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He is aged about 50, & for these 8 years' has been from time to time troubled with
a scorbutic eruption of the back of his hand, sometimes in both hands, & once a simi¬
lar eruption appeared on one of his Legs.

It consists at first of ↑very↑ small elevations from the skin, containing a serous
humour, very itchy, & discharged upon scratching the part. These run into
clusters & form circumscribed spots, generally circular, which sometimes
unite so as to cover the back of the hand intirely. The whole then ap¬
pears elevated, rough, & of a fiery colour. When about to heal, small
white scales fall off, leaving the part very smooth, glossy & red. The
skin soon after recovers the natural appearance, or more frequent¬
ly this is prevented by a new eruption. -- At Intervels both
hands seem quite well, & have sometimes continued so for a twelvemonth
together. It is most disposed to break out in the Spring. This disorder,
at present is confined to the metacarpus: the cuticle thro' the rest of
the body is smooth & white.

The Patient is neither corpulent nor very thin: his Pulse natural
his appetite very good, & his excretions regular. He has no other Ailment.

Last spring, being then first called upon to see the Gentleman, I put
him under a course of the solution of sublimate in spirits with Dec¬
coct' of the woods, the part affected being rubbed every night with mer¬
curial Ointment. He was kept moderately warm, & this course
continued for 4 weeks. -- At first the eruptions seemed to abate for
some time, but all at once it broke out worse than ever in both
hands. He was tired with the confinement & discouraged: so it was
given up. The sublimate did not excite sweat, & not above 1/4 gr. of it
could be given daily without occasion g. loose stools, which was avoided as
much as possible.

A Liniment of Saccar. Saturni with oil & wax ↑was↑ applied a few days with no
advantage.

A lesser attack of this complaint had been formerly for some time
carried off, as was supposed, by the use of saltwater taken in large
doses twice or thrice a week. -- After some Weeks interval, therefore,
I desired Mr Sinclair to take Saltwater every morning so as to procure
a loose stool every day. Also he took a draught of the Infus. amarum
twice a day. Nothing was applied to his hand but Diapalma.
This course was continued for two months, till now. About 3 weeks ago
the eruptions were almost quite removed: in a few days after
they returned, & continue in both hands as inveterate as ever.

His diet since spring had been almost intirely vegetable, with
sometimes Fowl or Mutton. But no salt or highseasoned food was allowed
him, nor fish. He does not exceed 4 or 5 glasses of Wine or Punch daily.

I would have tried a Salivation, but at Mr Sinclairs time of life
I was affraid to do it without your advice. I am now to intermit
all medicine till I have your opinion about the Nature & proper
treatment of this disorder, which it's expected will be as soon as you
can conveniently.

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I have been favoured with yours of the 10th & 26th
of June, ¹ & your directions in both shall be punctually complied
with. --- The scrophulous patient is using the expressed juice of Tu¬
ssilago, which agrees well enough with her stomach, tho' I have
given it to her simply expressed without any depuration, for fear of
injuring it's properties. If you disapprove of this it will be altered.

The Extr: Cicutæ & Mezereon have not yet come to hand, so the other
patient continues the Pulv. Cicuta.

The inclosed above is the case of a brother of the late Mr Sinclair of

I cannot help taking your kind offers of assistance & advice in
the conclusion of your Letters as something more than compliment,
because you was always very ready to bestow them upon me when
even a greater stranger than at present. I will therefore venture
to trouble you sometimes with a Query for my own instruction, in¬
dependent of the patient who consults you. ---

I wish to be informed of the nature of the disease commonly called
scorbutic. Is it a genus or species? How are the species distinguish¬
able? Do they require difference treatment?

I remember to have heard you say, in a lecture, that mercury was
what was most to be depended upon in procuring a return of obstruc¬
ted menses. If that is not a mistake of mine, in what circum¬
stances is this the proper remedy for Ob: Mensuim, & how is it {illeg}
administered? --

What are the immediate & ultimate effects of Mezereon. I am quite
unacquainted with it. --- A short answer upon these heads, or
your recommendg. such books as may give me infomation will very
much add to your former obligations.

I hope, Sir, you'll pardon all this freedom, for it is really the con¬
sequence of a high opinion of your knowledge & goodness: and my sin¬
cerity need not be doubted in this, altho' it had not been the public
opinion; for any sense of the former led me at first, when a stranger to
you, to solicit your acquaintance; & several years experience has now
confirmed me in the certainty of both. -- I would not make use of
[pr?]ofessions, if had a more substansial opportunity of expressing my
regard: and were there any method of serving you from such a corner

To
Doctor William Cullen Physician
at Edinburgh