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Upon the receipt of yours of January 2
Miss ↑Semple was↑ put upon the use of the bark in half drahm
doses taken every four hours & continued for some
days, it did not dissagree with her Stomach but
her Appetite grew no better & her strength rather
diminish'd – from that time till within these four
& five days past, she continued much the same
frequently attacked with hot fits which upon
a sweat coming out went off, her pulse for the
most part quick & small, urine constantly limpid
nervous tremors, palpitation of the heart, & her
head often affected as she described it with un¬
common noise & a beating in it that she thought
might have been heard by a bystander – As
the bark had not produced the desired effect I
tryed her with the Elixir of Vitriol for some days
but this neither encreasd her strength nor appetite
During this Period ↑she↑ has had a return of the Catemen↑ia↑
twice at the stated times & the first which happend
about six weeks ago in greater quantity than
for a twelvemonth before – The change of her

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Case that has happened of late is her being
attacked with a feverishness in the forenoon about
12 oClock & in the afternoon about five attended
with a suffocation & spaasms over her whole body.
The first day she was affected in this way she
shook as in an Agueish fit & had twistings of
her arms, this description her Mother gave me
for I have never seen her in any of them, this day
it continued near an hour in the forenoon, but she
had no return in the afternoon. Since this appeard
I have given her the cold infusion of the bark ––
For a troublesome tickling cough with which
she was affected some weeks ago I gave her the
Elixir Paregoric: this always easd the Cough
which is now quite gone, & has generally
alleviated her nervous symptoms – it is
remarkable that her pulse has been better &
considerably slower since she was attacked with
the faintings – She is now so weak that she cant
be brought out of bed & even moving from one
part to an other of it discomposes her much –
She continues generally costive, & as you

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advised by your last she had now & then
a small dose of James's powder given her
to obviate that complaint –– After stating her
case as fully & distinctly as I can I woud beg
your opinion as to giving her the flor. Zinci
of this Medecine I have had very litle experience
myself, & if you shoud judge it proper to try
it shall be much oblidged if you will mention
the dose you woud wish to begin with & how
far to encrease it – I add no more but that I
am with much esteem & regard

✍

The above is at my desire from Mr Fleming & I
beg you will answer it as soon as you can conveniently
& I ever am

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✍

Doctor William Cullen
Physician in
Edinburgh

✍
Miss Semple
February 1779.
9. p. 127.