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Case of a Patient to be laid before an Eminent Physician
for his Opinion and Advice. --

Mrs. Hay, spouse of Dr. Hay, a Scots Clergyman, is Aged 37.
years, of a delicate but not sickly Constitution, has had Six
Children & is not at Present Pregnant, The Menses are Regular,
tho these Evacuations have for some time past been lesser in quanti¬
ty than usual, on account of her Valetudinary State of health.
Her Present disease is of a dyspeptic ↑& hysterical↑ kind, of which it may
be Necessary to Give the following Short history.

The Patient was originally & from her infancy Subject to a
Constitutional headach, arising from a redundance of bile in
the Stomach which was relieved only by cleansing of the Sto¬
mach & Vomiting, which She was wont to provoke by large
draughts of Tepid water -- In September 1775, these bilious
headachs began to be more frequent, & continued so for one
whole year, returning once a fortnight, whereas formerly
She scarcely had them once a Month. - During this
Period, the Patient indulged too liberally & unwarily in
drinking copious draughts of lukewarm water, the only
means which She found of Easing the Violent headake, & tho
warned of the danger, would not take an Emetic nor even
Substitute weak Negus, in lieu of her Tepid water --
About September 1776, the Violence and frequency of the head¬
ach abated, The Stomach Seemed to be Cleared of bilious
matter, She loathed the lukewarm water, & all Slops, & liquid
food, & only Complained of a Wateryness in the Stomach, but
during the remainder of that year & the beginning of the
Current (↑next↑) year, She was seized with Dyspeptic Symptoms, in¬
dicating a Relaxation of the Tone of the Stomach. While

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These Symptoms were moderate, no danger was apprehended, &
She thought her Constitution mended by freedom from violent
headachs, but about Three months after (↑after, videlicet in aprile. 1777 -- ↑) the Dyspeptic Symp¬
toms encreased, to wit, loss of Appetite, Indigestion, windiness, belch¬
ings, Eructations, reachings very violent, nausea, & Sickness, [ivg?]
a Spouting up of phlegm & a watery humour from the Sto¬
mach, the Stuff thrown out from the Stomach in mouthfulls
was commonly Insipid, sometimes acid, her Urine for Some
months past has been (↑was↑) voided in Small Quantities at a Time,
& Soon turned of a whitish Color, leaving at bottom a Slimy
Whitish Sediment up of Mouthfulls from the Stomach, these
consisted of the food She had last eaten, of phlegm, & a watery
humour, the Reachings were commonly preceded by a false
appetite, or Sensation of hunger, which being gratified by a
Small Quantity of proper Aliment, the Reachings Succeeded
amd commonly were accompained with, or Ended in a Slight
Colic, and Gripes in the bowels, She has also been frequently
plagued with Costiveness, which however was readily Cured
by the use of a Glyster. -- The fits of reaching, and throwing --
up mouthfulls of phlegm, &c, for some time returned once every
other day, but after the use of the medicines, and regimen
to be afterwards mentioned they became less frequent, but
as Severe as before, & of for longer Continuance; & Such is the Pre¬
sent State of the Patient. -- in Summer 1777 -- Since that Time
For about ↑a year &↑ three months past, to wit ever Since the Symptoms --
became alarming, The Patient has had the Advice and Assis¬
stance of ↑two↑ Physicians of Character, The medicines they prescribed
were an infusion of the bark, & Chalybs, in wine, or brandy, to be

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taken in a Small Quantity twice or thrice a day, an infusion of Chamo¬
mile flowers drunk cold, the moderate use of lime = water, magne¬
sia Alba, Columba root, & Glysters, & in the Event of a Violent
fit of Vomiting, Tartar: Emet: Fortifs: four grains in four ounces of boiling spring water
. Dozes of Rhubarb also have been prescribed
for cleansing the Stomach of bile which the Patient voluntarily
vomits forth after Every Severe fit of Illnefs, but the Rhubarb
did not agree with her Stomach, but was always thrown up,
↑She also received Cordials in Time of Great languor & debility ------ ↑
The Regimen prescribed was to avoid Slops & liquids as Tea,
broth, Small beer, soups, Greens & vegetables, white = wine &
Claret & for Common drink to use cold water, either alone, or mix¬
ed with red=port=wine or brandy, and to eat meat, fowl, Solid
food of a dry kind, & roasted in preference to boiled meat, to drink
a Glass of red port=wine, to ride on horseback & use as much
Exercise both within & without doors as her Strength would per¬
mit.The Seidlitz Mineral water has also been prescribed
& used, and the Chalibeate waters of Peterhead, which the Patient
attended during the whole Season in Summer 1777. --

These Medicines have been used, and this Regimen Strictly
adhered to, for about a year and a half, without any sensi¬
ble Good Effect, Excepting only that She had some better health
during the Time of Drinking the Chalibeate water of Peterhead,
in Summer 1777. But soon after her return, relapsed & became
worse than before -- She had Another Interval of ease in July of
this year (1778.) during a Journey to visit her Friends, but on
her return home in August, tho She Got on horseback Every
day as long as her Strength would permit, She relapsed in two
weeks, & Since that Time has not been able to Get on horseback
but in Commonly Confined to her bed, the Disease is now encreased
by Strong hysterical symptoms, such as an Universal sense
of weakness & Debility, in so much that She must be Carried from
her bed to her Chair, & can Scarcely hold up her head Straight, a
languor & insensibility in so great, as not to know what passes
around her, a Total loss of appetite, she being able to take
Scarce any food, save a Dish of Coffee, or a spoonfull of portwine,

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She is worst in September, October, & August, & in February, March, &
& Aprile, & is a little better during the Cold months of November, Decem¬
ber, January, & thro the heat of Summer in June, July, & August,
but commonly relapses towards the End of August -- At present in
October 1778, She is Seized with all the Above violent Dyspeptic and
hysterical Symptoms twice Every Month, first, quo tempore fluunt
Evacuationes Menstruæ, and about a fortnight after, Sometimes
She has an Interval of Ease betwixt these two Turns of her disease
so as to be able to walk into the open air, or Get on horseback, but
in a few days her Disease returns, at other Times, & for a month
past these Returns of Distress have had no Interval so that She is
entirely Confined to bed, & her Stomach much Distressed with
bile, nausea, & vomiting, but She is so weak as not to bear the
medicines prescribed for Cleansing her Stomach -- The languor
& insensibility is Extremely Great & a Sense of Great weakness, De¬
bility, & dejection yet she is not low = Spirited, but hopes that She
will yet Recover, her appetite is quite gone, & Costiveness is very
troublesome to her --