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At Lord & Lady Saltoun's desiring I give
you the trouble of the following case begging
your opinion & advice as soon as convenient.

Eleanor Fraser daughter of Lord Saltoun
about nine years of age of a healthy constitution
& very lively turn had in Autumn last a fever
of about three weeks continuance which except¬
ing some slight twitchings of the Muscles, & a
fetid Diarrhoa that accompanied it, had no very
uncommon Appearance -- For sometime she seemed
to recover but beginning again to droop & lose
her Appetite she got an easy vomit from Dr
Findlay at Fraserburgh who had attended her.

Soon after this without any return of the fever
she was siezed with Fits of a sort rather un¬
common & such as it is not altogether easy to
describe -- The Motions were entirely confined
to the Muscles of the Trunk & Neck so as alter¬
nately to bend backwards & forwards the Body
with more or less violence & rapidity as she
lay on the bed, continuing almost half an hour

every time she was siezed- The Limbs followed the
motions of the Body, but for the most part there
was not the least Spasm in their Muscles no
clenching of the Fists, no distortion of Face nor
locking of the Jaws, nor any foaming at the mouth

During the Fits she often turned herself & held
out her hands for certain things from the bystanders
which she seemed earnestly to require & to make
sensible signs for- Any thing cold or wet seemed
particularly agreeable to her when rubbed upon the
bend of the Elbow or passed close upon the upper
part of the Breast near the Clavicle & when she
cou'd get hold of any thing of that sort she always
stuffed it into her Bosom with great eagerness,
but when she was indulged in this or had any
odorous substance held under her Nose, tho' she
seemed to be pleased with it, the Agitations were
visibly increased- The Fit always ended in a Tremor
& Subsultus in one or both Legs, & immediately when
that was over she cou'd sit up & made Signs or
called for drink & generally ask'd for a Small bit
of Sugar with Pepper Mint water dropt upon it-
when she came to herself she seemed perfectly re¬
collected & cheerful & immediately begun her or¬
dinary amusements, but her Legs & Thighs were alway↓s.↓

for some little time after the Fits so relaxed that she
cou'd not walk without help- Tho' she had all these
signs of Sensibility some degree of Sensibility during
the Fits & appeared often to hear & understand what
was said to her she recollected nothing of what had
passed-- In the Intervals she was lively & in good
Spirits conplaining of nothing but a constant
pain in her left Brow which affected a little the Sight
of that Eye, but tho' constant was never so violent
as to interrupt her little Diversions & sometimes
she had involuntary startings & Tremors of her
Legs -- Of such Fits she had at first three in the
day very nearly about the same hours, at 10 in
the Morning, one o'clock & 4 in the afternoon &
at the approach of a Fit she felt herself a little un¬
easy, changed colour & cou'd tell in time enough
to be carried up stairs to bed- After a few days
she had four in the day, the morning Fit came
on an hour sooner & she had an additional fit
at 11 o'clock in the forenoon-- In this state she
was when I saw her first. her pulse perfectly
natural, belly regular, Appetite not bad, slept
long & sound, her Urine rather pale but natural
as to quantity & no appearance of Flatus either
during the Fits or in the Intervals- As for Medicine

she had got some of the volatile Antispasmodics &
the warm Bath every Night- Tho' the Child had never
had any of the more common Symptoms of Worms
nor ↑had↑ any worms ever appeared Dr Findlay & I were
both of opinion that these strange appearances
might notwithstanding be owing to that cause-

With a view to this we ordered her a Dose of
Calomel at Night & gr. XV of the Pulv. Vermifug. P. l
next morning-- This produced a copious & very
fetid discharge but no appearance of Worms-

The next course was every Morning Pulv. Valeria
Sylv. [ʒ i?] & this the day Pulv. Stann.-- After
three days of this course the Mercurial & Cathar¬
tic were repeated- At first this Method seemed
so far to agree with her that the Fits became
shorter, continuing sometimes only six minutes
& for some days she dropt one of the forenoon
Fits altogether- We all attempted to break the course
of them by giving upon the first appearance of
uneasiness a large spoonful of a fetid Julap &
endeavoured to amuse her & keep her in Motion
either by carrying her about or setting her on the
spring Deal but without the least effect--

After trying this Method for eight days or more, we
gave her the Cort. Peruv. [ʒ i?] ter in die & the Valerian
in the Morning, but the days she took the Bark
the Spasms were more violent & as this was as¬
cribed to the Medicine it was laid aside & the
former course repeated-- We have also given her
the Decoction of Cabbage Tree Bark as much as
her Stomach wou'dſ bear, but notwithstanding of
this & of late a trial of the Fl. Zinc, beginning with
gr. ſs. to gr iii. three times a day we have gained
nothing-- It was imagined indeed after one of the
Doses of physic that something like the [Exurial?] &
small fragments of Worms appeared among the
Slime that came off, but not distinct & attended
with no Relief-

She has now five Fits a day, the
last at 9 o'clock in the Evening, each about
twelve Minutes duration & the Motions totally
different- She gets upon her Knees & with pretty
quick Motions rising & falling beats her forehead
upon the Pillows in different parts of the bed-
sometimes she gets up to her feet makes to the
bedpost & presses her forehead strongly against
it then falls back with repeated & strong Spasms

of the Neck & Trunk- Sometimes she pulls & tosses the
Pillows about & at last the Fit ends with some such
Motions as she used to have in her first Fits- Her
countenance all the while is perfectly natural & her
Eyes shut- Some of the Fits are more gentle than others
but upon attempting to restrain the Motions they be¬
come stronger & they still keep pretty exactly to the
same hours- The pain of the left Brow continues, the
Eye is rather more affected, she shee sees black Spots
before it & the Pupil does not contract quite so much
as that of the other upon the approach of a Candle-
The right Leg too is almost constantly paralytic
except in the time of the Fits when she moves both
equally- Sometimes in the Intervals she can use it
for a few steps but no more- Dr Livingston has
has now seen her & last night we blistered her Head
& propose to keep a drain upon some part of the
Scalp with Empl Calid- She got also the night she
was blistered a Dose of Camphor & Castor oil aa gr.X
& we intend to persist in the use of Fl. Zinc &
now & then to interpose the Calomel & Purgatives as
there may still be some reason to suspect worms
present-

We are somewhat apprehensive that the
permanent pain of the left Brow & the weakness of

To
Doctor Cullen
Edinburgh

The
Dr Skene about
the Honble Miss Fraser
Novr 14th 1775

V. IV. p. 83.