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Mrs. R. -- about 30 Years old - dark brown complexion
& of Athletic form, and before Marriage inclining to Fat.

Has two Children the Eldest six years, the Youngest five Years
of Age, since the Birth of the Youngest, she has never had any
signs of Conception, and has been ever since afflicted as follows

The Fluor Albus to a high degree, fœtid, & ill colour'd.
Hysteria. -- with all its concomitant Symptoms, Sometimes with
porraceous Vomiting, and after one of these a Syncope of so long
continuance, it was for some Time doubtful, if ever she would ever
recover from it. --

The Menses have kept their regular periods, but so trivial
in quantity, & of such a pale watery colour, as to be scarce deserving
the Name of a Menstrual flux.

Her Habit ↑of↑ Body is costive, and the Urinary Secretion, often
much less than it ought to be.

The Apetite is to be considered as good in general, yet Indigestion
Acidities, Head Aches, & Vomiting, are the constant attendants on
indulging it.

The Sleep, in general good, except two or three Days before
the Hysteric Paroxysms, wh almost constantly precede the eruption
of the Menses, for a Day or two.

The Pulse - is at all Times slow, & weak, & often scarce
perceptible, I have never found it exceed 60 strokes in a Minute
& its general course, is no more than fifty 3 or 4 pulsations P Minute
this exceeding languid circulation, I consider as an alarming
symptom, and if not remedied must in Time be productive of
sudden fatal, Nervous Debility, or the usual attendant on Cachetic
Habit, as Dropsy &c. --

Her Countenance is sallow, & she is exceedingly emaciated, tho'
neither afflicted, with Cough, Sweats, Thirst, or any preternatural Discharge
may not this be consider'd in some degree a Nervous Atrophy.

For these ten or eleven Months, the Flupr Albus, has ceas'd, or
is so trivial, as to be no longer consider'd as Proximate Cause.

Once or twice, within these 4 Months the Menses, have been
more copious, & of a good colour, particularly so the last Period.

The Cure, has been attempted by First Tonic's among
which the Cortex Peruvianus in various forms, has been
relied on, Chalybeates, Cold Bathing in Sea, & fresh Water,
Exercise, on Horseback, early rising, lying cool & on a Mattras.
Abstinence from Tea, warm Liquours, & a separate Bed have
been all enjoin'd & adhered to.

By Nervous Medicines occasionally viz. G: fœtida in large
Doses, with & without the Volatile Spirits, Valerian, Musk &
Opium, & the Body kept soluble, by Pills composed, of G: fœtida
& Pil: Rufi.

By an Issue in each Thigh which contrary to my wishes
are healed up.

Bleeding was once tried, but the Debility being
rather encreas'd was never repeated.

Mild Vomits of the Rad: Raphani, & Flor: Chamom: repeated
as the Acidities, or Nausea required them, which was frequent.

She since has had recourse to the Cortex, Tho Chalybeate
Water of this Town impregnated with fix'd Air, and Bathing
in the Sea, from these she Thought she found the most
permanent Benefit -- -- -- & persisted in for a long Time, but at
length loathing the Bark, laid them all aside, & now continues
as I have already stated, confiding in Exercise, the White
Mustard Seed, & Infusions of the Hol: Centauriis min: & Pil: fœtid
pro re nata.

She is very attentive to a Regimen, avoiding all kinds
of Relaxants. as Tea &c. -- Butter & Vegetables, takes
Meats of all kinds, & as Nutritive a Diet as possible.
Drinks Celery Tea, & at her Meals puts a little Geneva in
it, & some grated Ginger on the top of it. -- seldom eats any
Supper, goes to Bed early, & rises early. -- -- And takes every
step, recommended to her, that can tend to procure her a
restoration of Health. -- She has three Sisters, who are all
troubled with the Malum Hystericum tho' not so severely.

Hysteria must have some Proximate Cause, and I have
some inclination, to think this to arise from a latent Scorbutic
Diathesis. With a view to this, & the advantages accruing from
Exercise, I have recommended her going to the Lucan Spaw, which is
a Sulphureous Water, most probably known to you.