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The Case of Mrs MacKenzie aged 46

From her youth she had been of a tender and
delicate constitution. About three years ago she was married.
Four months after the menses stopt for nine Weeks. - She was
affected also with a Moving of the stomach, Gripes in the Belly
Loathing of Meat, Belching of Wind, Headach and Toothach; such
an alteration made her suppose she had conceived. - Upon
taking a little more Exercise than usual, she felt a Weariness
and a great [Heat?] in the lower part of the Back: the menses then
returned for two or three Days, tho' not in the usual Quantity. -
The former complaints still remained, and rather on the increase.
She was now sensible of a crawling motion in the Belly - Below
the stomach, the Belly began to swell and a small Body was here
felt, which on leaning back in her Chair she perceived to
move. - Sometimes a swimming in the Head took place at this
Time. About seven Weeks after, a Fit of Sickness, attended with
a violent stress of Vomiting brought on a Return of the Menses
in the usual Quantity as when regular, tho with much more
Pain. - About somewhat more than two months, she was
seized with a cold, which brought on violent Gripes about the
Navel, Pain in the Back, and a slow Fever - This occasioned
an uncommon discharge of the Menses for two or three Days
when an Abortion ensued, supposed to be of a two Months
conception - the Menses then stopt till next Day, when getting
out of Bed, it returned with Violence. - When able to sit in
a chair, to her surprise she found her Bulk not much

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diminished: - still a Hardness remaining in the Belly, with
a various Kind of Motion, and a nervous Disorder of the
Stomach. - She had been ordered, for some time, to use only
roast and boiled meat, and drink a glass or two of Port
Wine after her meals, which had a very good Effect on the
Stomach --- She was often troubled with a stoppage of
Urine - a frequent Desire, but in small Qualities. sometimes
of a natural Colour, sometimes whitish and slimy - some
times an uncommon Discharge and pain no thirst but
often costive. -- The Menses now quite irregular
for seven months after the former Discharge, during which
Time, she was affected with a violent dragging down Pain in
the Back, and Heats in the Loins, and the Bulk was con¬
siderably increased. -- From the End of January 1771 the Menses
stopt quite for fourteen Months. The Motion and Bulk now
considerably changed. The Bulk fell to the two sides, but
more to the left than Right - She felt too a violent lifting up
Motion to the stomach, which would sometimes move her
clothes - Sometimes this motion was felt below the Navel,
and sometimes in the Bottom of the Belly - The motion in
the sides was quite different, like something crawling and
sometimes starting - rolling and pushing. -- The Back was
freed from Pain and strengthened, some Months after the
Menses disappeared, and the Pain grew more troublesome
in the Sides and Belly, and the Heat formerly in the Back

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was felt below the Stomach, attended with violent Flushings which
were almost suffocating - These Flushings were considerably
relieved by Bleeding in the arm but the Bulk was still
increasing, which occasioned a Weariness and Stiffness in the
Thighs and Legs and disabled from walking. - The appetite
was pretty good and the Discharge by Stool regular - but the
stoppage of Urine was very troublesome. When the Pressure was
downward and to the Bottom of the Belly there was a forcing desire,
but the Urine small in Quantity and scalding hot - In December last
she was ordered Circuta Pills, and to rub with [Camphorate?] Oil -
Soon after the violent motion upwards subsided considerably
but there was still a Bulky Motion in the Belly, which would
have shifted its Place, and the Bulk appeared sometimes bigger
sometimes less, with a flapping Motion particularly when
walking - The Belly never fell or grew less all this time. -- She
felt afterwards a violent Weight to the Bottom of the Belly, and the
sides were so much pained as if something was leaving asunder
from them - and from the stomach to the Navel a considerable
Flatness was visible - The Belly was bandaged up which gave
some Ease to the sides - the Appetite still continued good, the
Discharge by stool regular she slept tolerably and looked
better than usual. -- About three Weeks ago, upon going up
a Pair of stairs, she was seized with a more than usual
Feebleness in the Limbs, a Pain in the lower Part of the Back
and a swimming in the Head, which was followed by a

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small Discharge of the Menses from three Days - The Pain of the Back
then ceased, and the Menses disappeared - The Weight still remains
in the bottom of the belly, attended with a stinging Pain some
times intolerably violent. The Belly is much softer in Bed - She
cannot attempt to lie upon the left side, and when lying upon
the Right, she feels sometimes, a swift kind of Motion without pain
She complains of great [stounings?] ¹ . in the Breasts, rather more
troublesome of late - The Pain and Motion are most distressing
at the time the Menses should return, if regular - The dragging
down weight is not always alike The [Bu↑r↑then?] is much lighter
at one time than another, nor is the Motion constant but ceases
sometimes entirely -

June 1773 -
It is to be observed, that the Bulk never fell after the Abortion,
but was on the Increase for sometime - It has subsided a little sinc[e?]
last year, but she is as big at this Day, as a pregnant Woman almost
at her full Time - The Belly is considerably softer, but she can never
lie on the left side, and it is by far biggest, however when on Foot
it is not more uneasy than the Right. The [stounings?] ² in the Breasts
are quite gone, and no shed of the Menses for above a twelvemonth.
She still has frequent Flushings, and the Motion in the Belly and
sides still continues - There are Nothing like Lumps to be felt by the
Hand, which were sometimes felt last year. When standing for any
Time, or taking more than usual Exercise, particularly going
up or down stairs, a Bulk is felt to fall to the Bottom of the Belly
& sometime after as sensibly to rise upon taking a little [Exercise?]
The jolting of a chaise occasions the Bulk to fall sometimes, and
sometimes not. Would Exercise be proper to be persisted in