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A Lady in the fifty second year of her age, middle sized,
of a full corpulent habit, & tho remarkably healthy & of strong
constitution, is not without evident symptoms of a scorbutic
tendency; who's menstrual discharge continued regular to her
fiftieth year and then ceased without trouble or inconvenience:
In the month of Augt. 1780 first discover'd a hard Schirrous tumor
under her right Breast almost close to the ribs, but unattended
with the least degree of pain. The Breast was naturally so large
that the size of the lu{illeg} (↑m↑)p cou'd not then be ascertained, but was
thought to be about the bigness of a hens egg. On raising the Breast
its surface appeared the breadth of a halfpenny firmly connected
[wi]th the skin. In the month of Feby 1781 she went to London &
consulted Docts. Warren & Hunter. At that time a red speck
appeared in the middle of its surface. Both the Docts. look'd upon
it as not immediately dangerous, at the same time Dr. Hunter
was inclinable to recommend an extirpation of the lump either
by caustic, or what he thought more eligible by the point of a Knife.
The Lady was much averse to an operation, so was advised to
leave Town, and from a full generous diet and much exercise
which she had always been accustom'd to, was order'd to keep still
and quiet, & to live very low, chiefly upon pudding & vegetables.
abstaining from Wine and animal food, & to take ʒij of Sal. Rochel.
twice a week. In June last she was further advised to drink
twice a day, a strong decoction of Veronica mas, which she complied
with for a month, but it operated so much physically that it
was thought advisable to discontinue it. From the end of

The secretions & excretions are natural & unaffected by the use
of Hemlock, nor has it any sensible effect further than occasi¬
oning a little giddiness, the common criterion of the sufficiency
of its dose. The external surface of the lump is now increased
to about three inches diameter, nearly circular, several red pro¬
tuberances appearing on its surface from which a little
serous humour has ouzed at times for three Weeks or a month
past. Ten days since one of these protuberances burst & dis¬
charg'd a little Blood, Since which time, the serous discharge
is increased, & a small ulcer is form'd attended with some degree
of foetor. No outward application has be used further than
washing the part with Sea Water two or three times a day,
and afterwards covering it with a piece of soft cambrick, &

As she will with the utmost reluctance submit to an operation
Your authority is requested, to know how far and in what
manner the use of Hemlock, or any other medicine you can
propose, may be persisted in without risqueing the chances
of a radical cure by means of the Knife ----------

Doctr. C[ulle]n