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I have considered the full and distinct account
of the Case communicated to me by Major Hamilton
with all possible attention, and shall give an opinion
and advice, which assisted by Dr. Hallidays good
judgement proveshall I hope prove usefull.

I take the most part of this Lady's com¬
plaints to depend upon the irregularity of her
monthly evacuations, and this again upon her
period of life, disposing to a total ceasing of these
evacuations. This I think may happen very soon
and then it does, she is likely to have tolerable health
but till it does, we shall find it difficult to
relieve her entirely from some of her present
complaints.

Besides the affection of the Womb, which I
have mentioned I think there is also an affection
of the kidnies with a tendency to gravelish com¬
plaints, which have a share in producing some
of her Symptoms, but none of these [make me?]

Upon this opinion of the case I am to pro[pose]
a medicine which is equally as I judge adapte[d to]
both the sources of her complaints. This is the [Uva]
Ursi, which is an excellent tonic and moderate [As]¬
tringent, and has very peculiar virtues [even in?]
repect to the Urinary passages. I would {illeg}
her begin with taking half a dram of the {illeg}
of the leaves twice a day, and after taking th[at]
quantity for eight or ten days, the dose may [be]
gradually increased till she can take a dram
twice a day for a fortnight. If this dose is [troublesome?]
by its bulk, she may take two Scruple thre[e]
times a day. It may be taken in plain water
Tea, or in a little wine and water, as She likes bes[t.]

I have no other medicine to propose at pre¬
sent, but if She finds her stomach relieved and
her appetite better preserved by the infusion of
Bark and Colombo in water I have no objection

While She is taking the Uva Ursi She should
take the same sort of diet, that she used when she
was taking the Lithontriptics, that is taking as
little acid or acescent things as possible. I am
glad to find she has entirely laid aside those Lithon¬
triptics, for though they promised the relief of
some of her symptoms , they were likely to do harm
with respect to some others. The only kind of
Lithontriptic I could allow of, would be now and
then a glass of Lime water, which might possibly
be of service.

Besides the medicines mentioned, the only
other to be thought if is the liquid Laudanum
which however I would advise more from necessity
than choice, but I take it that the necessity
is very great and I hope the harm to be feared
is little. I must leave it to Dr. Hallidays

One inconvenience that must certainly attend
it, is costiveness which if not prevented from going
too far will always irritate both the Uterus and
the Urinary passages. I know it may be
difficult to find our an easy laxative, and I must
leave that to Dr. Halidays skill, but and from
trials made, but I have one observation to offer.
I find the Lady has formerly employed the Ol.
ricini with a good effect, but that of late it
has failed, and as I think from its not ↑being↑ given
in a sufficient dose, for I am told this has
never gone to half an Ounce, which is the least
I can depend upon. I always give the oil mixed
with a fourth part of the Tinct. Senn. comp.
of our Dispensatory ¹ , and of this and the oil
well shaken together I give from half an Ounce
to an Ounce, and it seldom either disappoints
me or works too strongly.

I find this Lady is very much confined
to her house, but I think I would be

It appears to me that she was nothing
the worse for the Sea Bathing which she employ¬
ed last year, and I am of opinion that She might
be better now for employing a Shower Bath,
within doors, the water being tempered to what
she can easily bear.

These are the several advices and remarks
that occurr to me at present, but if sometime
hence Dr. Haliday will favour me with his obser¬
vations, on the effects of my present advice I shall
endeavour to mend it as far as I can.