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It appears very clearly that the ailment is in the
lymphatic System and as it appears externally in so great
degree it is much to be feared that the internal parts
are also considerably affected. Such a general affection
must be of doubtfull event and at best of very difficult cure
but the change that has been produced on the tumour
of the neck gives hopes that the Same remedies carried a
little further may discuss also the other Swellings.

I cannot find any thing more promising than the
flores Martiales and I would certainly have it tried to
carry by degrees the doses of that medicine as far as the
Stomach will bear. At the same time I would take
what other assistance we can get from the Bark but
I would prefer an Infusion made as Strong as possible to
any decoction. To the flores Martiales and Bark alon[e]
I would Stick to for some time but if it Shall be found that
either She cannot bear these medicines in Sufficient

With respect to external applications I have no
objection to these employed but I must observe that
what you call Goulards extract is always an uncertain
medicine and the Saccharum Saturni can be with a little
attention can be rendered more so. With a Solution of
the Saccharum Saturni I find a fourth part of Spirit of
Wine that has not been rectified upon an alkali a very
good embrocation for Such lymphatic Swellings and I
have frequently employed equal parts of Spir. Mindereri
and Brandy with a good effect.

Your patients friends will probably be uneasy about the
ceasing of the menses but there is nothing to me promises
to be more effectual than the flores Martiales but if you
find that the patient does not bear a large does of these -
Let her take after every doese of them twenty drops of the
Tinctura Martis Pharm. Edin. ¹ in four ounces of Spring
Water.