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The History of this Ladie's Case previous to the Month
of September last was already sent to Edinburgh in order to
have the opinion of Drs Cullen and Rutherford - A Copy
of the State of the case, as it then appeared, with the Con¬
sultation from these Gentlemen is herewith transmitted.

In consequence of their advice, an Issue was cut in
the Leg formerly affected, & the ulcer has never relapsed,
notwithstanding the many alterations upon her Consti¬
tution in other Respects - About three weeks after the
consultation came from Edinburghthere appeared undoubted
symptoms of a threatening ascites, such ↑as↑ a paucity of
Urine, & an evident fluctuation of water in the Belly,
tho' seemingly in no great quantity, attended with the cir¬
cumstances narrated in the first part of the case, and
all the ordinary Symptoms of a confirmed tympany

Upon this alteration I ordered an Infusion of the warm
Diuretic Medicine in Rhenish wine, vizt the Raphan.
Millepedes, Mustard with a small proportion of Rhubarb
and Sal Absynth, this withsome of the Pilul. Scillit, a suit¬
able Regimen and proper Exercise appeared to me
the most proper course, but it produced no Salutary
Effects - the Quantity of urine was not encreased and
the Swelling of the Belly advanced very Sensibly --
Different forms of the Diuretic Medicine (particular¬
the Broom Ashes) were tried, but to no sort of pur¬
pose - The Belly was rubb'd with Oil every night at Bed¬
time -

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As none of these Methods were attended with Success, she
was tried with the Hydragogue purgatives, which in the be¬
ginning seemed to flatter her hopes and Expectations,
two Spoonfuls of the Syrup de Rhamno, with about Ʒi
of the Tinct. Jalap. served for a Dose, & was repeated for
the most part every other day, as her Strength and
Symptoms wou'd admit - The Physic never failed to
operate without giving her any uneasiness, & produced a
discharge of loose, watery stools in considerable
quantity, which in the meantime gave her some Ease,
by restoring relieving the oppression upon her Breath¬
ing, but only proved a temporary Palliative -

As she was much distressed with the sudden Inflations
& Spasmodic pains of her Bowels, She was ordered
an Anodyne every night, from the time she began to
take the Physic, & which She has been obliged to continue
ever since.

This method was not attended with better Success than
the other and as her Strength was considerably impaired
and the disease greatly advanced, it was determined
to be given up -

She was then tried with the Seneka Decoction and ↑the↑ An¬
timonial wine, neither of which produced any Evacuation
which proved of the smallest Service. As her Belly was
now distended to a very great Size, her Body ex¬
tremely weakened and emaciated and no prospect of

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Success from Medicines,the only remaining method
of procuring relief was proposed by tapping, which for
several weeks (from the first mention of it) she wou'd
not agree to, & in the interim some innocent Placemus
was now and then ordered, and amongst other things
she was wrapt in a Sheep's skin newly killed, which she
insisted shou'd be tried, from some accounts she had
heard of it's Success with others, but in this too she was
much disappointed -

Her Belly Thighs and Legs were now so much dis¬
tended and her Strength so very much exhausted,
that She at last consented to the tapping which was
performed upon the last day of January under the most
discouraging and unpromising circumstances -
She however kept up during the operation with surpriz¬
ing Spirits - and eleven Scots pints and a Chopin of
water were evacuated - The water was of a light green¬
ish Colour, but in no degree fetid or very thick or
turbid - This method procured the Relief common in
such Circumstances, but her Expectations in a few
days afterwards were much damped, with the appearance
of a sudden Relapse, which made such rapid progress
that in seven weeks there was a necessity of repeating
the Operation. During the interval of the tappings she
was tried with some strengthening medicines, and
nourishing diet, but the Severity of the weather wou'd

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not allow her the Benefit of Air or Exercise - The Second
operation was undertaken with much less dread and
diffidence than the first, asShe had acquired a con¬
siderable degree of more strength & Spirits, and up¬
wards of ten Scots pints of water were taken off -
From this last tapping she continued surprizingly
easy, the Swellings of her Thighs and Legs gradually
subsided, & the quantity of Urine was considerably
encreased. Upon the Evacuation of the water, great
care was taken to examine if any hardness cou'd be
found about the Liver, Spleen or Mesenteric Glands,
but nothing of that kind cou'd be discovered. I forgot
to mention that the water upon this last tapping had
much the same appearance as the first, & it formed
a very thick glutinous coagulum, upon trying it over
the fire with a very little boiling - From March 24th to
April 4th She continued very easy, no appearance of
a Return of the disease, tho' she frequently complained
of thirst. About that time she was siezed with a smart
fit of fever and headach, which continued for Several
days & luckily terminated bya pretty copious Sweat¬
ing, which was afterwards followed by a plentiful dis¬
charge of Urine - Since that time She continued to re¬
cruit her Strength daily, & no evident appearances
of any return of the disease, till about ten days ago

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that her urine was not voided in such quantity and the
Size of her Belly was sensibly bigger - As She is very an¬
xious about trying the Effects of a continued easy
journey, she is now resolved to go to Edinburgh in order
to have the Benefit of the Physician's advice and
Directions.

I ought to have mentioned that She continued very
regular in her Catamenia, till towards the End of December
last, since which they have never appeared- She has likewise
been using Asses Milk during the most part of the Win¬
ter and Spring, which has always agreed with her - Many
other particulars of her case are ommitted, which perhaps
shou'd have been mentioned, but as the most essential
things are narrated, & as the Lady herself will be present,
I have endeavour'd to avoid unnecessary minuteness
and prolixity -Her pulse generally is soft & easy & her
Belly is for the most part regular - When She is costive,
that complaint is commonly relieved by using a little
Cremor Tartar flor. Sulph, or by Carminative Injections

Dated Aberdeen May 10th 1762

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✍

Case of Mrs L
since September 1761