[Page 1]

In consequence of your last letter Mr Irwin
immediately discontinued the medicines
formerly ordered, and has been taking those
last prescribed. They have kept his belly regu¬
larly open and have promoted a free persperation.
The Rheumatism has visited almost all his
joints, but in the same mild and easy
manner as mentioned in my last. It is
now I think entirely gone. There is no
swelling or inflammation in any joint
and any pain that he has at present is
inconsiderable and never constant. His
pulse is now as usual under 70, and his
urine has ceased to deposite any sediment.
His appetite was never much affected, so
there was no change in his diet,
except in respect to his wine, the quantity
of which I ordered to be diminished. The erup¬
tion is altogether vanished, and the

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itching is not so general, and fixed, but as
he says, is more wandering. The Oedematous
swelling of his legs is trifling, and in short,
I believe he has little or no real complaint,
yet like most hypochondriacal patients
he is at times very low spirited and con¬
siders himself extremely ill. I think he
he may with safety return to the Chalybeate
particularly as he imagined himself be¬
nefited by it, and perhaps the Bark or
some other tonic may be conjoined
with advantage. He has been over at
Carlisle this week and bore the journey
which is 14 miles exceeding well; still
talks of some watering place, and as
it seems impossible for him to remain
easy at any particular place for a length
of time, I think it will not be improper
for you to recommend a journey into the
south sometime this summer. These
hints I submit to your consideration
and am sincerely yours &c

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[Page 3]

Dr. Cullen
Edinburgh

✍

Dr Heysham
Concerning
Mr Irwin
April 15th 1779
9. p. 166