[Page 1]

[Page 2]

[Page 3]

[Page 4]

I had the honor of your letter by
last packet, and am sorry my history of Miss Annie
Betham's case, was not so Explicit, and Satisfactory,
as you could have wished; all I can say is, that I
gave each Symptom in her own words, as nearly as
I could express them, thinking that would convey a
more clear Idea of the patients complaints to you
then any other Language I could make use of.----

I have further inspected the affected
parts, and examined the patient as far as in my power
and shall report every information I have been
able to learn ------ .

Whether the appearance of falling
in on the left side, may be owing to a contraction on
that Side, or to weakness, and relaxation on the other,
is really not in my power to determine; as their ap¬
pears no contraction or Spasm externally on that
side, neither can I observe any weakness or Relaxation
on the other. -- All I can say is, that the Mus¬
cular parts of the left side appear Quite Emaciated
and thin, from the breast, down to the hip bone.
So much indeed, that the ribs looks as they would
cut the Skin; that the whole of the ribs appears
as if sunk down upon the contained parts, that
the patient almost constantly complains of the
internal parts being sore on this side; as She
thinks from the pressure, or falling down of
the ribs, and breast bone, upon them.--

Whereas on the opposite ↑side↑ their is a great
deal more flesh, or Muscular parts, their is No

Miss Betham never had any apparent
Paralytic affection in the Eye, Mouth, Neck, arm, or limb
of the Diseased side; but upon Sudden Surprize, or
great fatigue, She has observed a Coldness as if water
was runing down that Side, attended with a Sudden
Shakeing, and tremulous Motion of that arm, and limb;
the weakness, and falling in of the side, would Instan¬
taneously take place, to such a degree, that she would
Not be able to Sit, or Stand Erect, but involuntarily
fall, or lean over to the Diseased Side; these feelings
are afterwards attended with a Violent Perspira¬
tion upon the whole of the diseased Side from the
arm downwards, so great that her Stays are
Immediately wet through.----

The Above Symptoms likewise
suddenly takes place from Emotions, or Affections
of the Mind; more particularly Anger, Grief &ccc-;
as well as from bodily Exercise, or fatigue.----

The flowing of the Menses
likewise, brings it on to a violent degree, and
as the patient has had a return of that discharge
Since my last, She has not yet recovered it; as
the falling in of the ribs, the pain, pressure, and
weakness &c-&c-. of the diseased side is much greater
then when I wrote before.--------

The diet has always been light
and Nutritious, She has always Eat fresh animal
food for Dinner which Seemed to sit Easyor on
her Stomach, when Spoon Meats and Slops
would Not. -- She Never can Eat any vegetables
with her food, or Not Even Roots, Potatoes only
Excepted.----- The patient still keeps altogether

Her appetite is better
then it was some Months ago. The Stomach
Never rejected food, Even when She was Ill
as She Never had any vomitings &--

Miss Betham drinks two Glasses
or So of red port wine after Dinner, as She
thinks it Strengthens her More than white
wines; She does Not now complain of pre¬
ter Natural heat or thirst. ----

The Medicines you ordred
the patient is Now taking.------

William Cullen Esqr.
M:D:
Edinburgh

Dr. Scott C
Miss Betham
July 3d. 1779.
X p 45