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Dr Hamilton Concerning Mrs Hamilton

I understand that Mrs H has been of late irregular in her
time of Menstruation at longer intervals & in larger quantity than
usual - At the same time her greatest distress has
been violent pains at the coming on of the Menses. The
pains have been chiefly on one side of her Belly but
shooting down to the Orifice of the Uterus. As these pains
are no ways felt in the intervals of menstruation. I hope there
is no topical affection & that the pains are purely
Spasmodic - Upon that Supposition I think Opium the
only effectual remedy and commonly a large Dose is necessary
& often a repetition of it. I would give the Opiate as soon as
any pains come on, only it is necessary that the belly be open
or if it is not that it be opened by Glysters before the Opiate is
given - When that period is foreseen or when the coming
on of the Menses can be concieved or apprehended it is of service
to open the belly gently by an Aloetic Pill or elixir & upon
the actual coming on of the Menses to keep the belly open
by large Water Glysters - The management of these with the
Opiates will I hope avoid the violent pains which Mrs H. has
formerly suffered & I know nothing else that can contribute to
the same but external formulations or Semicupidium which I
leave to your discretion - Besides thus giving my opinion
of the management of paroxysms I should give it for preventing
them, but as a Period is just now expected I shall wait &cc.