She will take no nourishment of any kind and rarely leaves her bed. On the other hand, she does seem to be becoming sicker and still retains a healthy form. This mysterious situation is perfect fodder for a case study. Dr. J.S.Mackenzie saw an opportunity to both help this poor girl and write an analysis for the Royal Academy. His 1793 article recounts the doctor's interviews with the parents and his examinations of the girl. On the surface, the article looks like a purely empirical study of this girl's condition, but beneath the surface lies the doctor's subtle use of language to protect the family's reputation, while asserting his own diagnosis.
Dr. Mackenzie is a well-trained observer, like any good doctor of his time. He does not have the aid of complex medical instruments to examine his patients, just well trained eyes and ears. He uses these tools to construct the case study of Janet MacLeod. The first four pages of his article are merely the patient's history as told to him by her parents. He recounts her problems from her early teens to the present. He goes into great detail about her seizures, long bouts of being bedridden, and her parent's struggle to force feed her which was "not without violence." Mackenzie backs up these accounts by the parent's with confirmations from neighbors and priests. At this point in the article, he only relays these stories. He does not pose any theories on her condition because the empirical data is heresy and he has not yet examined her.
The remainder of the article tells of the doctor's own examinations and his path to a cure. By the time the good doctor arrived, the woman had supposedly not eaten substantially in three years. Her jaw was locked and her teeth had been removed to force feed her. Dr. Mackenzie expected to find an emaciated woman clinging to life, but instead he found her "features not disfigured," her skin to be "natural" and her breasts "round and prominent.