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I have with great attention perused the full
and judicious account of this Lady's case communica¬
ted by Dr Dixon, and am sorry to find it a very in¬
favourable one; not only from its symptoms but from
this also that it has already bafled a very Skillfull and
judicious treatment.

I am persuded that the disease is a Schirrosity of
the uterus
which presses on one hand upon the bladder and on the
other upon the rectum, and the pains which so
so frequently distress her in a particular direction and
the nature of the present discharge give great reason
to the fear that the parts within are in a bad State.
The discharge at its first appearance was not Such
as commonly attendes a Schirrosity but I have met with
it several times in Such cases. After giving this
opinion of the nature of the disease I need not say
again that it is unfavorable & must be difficult to

While either the Cicuta or this is employed I hold it to
be very necessary to prevent as much as possible the retention
of acrid matter in the uterus and vagina and for this pur¬
pose to inject into the vagina with a proper Syringe
once or twice a day an infusion of dried roses not very
Strong but with two ounces of Syr. e ros. Sicc. to every
pound of Infusion, and to the Same quantity an ounce
or two of brandy if this is not found to give irritation.
To the Same infusion once or twice a week may be added
a dram of the leaves of the cicuta or more if it is found
not to affect the nerves very Strongly which it is something
found to do when applied to ulcerated parts. These are
the remedies which I hope may be employed with advan¬
tage but as they do not commonly give any immediate
relief I am clear that the employment of opiates and
with these the Oleum ricini as judiciously advised by
Dr Dixon will be absolutely necessary.

With respect to Mrs Ponsonby's diet I have nothing
now to offer as it appears to be very judiciously ordered
at present, for, I am certain that it ought to be light
and cooling.