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I have Enclosed you a hasty narative
of Mr. Montgomeries Situation which however I
hope you will understand, and favour me with
your opinion as Soon as you Can what is but
to be done: if his life seem of less Consequence
than it is to all who know him Suffering would
Call for the the utmost Exertions of Every man
of the least humanity: whether the various methods
recommended in Cases of galstones have any other
Efect than what is Evident; their Keeping the bowel open
& promoting the Discharge of Urine, I will not pretend
to say; but Im pretty Certain in Mr. Montgomries
Situation, Especially Considering the delicate state of
his Stomach, he Could not goe Deep in any of
them, not Even Van Sweetens grass diet, ¹ I
wait with Impatience a renewal of that pleasure
I have always had in hearing from you and
knowing your assistance in Such Dificult
Situations and with Great Esteem I am

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Dreadfull pain and vomiting he threw up
a gull Stone of the Size of a Small pea but
very rigid: I did not See him till Monday night
the 29th. when he was Easy but very deeply
Jaundiced his pulse natural and Complaind of
nothing but weakness & Soreness from the vomiting
the Day before, he was Costive and what he passed
of a whiteish Color: I gave him a purgative with
Some Calomel which produced Some Stools but not
tinged with bile, after this was over on tuesday
he grew uneasy but upon throwing up a
Glyster of warm water and fomenting his
Stomach and bely he got into a [profound?]
Sweat and Continued Easy all Day & his pulse
not increasd, in the night however he grew very
uneasy and at Eight in the morning I Saw him
his pulse as hard as a whip Cord and past all
[running?] with frequent but Irregular Intermissions
I took Immediatly ten ounces of blood away
at twelve Eight ounces more and at Eight at night
about six ounces it was very buffy & as yellow
as Safron he had various glysters through the day
and the fomentation was Continued [Closs?] he grewd
Easier after the last bleeding and passd a tolerable
night, in the morning of thursday the Second
current he had little or no Complaint but a general
languor, his pulse was weak quick and Exceedingly
Irregular I gave him Some more and Kept
flanels wrung vomiting out of warm water and [spread?],
Constantly to his Stomach and bely and about
one his pulse began to grew fuller [Stener?]
and more regular he had two Stools in the
Evening with a glyster - but not in the least
[tinged?] with bile he had a tolerable night &
on friday the 3d was So well that he rise &
walked without [tripod?] to his Chair till his
bed was made but Still no appearance of bile in
his Stools & thereafter given him a purgative with
five grains of Calomel about ten at night: about
three in the morning he was much griped and had
Several Stools the first white the last highly [tinctured?]

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Mr. Montgomerie at Coilsfield aged twixt Seventy
three and four, Subject for some years back to
Severe gravelish fitts, in which he has passd many
Stones of Considerable size; was about three
months agoe when in better health than usual, all at
once atached with a pain in his Stomack Strikeing
through to his back, and vomiting, which Continued
to Distress him Severely for Some hours when after
warm glysters & fomentations & the [ampluatum?] of
Laudanum to his Stomach outwardly he grew Easier
but was observed next Day to be jaundiced all over
he was Costive & his Stools of a white Clayish Color,
he got a Smart purgative & his bowels were
relieved, the Stools at first Continued whitish but
the two last (for he had Six) were highly Saturated with
bile, next day he began to take Every three hours
a Spoonfull of the best vinegar Could be got
Saturated with Salt of tartar Every three hours
he Drank whey or watter gruel acidulated
with Crem of tartar plentifully, his diet
was porridge and aleum the morning, a little
Chicken broth with Some Crem of tartar &
Bread for Dinner, and a little negus with
Crem of tartar and bread for Supper, in this
way his bowels were kept Easy his Urine
flowed plentifully, his Skin & Eyes grew Clear
and his urine and Stools Continued of a natural
Color: he got Strength & Spirits & he Suposed
himself in Safety; but in twelve Days I think
we held past the {illeg}
Every respect:and he was releved in the Same way
only as his bowels were now more Distressd I got him
to take from two to three Drams of [Sope?] Every
Day, in adittion to his other medecines, by which
he was in four or five Days Clear again of the
apearance of Jaundice, and Continued well and in
Spirits for a few Days, when he was again
attacked & Relieved in the Same way, & this
went on he having an attack Every Eight or ten days
till Sunday the 28th. Curent when he had a fit
more Severe than any before, when after most

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with bile: I was obliged to leave him but
desired the Servant to Inspect his Stools very
[nearly?] as he had Seen him day before and
at night when I Came back he brought in
a galstone he had in them nearly round
but longer one way than the other the longest
way round an Inch and an Eighth the other
way a full Inch as Near as we Could guess
for we had no rule to lay the measure to
he has Continued Every Since his pulse quite
natural and his Eyes begining to Clear
again I must Apologize for working on Such
Scraps of paper but to it hapens I have no
Blotter nor have I any more to make a Clean
Coppy

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✍

Montgomerey of Coilsfield
October 1783
V. xv. p.288. -