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Miss Douglas who was formerly under
your care when there was a suspicion of her being threatened
with a Phthisis Pulmonalis, the symptoms of which disease
at that time left her intirely. This Winter in Edinr was
seized with the Epidemic fever followed by a cough for which
she was advised to go to the Country.

In the beginning of March on her way home she stopt a
few nights at my house. Her pulse then was feeble at 120
her breathing fast, her cough constant. She spitt up a great
deal of thin defluxion.She was in a perpetual sweat, and
she had the Hectic redness in her cheeks after meals, joined
with a looseness, attended with gripes At this time she lived
mostly on fruit apples, sweet oranges &c. These I discharged
and recommended a milk & mucilaginous diet.

She went home. On the change of diet the purging ceased,
but the other symptoms continued. In a few days she was
confined to her bedchamber, and soon after to her bed.
Her end seemed just at hand. However as the Season ad¬
vanced she gathered more strength, got out of bed, began
to be able to walk throw the bedchamber, was brought to
the Parlour and last week went thrice out in the Chaise

At present her cough is not near so frequent as it was
She not spitt so much as she did, but now and then
brings up some yellow purulent matter. She lyes easily
on either side which she always did, and the flushing
in her cheeks is almost gone. Thus far she seems to have
gained some ground But her pulse is 140 at least, her breath¬
ing very quick, her feet and ankles begin to swell. She is
reduced to skin & bone, and her face is almost Hippocratic.
She has a constant moisture on her ↑yet↑ wears too many
cloaths, but when any of these are taken off she is chilly
The same thing happens to her when her bedchamber is
made tolerably cool. The Purging and Gripes have returned
of late, but always are moderated by the Potio Cretacea &
a Julep of Confectio Japonica with a few drops of Tinct.
Thebaica.

I have found it necessary to allow her a little light
animal food at dinner her other meals are composed of Cow’s
& Ass’ milk.

Her case I suspect is desperate yet you must say something
to me about her.

Mr Cowan is much better than when Doctor Hope left him.
He says he fells feels no trouble or uneasiness whatever except
now and then a little pain in his head but as his pulse at
a medium is rather above than under 100 there certainly
yet is an Anguis sub herba. ¹

When I have more leisure I will you give you ² some account
of the advice C. I. ³ received at London from a numerous con¬
situation of Physicians & Surgeons who declared his affair,
as no doubt it is, to be a Hydrocele.

Since the End of April I have almost been confined at
home with the Lumbago and morbus Ischiadicus I give
my disease both names because it shifts from my bac[k]
to my hip joint & thigh. Tho on the whole ↑the pain is↑ not very acute
yet it has deprived me of many nights rest. At
first I used Gum Guajac, then Semen Sinap. finding after¬
wards a dryness in my mouth I was bled & have delt
pretty freely in the Vin. Antimonial. My appetite is not
good, I live sparingly from these causes you may easily believe
I doe not grow fatter than I was nor improve in strength
yet when not ill can execute an Expedition of eight or
Ten miles & return home in the evening not choosing to sleep
from home. Is there any thing you would advise me to doe.

To
Dr William Cullen Physician
Edinr