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This comes by a young Lady-
A Patient of mine to whom I have recommended a Ride to
Edinburgh and to consult you about Her Distress. She and
Friends that are with Her will give you a full account
of Her Case so that I need say little on that Subject. ---
She is 16, Years of age, of a lax and irritable Habit, come of
consumptive Parents, particularly, Her Mother, ↑who↑ was liable to a
Hæmoptysis and died of its Consequences, a Phthisis. She has had
irregular Returns of the Menses, in small Quantities and at
different Periods for more than a Year past, and has likewise
been affected with an Hæmoptoe for much the same time.
She at times discharges a considerable Quantity of florid Blood
but in general spits or hawks up a watery Ichor of Blood
mixt with Saliva, &c. Lately She had a copious menstrual
Evacuation, and the Spitting of Blood at the same time or
Pain in her Breast and is frequently troubled with a Cough
The Bark in substance, and infused among water, The Elixir Vitriol.
Dulc. and gentle laxatives when costiveness required, are the only
Medicines She has got. She has been in the Country this, and

last Summer, has observed {illeg} regularity in Regimen
with a Milk and vegetable or at least a mild Diet, and
riding on Horseback when the weather would allow -
Leeches have been once or twice applyed to her Feet when
the Pain of her Breast and Bloodspitting were severe.
This much concerning the abovementioned Lady, Miss Swan;
but I must beg your Opinion a little further about Mr.
Thomson, of whem I wrote you in April last, tho from his
Circumstances I cannot promise you another Fee--
The Syrup. Colchici, tho instantly made from fresh Roots
and given fully to the Quantity you directed had little or no
effect, as a Dieuretic or otherways. The OEdematous Swelling
of his Legs and Thighs encreased, and what appeared
uncommon was, that it subsided in one Leg and Thigh
and then the other was affected with it. In this manner The
Swelling has alternated several times, but it does not go off
entirely, the Leg &c. only becoming considerably less and softer
when the other swells. He had no pain in them as formerly, tho
the Swelling was so great as to prevent him from taking
and Exercise. The Belly and Thorax seem as yet to be free
from any Collections of Water, tho some Weeks ago, when his
Legs were not much swelled, He was seized with a Cough
and Hickup which made us dread Water in the Breast. He in
general voids little Urine, and all along has made a greater

Quantity thro the night than in the Day Of late He has been
in the Country, got a little Horse which He rides daily, and
seems to have acquired more Strength & is every way better.
The only Medicine He uses is Crem. Tartar made into a Electu¬
ary with Syr. Ros. ¹ . and taken so as to prevent Costiveness
He indeed often takes purgative Pills unknown to Dr.Watson
or me, and is of the Opinion that He is never well as
when He has several Stools in 24 Hours, which keeps him
from recovering Strength. We were once thinking of
Scarifying his Legs when so much swelled but were somewhat
apprehensive of the Consequence - I suspect His Complaints
will recur when the Season changes and would be glad
of your Judicious Sentiments about Him -- I am with the
greatest Respect and Esteem

Dr Mudie C.
Miss Swan and
Mr Thomson
Aug. 4th 1778.
V. IX. .p. 31.

Doctor Cullen