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About two years ago I consulted you concerning a weakness of the
back, lowness of spirits &c. I have wrote to you since & received your
answer containing your prescriptions, which have been only admini¬
stered & often repeated: And although they have not ↑had↑ so good affect as
to work a complete cure, yet I am sensible they have done much
service & find myself much stronger & healthier than before.
But I now app[re]hend that my complaints proceed from an ailment
which I have hitherto neglected to mention ↑which is as follows.↑ -- After going to stool I
always observe a small quantity of blood upon the conclusion of
my excrements, and is accompanied with a falling down of some kind
of excrescence next to my back bone, & is with difficulty drawn up
again into its place. This I think is accompanied with some
inflam'ation, because it is sometimes painful in the part, when
riding on horse back or the like: And whether by affecting the
neighbouring parts it may be the cause of other Ailments, must be
left to your deeper skill & penetration. I have observed it ever since
the beginning of my other complaints, & think it must be ye piles,
a fistula in ano, or something of that nature. -- I beg the favr.
of your opinion about the same, and if you think it requires any
manual operation, I cou'd make it convenient to come to Edinr. a few
weeks; or perhaps a Surgeon here might do the same: But I will
expect your ansr. before I apply to any other, & will be impatient
till I receive it. -- I was disappointed of getting over to Edinr. this year,

To
Doctor Cullen
Edinburgh