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In all affairs of difficulty & importance it
is natural to wish for the council of those we
entertain the most favourable opinion: On
this principle it hath several times been my ear¬
nest desire to have yours in many perilous
diseases which have fallen under my care, but
till now have never been able to obtain the hearty
concurrence of the patients and their friends. At
present I am solicited to ask it on account of the
bad state of heath of the only son of a considerable
merchant in this town. Being a youth of most
irreproachable character it is not wondered, if his
parents are excessively anxious about him, and on
making them acquainted with my opinion of the danger
and obstinacy of his disorder, and expressing a desire
of having your advice they immediately requested
I would not delay {illeg} attempting to obtain it; for
which purpose I send you the following history of
his complaints and must desire as speedy an
answer as can be remitted. I will take care you
shall be recompensed by the first opportunity.

He is about 20 years of age, of a middling
size and well proportioned. Habit in health rather
sanguine with a florid countenance, large eyes, and
brown hair. Is very much devoted to business which
he prosecutes with great ardour -- accustomed to

The present {illeg} condition of his health is almost
a total loss of appetite, eating but a very few ounces
probably ↑not↑ more than three in the space of twenty four
hours - he {illeg} is not thirsty tho his tongue appears
whitish and a little clammy. His complexion sallow &
{illeg} countenance languid & he appears to be a good
deal dispirited. Now and then complains of a consi¬
derable uneasiness in the upper parts of his face which
wanders is attended with a [confused?] sense of noise, that
at times confuses his speech -- Often feels a great
degree of variable uneasiness and sometimes great pain
like the colic in the belly - this moves to different parts.
The abdomen is small, and no preternatural appearance.
His eyes wear the pearly hue of the consumptive: ↑Pupils very open.↑ In
general feels cold which makes him sit much by the (↑a↑) fire.
He is greatly emaciated -- Skin always cold & dry.

Urine moderate in quantity and quite natural in its
appearance. His alvine discharge so amazingly restricted
that I shall scarcely be able to give you an adequate no¬
tion of it, unless you can obtain it from the effect of the
medicines he has used. He is generally six or eight days
without any stool and often a fortnight -- it is always indu¬
rated, consisting of a few round bumps, of a natural yellow
tinge, tho perhaps {illeg} (↑a little↑) darker {illeg} (↑than↑) is usual at his time
of life. He frequently attempts to force one. ---- Of late
his sleep has been short & disturbed, feels in the night
great lassitude and considerable anxiety. Pulse slow,
regular, moderately strong and full; beats about sixty in
a minute more commonly fewer than more.

When I {illeg} was consulted which is about two months
ago my first intention was to remove the costiveness {illeg}
which I expected Aloes would answer, but I was dis¬
appointed for after exhibiting thus it in very liberal
doses sometimes half a dram at a time in every possible
form and combination I found it would not answer {illeg}
but seldom procured a stool. I suspected the aloes i[n]
any solid form might pass undissolved I therefore {illeg}
it almost fluid with honey with no better effect. [I?]
next thought of sea water, three pints of which could
be drank without procuring a single stool. Castor
oil he could not take. After trying a few other
purgatives determined to overcome this obstacle I
prescribed as follows

He has frequently taken six of the Pills & the full dose
of the mixture with no greater effort than a small costive
stool. He is at present using these medicines only the
proportion of Calomel is lessened, and never has a stool with
out their use -- I have mentioned the purgative waters
of Cheltenham which he is extremely anxious to try, being
tired of medicine. He waits with great impatience for
your answer, which will greatly oblige your

To
Professor Cullen
Edinburgh

Doctor Brandreth
C
A young Gentleman
Dickson
May
1778.
VIII. 111.