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About the end of April or beginning of May 1778 I -
used the freedom to ask your advice concerning a Lady, who was
afflicted, at that time, with a violent Scorbutic Disorder. Since
then, she has been sometimes better, sometimes worse, but never
entirely free of her Disease, and is so bad at present that I am
under a necessity of having resource to your assistance once -
more. But, as at this distance of time, you may have probably forgot the
Circumstances of her Case, shall begin by narrating it over again,
which I am enabled to do by from a Copy of the Letter you then
receiv'd. --- A Gentlewoman aged 50, and the Mother of fifteen Chil¬
dren, and strong and healthy in her youth, was, about two years
ago, seized with a periodical Headach, about the time her Men¬
ses began to disappear. The Paroxysms returned every four or -
five weeks; the pain was chiefly seated in her Forehead and eye¬
brows, bore a great resemblance to what is usually called the Me¬
grim, and was always terminated by a considerable watery dis¬
charge from the eyes, after which her ordinary health return'd.
At first the Menses were not entirley suppress'd, and an irregular
Flux of these at the end of two, three, or four Months, common¬
ly relieved her head for a considerable time. But afterwards, -
when this Evacuation ceased altogether, a kind of Scorbutic Erup¬
tion appeared all over her Face, Head, Neck, and sometimes her
Wrists. The Scalp was corroded by a large quantity of hot watery
Ichor, which constantly flowed from every part of it, the discharge
from her eyes still continuing. A number of Scales appeared on her -
Face, all which and particularly the Tip of her Nose was generally much
swelled. Copper-colour'd Spots, about the size of a crown-piece and often
larger, broke out on her Neck and Wrists, sometimes dry, and some¬

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times discharging a thin Ichor similar to that which flowed from her
Head. Reddish fiery Pimples would likewise make their appearance on
these parts, which generally came to Suppuration and healed after dis¬
charging a considerable quantity of thick, well-conditioned Pus. Thus
she has continued for the last twelvemonth; but about two months
ago a most violent Head-ach came on, which, after continuing seve¬
ral hours, terminated in a Delirium and this, again, and (↑was↑) carried
off by an encreased Discharge from her head. The head-ach continu¬
ed notwithstanding, and, for eight days, she was tormented with most
excruciating pain, but was, at length, relieved by the application of
a Blister inter scapul: and the Flux of Ichor stopped by degrees.
After this she enjoyed good health about a Month, when the Erupti¬
on on her Face, Head and Neck (which had entirely disappeared af¬
ter the last violent Paroxysm) again broke out; the Tip of the Nose
swelled much, and came to a sort of Suppuration, but soon healed.
The Scalp is, just now pretty sound; but the internal part of each -
eye-lid is a good deal inflamed, attended with a small discharge from
them and the other Eruptions, which are at times very itchy. -- Much
inclined to Costiveness, and always {illeg} relieved by a loose Stool
or two. Pulse natural, except in the exacerbations of her Disease, when
it is sometimes very quick. -- Her Legs have been much swelled for
many years past, owing to her frequent Pregnancies; but she is a¬
ble to go about ordinary Business, Appetite good, and the Stamina of
her Constitution still entire. --- It is needless to recapitulate more of
what was contained in that Letter, only that the Medicines, which
had chiefly been tried, were Decoctum Lignorum Mild Mecurials with
Play Laxatives now and then, and the Bark; that a Seton or Issue
had been proposed, but always delayed; and that the Bark made -
her costive, and did not seem to give any relief. --- In your an¬
swer a Course of Pitcathly water was advised, and a Repitition
of

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the Decoctum Lignorum in Winter. In consequence of which she went to
drink the water; but her Husband having gone along with her un¬
fortunately got a Fall from a Chaise and bruised one of his Legs:
soon after which (↑this↑) he felt the first Attacks of that Distemper which
afterwards brought him to his Grave, and about which you was con¬
sulted in Summer. Thus she got (↑receiv'd↑) little benefit of (↑from↑) the water for that
season; but having got something better by the end of Harvest -
scarce used any Medicines till June last when she went to -
Pitcathly a second time, and was still more unfortunate than
at first, the tedious Illness of her Husband preventing her from
using the water at all. During all this time her Disorder con¬
tinued much as it was, her head and Neck being sometimes -
hard and scaly, sometimes discharging Matter, and sometimes
almost quite healed. Only the same Eruptions have lately appear¬
red on her Legs and Thighs. -- Five or six days ↑ago↑ she had an execer¬
bation of her Disease, similar to what is described above, attend¬
ed with violent Headachs, a great discharge from her Neck -
and behind her Ears; Also great pains in her Limbs and the -
Small of her Back, Symptoms which she never had before, and
which are very troublesome, as they prevent her from getting -
Rest in the night. These pains I suspect to be at leas in some
measure Rheumatic, as she has lately got a good deal of Fatigue,
and been accustomed to go out after it was dark. Has again be¬
gun to use the Sarsaparilla &c. But her Blood seems now so much vi¬
tiated that I am afraid she will not long be able to support bear
the violence of her Disease, if some strong Remedy is not very -
soon applied. I have thought of giving Mercury, but am doubt¬
full about it, as there is reason to suspect it can be ↑but↑ of little -

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service, if not pushed to a greater length then her Constitution can
bear. Indeed my principal reason for giving you the present trouble,
is to be resolved about the propriety of this Medicine. Whither
it may be used with safety at all, and in what quantity: And whither
it should be taken alone, or conjoing ('d) with the Decoction. I remem¬
ber a Woman in Edinburgh, about eight or nine years ago, who was cured -
of a similar Disorder by drinking a quart of the Decoction every
day for two or three Months, without any other Medicines; but
as I took no Notes of the case, cannot say whether her Complaints
were of as long standing. --- Her Friends are very anxious to have
your opinion with regard to the probable Issue of her Distemper. -
Beg you'll be kind enough to accept of the enclosed two Guineas,
and I am, with great regards, Sir,