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Mrs Bisset, who is in the 37th year of her age, has naturally a tender delicate
constitution, with great sensibility of the nervous system; and, during 14 years past, has
been subject to a fixed ↑pain↑ in her left side, and the anterior part of her breast under the sternum;
which usually seized her on taking cold, and, when violent, was attended with an intense heat
at the sternum and pit of the stomach, formed with great shortness of breath, and a quick Pulse.
The Disease was sometimes periodical; and in Spring 1768 the Paroxysms were quotidian
during the space of three weeks. Each Paroxysm speedily increased till the Patient became ---
speechless, and the disease threatened suffocation and immediate Death: each fit instantly
yielded to bleeding, and to no other remedy. When this Disease prevailed, the Party's blood
was a little sizy, and the glairy Lymph always separated in hot water from the red globules,
and had a fibrous or ropy mucilaginous appearance.

Mrs Bisset became pregnant in Septr 1769, was exceedingly reduced by vomiting almost
every meal during the three following months; especially as she always pukes with great difficulty; and
in february following was farther reduced by a vehement cough. In the beginning of March she
was seized with an inflammation of the uterus; her pain was exquisite, the lower portion of the abdomen
became hard, and the Child had not stirred for a fortnight before that time. After repeated ---
bleeding, the use of Glysters, fomentations etcetera she was happily delivered of a dead Child, ---
which was livid and tender from its having been dead several days before: But the ---
Inflammation tho' much abated did not quite cease after delivery till she was twice more
blooded, which reduced her to the lowest ebb. She recovered slowly, but from that time ---
hitherto has been affected with an obtuse pain in the hypogastric Region towards the left side,
at the seat of the left ovary; and the Uterus seemed somewhat larger than it ought to be in a
natural state, so far as could be Judged by touching. Exclusive of this pain, which was not
constant, her health for some time was better, and she was more free from the aboves and
pulmonary disorder than she had been formerly: But for several months past the Menses
have been more scanty than usual, and never were copious, as they had often formerly been,
since she had that miscarriage.

The Patient, throughout the last spring, was exceedingly distressed by repeated ---
colds, from the inclemency of the weather. These colds were generally attended with a
swelling of one side of the face, or both sides of it, which yielded not to moderate bleeding,
repeated blistering, a temperate diaphoretic Regimen and warmness; but the cough
generally yielded to a Tinctur made with Conserve of Roses, the Juice of a roasted Lemon, and
some Sugar candy in Pouder; which has often been very serviceable to her. As soon as the
warm weather commenced the Rheumatic Swelling disappeared, her stomach at the
left ovary increased, and now, at times, affected the whole abdomen and the Stomach
by Sympathy; and a true Lientery commenced. This grievous Disease has been

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three or four times restrained by suitable medicines; but has been continual for a fortight past.
Ingested food comes away unaltered sometimes in half an hour, but generally in less than an hour and
half after eating it; supper excepted, which commonly stays with her the whole night, owing chiefly I
suppose to an horizontal situation. Her Supper consists for the most part of a little of the best cheshire
Cheese, a bit of toasted Bisquit, and about 4 or 5 ounces of Red Port burnt with Cinnamon; which agrees
well with her; and sometimes she makes a meal of Rice boiled in water with a little Cinnamon, and eaten
with Red Port. Tho' this Wine to the amount of half a wine glass usually affected both her head and stomach
before the auspicion of the present disorder; yet she can now take three times that quantity without any
inconvenience from it: probably because it remains but a short time in the stomach; and the nerves of
that organ may have their sensibility impaired both by relaxation and Phlegm. as she receives so little
nourishment from what she takes, we find it necessary to allow her a bit of meat sometimes; a bit of
roasted Chicken, or even the lean of roast mutton will stay longer on her stomach than boiled meat
of any sort; or even than some vegetable foods. The abdominal pain remits two or three times a day,
and ↑is↑ least troublesome at nights in bed: its exacerbations seem to contribute not a little towards pro¬
moting the Lientery, and rendering it more difficult to cure.

After the aforesaid abortion, when the pain in the Hypogastric Region commenced, I attempted to
cure chiefly by means of chaffing the affected part with the palm of the hand moistened with oil of sweet almonds, or Spt.
minder. or Liniment. vol. or Mixture of Sweet oil and Spt Mind: for there are few medicines that agree with the
Patient; and the most powerful attenuants and deobstruants, particularly Sope, Gum ammon. Mercur.
abeal. ¹ the Juice and Extract of Hemlock, disagree with her; likewise emetics, Emmenagogues, the milder sort
excepted; strong astringents, strong Bitters except in a very small dose, Nitric Lime water, Pyremont Water,
opium, Peruv. Bark, ass's milk; ↑sweet oil; Parmacetty↑ she cannot even bear the external application of the Bark. The internal
Medicines that were {illeg} at different times administered with a view to the old pulmonary complaint, and
the pain in the Hypogastric Region {illeg} consisted chiefly of Saline draughts diluted with simple Balm or
spring water; some vegetable Juices, the Juice of {illeg} China oranges, Ripe fruit, Bristol Water;
gentle suitable Laxatives at proper intervals; {illeg} the aforesaid Tinctur when a cough prevailed; and
a suitable diet.

Since the Lientery commenced a small dose of Rhubarb, sometimes in pouder combined with ⅓ of a grain of
Ip. sometimes in Tincture, has been administred every Second or 3d day; and she has taken, in the intervals of
purging, such mild astringents and corroborants as she can easly bear, combined with suitable Stomachics
and Diaphoretics; and observes a proper Regimen, but hitherto with little success. The abdominal pain,
however, seems to be somewhat abated within two days past, by chaffing with Spt Minder. combined with some
Spt. Nitr. dulcis.

Tho' the Party's nerves are exceeding irritable, in so much that smelling to Rhubarb blended
with water, or an Infusion of Senna will generally operate with her, yet she would seem to have good --
stamina; since she bore so well with reiterated bleeding when it was absolutely necessary; and her flesh, tho'
sometimes reduced, is always firm, nor is it easily reduced by the lowest diet; and she has always good
spirits when her strength will admit; nor has ever a strong breath, or sour belshing, ↑nor is troubled with flatus,↑ tho' she delights
much in acids; and has been greatly relieved by sweet oranges and other ripe Fruit. Mrs Bisset
has for some years past been much indisposed in the forepart of Summer; but always became
stronger and more healthy when the days were partly shortened, and the nights became
longer and cooler. Even under the present Disease her spirits are good, and her countenance ↑is↑ scare sensibly altered.