Mistress A. Downman, from the County of Devon
aged 28. At the beginning of 1771,
the known facts are, that she was afflicted with the utmost grief at the death of a favourite brother.
For weeks, indeed, for some months,
indulging in grief, she often shed tears during the day.
She received some solace from a young female relative,
and regained (so it seemed) her former state
of mind. But also
in the middle of Summer 1772, at her parents',
she abandoned herself and succumbed again to sorrow.
Now, however, she responded to her friends'
enquiries that they were not to worry about her
on any account, but that the cause of her grief and tears
she attributed to certain pains, resembling
the prickling of gorse on the skin
and diverse parts of the body.
Driven by these pains (true or imaginary), so she said,
she was perpetually in anxiety, sought solitude, often wept,
and begged the pity of her friends.

At first we turned a deaf ear to,
these complaints, which were surely light and of no great moment,
but because they were increased by her imagination
and fears, we took care of the tone of her general system
and the restoration of her mind. Therefore on alternate
days she was immersed in the sea, and, although it was
difficult to persuade her, often went riding.

However, as happens in cases of this type of Melancholy,
no rememdies are esteemed to be of use
save these proposed, we at length prescribed Gum pills,
[Castor?], Camphor, and common nervous tinctures;
at length, Tincture
of Mars, Bark Extract, Vomits of Ipecacuanha,
Rhubarb, Rufus's Pills as required, with a certain absorbency,
and for a long space of time
Breadcrumb Pills. It must be noted that
after any new remedy, or medicine or different
ingredient, she would be better for a few days,
but then she wanted to try one thing or another.
It must also be noted that the Breadcrumb Pills
lasted longer (because of their goodness, so she said, and sensible effect),
and she conceived great hope of her cure.

By riding and sea-bathing, or
having left home to be with others,
things were better, but having returned home,
she was affected again with melancholy, and
sometimes even to the point of despair. In
some of her manuscripts found in her desk we read thus:
"Since these stinging pains have attacked first my feet and legs,
then my body, and afterwards my viscera, why
then do not they not at once attack my brain,
and drive me mad? If so much misfortune was to be hers, she entreated,
that her parents, while they lived, could not remove it,
she would afterwards entrusted herself to her brother's care;
and when he also died, to that of her sister."
She also often spoke of the burden of life,
and wished so strongly for death that she
aroused a great fear in her friends (if her religion
did not prevent it), that she would lay violent hands upon herself.

Meanwhile, throughout this whole time
her appetite was full and good, the strength of her limbs
in no way diminished, her pulse regular,
her face with a healthy pink colour,
and she menstruated regularly; she never complained
of any other pain save those gorse-like pricklings mentioned earlier.
And with this pain her
grief, anxiety, and weeping returned:
she always strongly insists that this pain is not imaginary,
and is very angry if ever she hears any such suspicion. No instability
of her system is apparent, no globus,
or any other Hysteric symptom,
except sometimes a sudden urge to urinate,
with a copious limpid flow.

In April 1773 she consulted the renowned
Dr Fothergill, who prescribed
Aloetic pills and Calcified Antimony
to be taken every night; artificial spa water twice a day
with the addition of Peruvian Bark Tincture and Aromatic Tincture.
Also moderate Exercise and an unexceptional diet.
By this just advice and with happy hope
he tried to settle her spirits. While
she made the journey to London, grief and
anxiety scarcely often made their appearance,
and while she stayed in the city,
she remained cheerful and lively, and very rarely wept.
Thence she made for her sister's house, where either by
the wise support of the celebrated doctor,
or soothed by the change of scene, and delights of refined company,
for several few weeks she was calm,
and she did not shed tears at all.

However, in June, again despairing,
again we consulted Dr Fothergill
by letter. He prescribed in place of the Aloes
Cathartic Extract. and twice as much of the saline Laxative,
regular diet of vegetables and summer fruits, the Pill
of the Cathartic Extract to produce one stool a day,
the saline laxative two.