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Dr Hamilton Concerning Mrs Arnot

I received yours concerning Mrs Arnot
yesterday but could not answer it till to day.

The case is not new to me but it is very difficult to cure.
I don't believe that there is any tumour tho her feeling maybe as
if there was, but any degree of external tumour must I mean exter¬
nal to the oesophagus must be felt by your hand examining it.
I am perswaded that it has been originally a spasmodic constriction
and nothing else will account for its being relieved by pregnancy
and warm weather; but it is possible that there may now be a
thickening of the coats of the œsophagus which will render the
cure more difficult. After the trials that have been I cannot
expect any thing from urging the Mercury farther especially
at this Season. The blistering was at first a probable remedy
and may be tried again but I would first try antispasmodics and
emollients. Let a little good Æther be applied on each side of the
Larynx or a little below it so as to come ↑as↑ near to the œsophagus as
possible, and this may be tried twice a day keeping the throat con¬
stantly covered with a piece of fine and thick fur. If the soreness

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which you mention as formerly in the pharynx and mouth
be now so entirely gone that she bears the swallowing of some things
acrid as mustard; salt, spirits or such like I would let her swallow
a little æther diluted with water and according to what she bears ––
proceed farther. I once had a young Lady with a stricture of the Œso¬
phagus which sometimes for a day or two entirely prevented swallow¬
ing but a little æther made its way and allowed other things to follow
By the repetition of this practice and the use of Laudanum the dis¬
ease was entirely cured. When Mrs Arnot ailment was recent
the latter remedy might perhaps have been of service but I cannot
expect benefit from it now when there is probably an constriction from
a thickening of the coats and at least a rigidity of long contracted
fibres. I wish you had been a little particular with regard to the
state of Mrs Arnots swallowing. She certainly swallows some nou¬
rishment & pray tell me of what kind and consistence for this must
regulate some measures I might propose and therefore I shall say
no more now nor till I hear from you again but that I am
always