Leg
of the right side, in the time of labour, as she was delivered on the
left. The discharge of the Lochia was as copious and continued
as long as it had done in any of her former layings inn. About
the 16th. day after delivery she was seized with Fever, had two attacks
of 24 Hours each, she took some gentle purgatives and afterwards
the Bark, on the second day of her taking this last Medicine, it
purged her too frequently and she was directed to take some drops
of the Tinct: Japon: along with each Dose: by the use of which the
purging was put a stop to. On the Night following about the
usual hour of Eleven, she was attacked violently with her old Com¬
plaint in the stomach, and neglected to call for the Zinc till
too late, or till her stomach could not retain it; it was at last
given and frequently repeated but as often rejected. Tinct:
Thebaic: was next tried in large doses but with no better effect,
it was repeated and thrown up as often. The Pain or Spasm
continued with the most excruciating torture, and intolerance
of a horizontal Position till about five oClock in the Morning

This attack, tho' more severe than any of the former, was accom¬
panied with no alteration in the state of the Pulse, no heat of the
skin above natural, no inflamatory symptoms whatever. The
Urine was voided in the usual quantity and of the natural colour.
There was no dejection of spirits, nor despondency, till the severity
and length of the Paroxysm occasioned an apprehension of danger –
The Liver seemed to be the seat of the Disease after it had moved into
the right side, but had that organ been seized with Inflamation, a
fever must have ensued with quick, hard, Pulse, hot dry skin &ca
symptoms inseparable from Hepatitis – There appeared no dis¬
coloration of the skin, nor yellowness in the Tunics of the Eyes; no ob¬
struction to the free flow of the Bile could therefore be suspected. – On
examination no hardness of the Liver could be discovered; there was
an evident puffing and fullness in the right Hypochondrium attend¬
ed with a slight soreness, rather than pain, on pressure. A Physi¬
cal Freind joined in opinion that the disease took it's rise from
Congestion in the Liver itself, or in some part of the system of the

It was observed before, that in nursing her three first Children
the Catamenia had always appeared at the third period after de¬
livery, and continued to flow regularly for the rest of the time. –
At this time it ought to have appeared in the end of the Month of
March, but both that, and April passed over. without any appearance
of it. – It was thought, that the abscence of this customary evacu¬
ation might increase or keep up her Complaint. And to bring
it on, Calomel was proposed as a more powerful aperient and
deobstruent. Accordingly she took some doses of it in the course
of the Month of May; but the quick and violent operation of that
Medicine was found to encrease the pain in her side exceedingly
both during it's operation and for some time after, in that Case

In the Month of June she returned to her former course which
she continued occasionally till the end of September, but as her Pills
from her being accustomed to use them so long, had in a great mea¬
sure lost their effect of keeping her Bowels sufficiently open, it was
found necessary to add a little Aloes pro re nata to quicken their ope¬
ration; but ever since the year 1779, that she was first attacked with
her complaint, she has observed that all strong Purgatives have been hurt¬
full, or have encreased her disease for the time, either of the stomach
or side, and now her Medicine with the addition of the Aloes, was
found to act too roughly and to occasion too much disturbance in the
system, it was therefore changed in the Month of October for a Com¬
position of the Tart: Solub: & Elect: Lenitiv:, which she has continued
ever since, and which acts much more gently and with less distur¬
bance. ––

From the Month of January to this time, October, she has had
no return of the disease in her stomach, nor has she had any
appearance of the Catamenia. The pain in the right Hypochon¬
drium has been constant for all that time, but when the Bowels
have been regularly open and moderate exercise used, it has, in
common, given but little trouble. About the menstrual periods
however, both the pain and fullness have been considerable increas¬
ed, and have continued to give more uneasiness for some Days.
It has always been more troublesome in the Night than in the

About the end of October the Catamenia returned and flowed
for the usual time & in the usual quantity, without any Complaint
of the stomach, but with a considerable encrease of the Pain of the side,
both before the Eruption and after it had ceased. She now described
the pain as somewhat different from what it had formerly been; for
some seconds she felt a throbbing in the part, at another time a pricking
pain as formerly, but most commonly a very great soreness. In about
a Week after the Catamenia had ceased, her Complaints became much
easier than they had been for ten Months before and continued so
for about three weeks, when a return of that evacuation was expected.
In place of this return, however, she was attacked with the Complant.
in her stomach in the usual manner & about the usual hour; the
Flor: Zinci was again administred, and removed the Paroxysm in a
a short time, but as formerly, the pain in the side was more acute

The two next returns of the Catamenia (about the end of Decemr.
and January.) were perfectly regular as to time, but too abundant
in quantity, at the last Period more than double the usual quan¬
tity was voided. Before both of these, she complained much
of fullness, throbbing, and pricking pain of the side affected; and
after of great soreness and debility, for about a week or ten Days;
afterwards she became tolerably easy as before in the intermediate
times. As the Menorrhagia or excessive discharge at the
two last periods seemed to proceed from great debility. She
took in the Month of February, some Pills composed of the Ext:
Cort: Peruv: and Sal: Martis as a tonic. This preparation agreed
pretty well with her stomach and the next return of the Menses,
on the 20th. of February, was much more moderate in Quantity,
but was attended with the same symptoms both before and after
as has of late become (↑been↑) usual in her case -

She still takes the Tart: Solub: occasionally to prevent cos¬
tiveness, and the Ext: Cicutæ once or twice in 24 Hours when

In March she had the Catamenia at the regular time, in the
usual quantity and attended with the usual Complaints both be¬
fore and after, in a moderate degree. – In the begginning of April
she weaned her Child, and had the Catamenia on the 19th. of the Month,
which was the regular time for it's appearance. –– For four or five
Days before this, she complained of violent Pain, and fullness in
her Head, an increase of all the symptoms which usually preceded
the evacuation in her Case, and of great heavyness & fullness of
the whole habit, but particularly of the right side. –––– The Cat¬
amenia flowed for the usual time, a very considerable quantity was
discharged, which carried off all the above symptoms of Plethora,
and left only that soreness of the right Hypochondrium, which had
been customary with her, after the discharge was over –