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A Gentleman who is at present
a Patient of mine has for some time past
laboured under a Complaint peculiar in its nature
and obstinate in its symptoms : He has had
the Advice of several eminent surgeons &
One Physician before I saw him, but without
the least benefit, and tho' He is now considera¬
bly better from the Mode of Practice below
described, yet there appears so little Reason
to hope for a radical cure from any thing
hitherto done that his Patience is now
almost exhausted : I suggested the Propriety
of applying for the best Medical assistance
that could possibly be procured, and in conse¬
quence of that suggestion I am desired to say
that all his present hope is founded on the
expectation of the benefit He may recieve
from Dr. Cullen's consummate skill & extensive ↓experience↓

He is a single Man about 26 Years of Age & by
occupation a seaman. - In the Month of January 1784
He broke the Frænum Penis during coition in consequence
of which He had an ulceration which prov'd rather
tedious to heal - He had however no other symptom of
Venereal infection 'till three weeks afterwards when
a Gonorrhœa appeared with a Chordee which proved
violent and painful. - Besides the usual Ardor Urinæ
He had what He calls "a stanging sensation along
the course of the urethra, when not making water
He applied to an Apothecary who gave him some merc.
ointment and internal Medicines by the use of wh.
He was soon free from all venereal symptoms, &
apparently quite well. About the Month of May however
He percieved that the lower part of his face on expo¬
sure to Air was affected with a peculiarly painful
itching - this symptom became daily worse and was
at last constantly succeeded by an inflammation, &
considerable discharge of a Gelatinous matter in appearance
and consistence nearly resembling the white of an Egg,
only somewhat thinner, & sometimes to the Quantity
of an English pint in the space of one night.

His face after the discharge had always a scurfy
appearance but occasioned for the most part, if not

altogether) by the concretion of part of the glu¬
tinous discharge: There was no enlargement
of the subcutaneous glands, nor any solution of the
continuity of the cutis to be percieved, which might
afford a passage to the matter which was thus
thrown out. It is remarkable that on keeping
the House a few days these symptoms always entirely
disappear'd, nor was He again affected till He was
again exposed to the Action of the Air, He could
never observe any difference however between very
cold or very mild air. When I first saw him
(in Octr. 1784) He laboured under the symptoms above
described & these still encreasing in violence - One
of the submaxillary glands on the left side was swelled
to nearly the size of a Nutmeg, but without any appa¬
rent signs of inflammation, and He had a very
slight discharge of thick whitish matter from
the Urethra which occasioned no pain nor heat
in making water only sometimes a slight smar¬
ting just within the Glans Penis after the Urine
had all passed off.

Notwithstanding I found
that He had before had considerable doses of

Mercury I ordered him Unctions to the feet &
hands corros. subl. in the proportion of ʒij to
Axung Porcin. ℥j & as the Perspiration seemed
almost totally suppressed sudorific draughts
morning and evening prepared with Vin. Antim.
& Tinct. Theb.

By this Method the itching of
his face was somewhat relieved but the
discharge still continued as great as ever
I then gave him calomel for about a fortnight,
but without any apparent good effect. I next
ordered the celebrated Alterative Pills of Dr.
Plummer; He took these morning and evening
with Decoct. lignor. for abt 6 weeks, gradually
increasing the Dose, so that his Mouth was gently
affected by them the whole time - During
their use his symptoms gradually disappeard,
and when He went again into the Air, His face
was neither effected with the itching nor the dis¬
charge, but was very tender and smarted a
good deal, this however soon yeilded to the

following Fomentation applied three or four times ↓(a day :↓

He now enjoyed a state of good health for some
months - He went into a very bleak part of
the country by the sea shore and followed the
Diversions of hunting shooting &c with impunity.

Somewhat better however than two Months ago
His complaints returned, the same prickling
sensation on Exposure to the Air, & the same
relief on keeping the house for a day or two,
only He has not yet had any return of the
thick discharge before mentioned -.

His former Medicines even in increased doses
have now no Effect; in addition to them

He has taken the Æthiops Antimonii in conside¬
rable doses but to no good purpose : He now
sometimes percieves a single drop or perhaps two
of Gleety matter in his shirt in a Morning, &
feels at times "a slight tingling smart" (so He him¬
self expresses the sensation) shooting along the
Penis . His Pulse is natural, He sleeps tolerably
well, in his belly He is pretty regular, and his
Appetite is not much impaired. He earnestly
requests your Answer as soon as possible, as
his complaint (not indeed without reason) has
made him exceedingly impatient & very unhappy.

I have nothing further to add on this unfortu¬
nate Young Man's account, but in his name
to request your acceptance of the trifle inclosed.

- As to myself I have hitherto had the
happiness of being very successful in Practice,
& I find that calls upon me in the Professi¬
onal line "have increased, are increasing," &
--- but as to the remainder of Mr. Burke's
celebrated rhetorical flourish I hope I shall

not need to apply it to myself for many
years to come. I flatter myself your candor
will excuse the liberty I take in giving You
the trouble of making my grateful respects ac¬
ceptable to the Medical Professions - I am happy
in an occasion of paying my tribute of Gratitude
to my Alma Mater & her illustrious supporters;
& peculiarly so in an Opportunity of assuring
You, Respected Sir, that I remain,
unalterally grateful for the advantages I
have recieved under your tuition, and am

Dr. Cullen
Edinburgh

Dr. T. Brown
C.
March 1785
V. XVI P. 349