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enclosed I trans¬
mit to you Mrs. Hamilton's Case, who has been
for many years thro the Winter & Spring
very much a Valetudinarian, at this Time
she is so very ill & exhausted that her Friends
dread the worst of Consequences, I therefor si¬
cerely hope that this application to you for
your directions how this Case should be
managed, will have the most salutary effects,
& be the mean of preserving a Life that is
↑highly↑ valuable to her Family, Connections, & all
her aquaintances. –––

I think it proper to remark to you that she
is Daughter to Mr. Craick of Arbigland, & that you
were consulted about Miss Craick her sister some time

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ago, who had some pectoral Complaints
together with a particular affection of her
Tongue & Fauces; I understand she has been
greatly better of late. –––

Your Patient Mr. Willm. Mc.Dowal
still complains of the Straitness of ↑his↑ Chest
particularly when Costive which ↑is↑ still fre¬
quently the Case; his other Complaints
rather better; he still persists in the Regimen
you prescribed for him. He found that
the Gambo↑o↑ge Pills you order ↑last↑ ordered, lost their
Effects after some Time's Tryal as every other
thing had done, & he has had Recourse to
Glysters which he gives to himself by means
of a large Syrynge with a bent pipe to it. -
I have not seen him some Days & cannot
therefor give you a more particular account

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He wanted to know if he should begin to
the Cold bathe as you had recommended
to him. –––

I shall expect an Answer as soon as it
suits your Convenience & in the mean Time
believe me to be with due respect & Esteem

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To
Dr Cullen
Edinburgh

✍
Mr Copland
Mrs Hamilton
March 1780
V.X.p, 160.

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Case.

Mrs Hamilton of Aldershaw is about 43
years of age, has been always of a Thin habit of
Body and very delicate, has brought 14 children
alive into the world & has had several mis¬
carriages, which she apprehends has weakened
& hurt her Constitution much. ––– She
happened to be unluckily laid in wett sheets
one night when she was about 15 years old,
which gave her at that Time, a severe Rheu¬
matick Affection, accompanyed with Fever,
& since then, has been affected with pains of
her Limbs, Back, & even Bowells, before
Changes of weather; but in Winter these
were most severe, & mostly constant, whether
with Child or not, tho rather less so, when pregnant.
She was also at times troubled with a severe

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Cough, particularly when with Child, but ne¬
ver expectorated much with it, or Spitt up any
Blood, or phlegm that tasted Salt or Sweet.
She likeways had frequent feverish attacks
from Cold &c but thay were in general slight.
After recovering from her Lying in, of her
last Child but one, about 5 years ago, began
to be attacked frequently, with a troublesome
Looseness accompanyed sometimes with
Gripes, which when restrained by Medicine
or otherways, always sickened her much;
when it was very troublesome, the Rheuma¬
tick pains, generally went away altogether, or
were considerably diminished.–––

About the End of last Summer, she catched
Cold & was attacked with a bad Cough, which
has continued more or less severe, ever since

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has not been troubled much with Looseness, & has
scarcely felt the Rheumatick pains since
that Time. –––– After the winter began to
be severe, & particularly within these last two
Months, the Cough has become extremely ↑hard↑ on her
scarcely allowing her to sleep any of night, shaking
her Body so much, that she complains of pains
thro all her Bowels & particularly over her sides
after severe Fits of it; she Coughs with a great
deal of Force, & with a hard clinking Noise, spits
up a little tough phlegm, without Taste or Colour
except being sometimes a little tinged with
yellow & Frothy. –– When a severe attack
comes on which is mostly in the Night Time,
or after going to bed, she reaches with the Force
of it & brings up a good deal of phlegm from
the Stomach; she is also obliged often to

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sitt up in bed for a good part of the Night, from a
Breathlessness & Straitness across the midst of
her Breast which is at times troublesome to her,
both of these seem to be much relieved when she
gets up a little wind from her Stomach. –– Has no
other pain in the Chest except the above.---
Has all along had a bad appetite but particularly
so of late. –– Is much emaciated & wore down. --
Complains much of weakness in her walking up &
her own Room. ––– Looks remarkably thin
but her Colour not much altered from what it
used to be. –– Is not sick after eating any kind of
meat, more than at another Time. –– Dos not complain
of any Pain of her head from the Cough, & is never
thirsty. ––– Lys equally well on both sides in bed,
except after a severe fitt of Coughing, which seems
to affect the Ribs of the Right side so much, that two
of them shuffle easily past each other, when the

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Cartilages make a ratleing Noise. ––– Do's not
sweat any, except after taking a Draught of Milk
in the Morning, & falling a sleep upon it. –––
Is at present enclining to be Costive, perhaps
from the pills she is taking. ––– Has been
as usual regular, since Recovering from her Inn¬
lying of her last Child, about a year & a half ago,
but for the two last periods ↑it↑ has been less in quanti¬
ty, & she since then repeatedly has had attacks
of Cholick pains with Looseness & Encrease of
other symptoms (↑complaints↑) for 8 Days before & during
the continuance of the Catamenia, tho that
never was the Case in the former part of her life.

--- Has had an Eruption on the upper
part of her Chest at times for these ten years
when her Complaints were other ways severe,
of small spotts like incipient Warts, just to
be felt above the Skin; when they come

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first out, they are of a brown colour, become after¬
wards almost black, & then become gradually
lighter, till thay fall down, & the skin returns to its
former Colour & Situation; their whole continuance
is between three weeks & a Month. ––– Has never
had any other kind of Eruption. –––

Pulse at present 94, being quicker than usual
perhaps from being Costive this day, it is usually
about 80. ––– Is of a lively turn of Mind & in
general has good Spirits, which as yet have
not left her, tho they are at times more depressed
than formerly. –– Is not so irritable or nervish
as is generally the case with people in her weak¬
ned state.---

Has been all along rather averse to the use
of much Medicine or Mean's. ––– Has on former
occasions, when reduced low, after Miscarriages

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severe attacks of Cough or Looseness, been much
the better for rideing on Horseback, & other Exercise
the Exhibition of the Bark in many different
Forms, the takeing of Asses Milk (which she has a
great dislike to) & Mares or Cow's Milk. ---
After trying her with a variety of demulcent
& emollient Medicines with↑out↑ much Effects, as the
↑Cough↑ was at first very hard & dry, I gave her the Syrup
Scillitic mixed with a solution of Gum Ammonc.
which seem'd to have some little Effect; but still
getting no sleep at Night & the straitness of her breast
being troublesome I try'd her of late with the
following Pills,

These have softened the Cough a good Deal removed
the Breathlessness, & straitness very much, but
have rather induced a tendency to become Costive
for which I have this Day ordered her a Dose of the

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Ol. Ricini made into an Emulsion.-
I had sometimes ago recommended the applica¬
tion of a Blister to the Back to be keept open as
an Issue afterwards, but this she would not then
hear of, I therefore put on a Burgundy pitch
plaster which at first inflamed her back much
& raised it into a number of Angry red pimples
with a little clear fluid running from them, when
that was the Case her Cough seem'd to be better,
but of late the plaster has failed of producing
almost any Effect. ––––– Has for ten Days taken
a little new calfed Cow's Milk every Morning & Evening.---

I shall wait with Impatience for your
Advice and Directions how we are to proceed with
this most important Case on account of her
large Family &c.