[Page 1]

[Page 2]

[Page 3]

[Page 4]

I am desired to consult you on account of a lady
who for some years past has had a very troublesome
Uterine hæmorrhage which has at last broke her
health and reduced her to a very alarming situation

Mrs McMurdo is about fifty, of a Corpulent
habit, the Mother of a great many children and
had several miscarriages by which she suffered
severely - About five or six years ago the Menses
returned oftener and the discharge continued longer
and in greater quantity, than usual with her
but as her general health did not suffer she paid
little attention to it. Two years ago the Flux became
still greater and at times the fits of floodings were
very violent. She then began to reduce her diet
and eat the least nourishing things at table. Some
months ago when the floodings became so great

as to debilitate her and attended with pain in the back
I was consulted and found her pale, flaccid, her
stomach falling off, distressed with spasms and fla¬
tulence in her stomach & bowels. The floodings at
times violent and seldom absent a day or two
very seldom a week or two. Her belly always bound
except from Laxatives, a frequent inclination to
make water and considerable uneasiness for some
time after. From a review of the case I thought she
was carrying her abstemiousness too far. I therefore
ordered her a little animal food at dinner and a
glass of wine, to wear flannel and use the flesh
brush as she could use little exercise. For Medicines
I ordered an Electuary with Bark & Gum e Kino and
a dose of Elixir of Vitriol twice or thrice a day in
a wine glass of water. Her bowels were keept open
by the mildest Laxatives, as Sulphur, Crem. Tart. &c
{illeg} of the Electuary she took Bark in powder

for some weeks and to several ounces and at the same
time a cold infusion of it in water without any
advantage. I then ordered Pulv. Styptic. with
Pulv. Rad. Columbo and the Hartfell spaw and
to relieve the flatulence & spasms in her bowels
she took at times Pills with Gum. Asæfœtid.
On this plan I thought she was gaining ground
As Mr McMurdo lives at a distance I had no oppor¬
tunity of seeing her for some weeks till yesterday
when [I] was much concerned to find her
much fallen off. The discharge much
the same, her appetite almost entirely gone, emacia{illeg}
slight œdematous swellings a parched tongue and a vile
creeping fever constant uneasiness in her stomach and
frequent Cardialgia. I have no reson (↑reason↑) to apprehend
Schirrhus as the cause of this Menorrhagia. Want of tone
in the Uterine vessels seems the cause, but this I humbly
submit to you & with the highest respect I am

Doctor Cullen
Edinr

Mrs Macmurdo
March 1784.
V. XV. P. 426.