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Graham of Dougalston
April. 1782
V. XIV. p.19

I am desired by Mr Home of Wedderburn
to state to you the case of his friend Mr Graham,
in order that I may have your advice, or, if you
think necessary, a visit from you to Wedder¬
burn house in this nighbourhood. --

Mr Graham is a Gentleman of betwixt 50 & 60 ys
of age, has lived pretty freely, in different Climates,
& in the west Indies has had frequently Fevers of
the Bilious kind as he calls them. --

When over in Flanders about the end of last year,
he had a Slight Fever attended with vomiting of
Bilious matter. --

Coming from London within the last few days, down to
see his friends in Scotland, he travelled under night
& was seized at Newcastle, on the 2d of this month
with symptoms of what he reckoned his old Bilious
Disorder. -- For this he took a Medicine which
he says has often saved his life in the west Indies,
viz. a Dose of Bark with as much Jalapp as
purged him several times. --

On the 3d he set out - & after being very sick on
the road, he arrived at Cornhill on the 4th
within 10 or 12 miles of Wedderburn. -- Here he
staid two nights & prescribed a little of his
own favourite Meds. Bark & Jalapp - one Day,
& Tart. Emet. the next. --

On the 6th in the Evening he arrived at Wedderbn
very sick, & altho' much pressed by Mr & Miss
Home, & his own Daughter, he refused to allow
them to send for me till Sunday morning last.

When I arrived I found him very sick, P. 106
in a Minute; Skin hot, great thirst, a constant
puking of Bilious matter. - He had no Sleep
he told me for 3 nights. -- No appetite, great
oppression, ↑Headach↑ Urine high coloured, & sometimes
so yellow as to tinge his linnen of a yellow colour.

He got an eight ounce Decoction of Tamarinds ℥ſs
Manna ℥ij & Tart. Emet. gr. ij. -- The half of
this taken par reprises vomited & purged him
several times. What he vomited was yellow &
evidently bilious, the Stools, of which he had
thro' the Day & night about 15, very offensive.
He seemed to have a Remission betwixt midday &
6 in the evening that Day. --

7th-- Had but an indifferent night, slept little
but still distinct. -- He insisted, & I had no
objection, that he shou'd suffer some farther

Pulse still about 106-110. -- Headach less, Nausea
& Puking less after the operation of this medicine.
None of these ever opened his Skin, which has been
all along dry, tho never so hot since this day.
Urine with a Sediment. --

Drink these two Days - Claret & Water, Lemonade
Tamarind Tea, Crem. Tart. Whey. But the
wine is what he has principally taken. --

This eveng he complained of Sourness at Stomach
& a little Hiccup. For this he got some Magnesia
with a few Drops Sp. Lav. comp.

8th-- The Sourness & Puking gone almost entirely.
He insisted to have some Bark & Jalapp which
he got, & which procured 4 or 5 stools - very offensive.
Hiccup more troublesome than before. -- I now
insisted that he shou'd take more of the Bark
by itself, & none of the Jalap. However he did
not chuse to follow this Plan. For on the the
9th-- he took another Dose of his Bark & Jalap,
which had the same effect as before. The
Hiccup rather worse - with the addition of
a Cough; - I proposed a Musk Julep for
the Hiccup & a Diaphoretic Mixture - chiefly of

As he had got little sleep all this time he got
gr. iſs of opium on the 9th at bedtime. - He found
such relief & rest, that he has called for
it every night since. He has never taken
the Diaphoretic Mixture yet. - Last night
he allowed a Blister inter scap. which did
not rise so well as I cou'd have wished. In
the evening of wednesday I observed a little black
blood in the Spittle on the Handkerchief. There
was some yesterday, but more to day. --

On Wednesday night - he had the the first appearance
of Delirium - which has contd more or less ever
since - with Hiccup, & Tongue parched - which
it was not at first. At the same time he
complains less of Thirst. - P. 106-110 - all along.
This afternoon his P. has rose in Quickness
to 132 - & weaker. -- He can rise up, & do
a good deal for himself notwithstanding. - Skin
still dry. -- He has drunk a good deal of wine
Claret - & Madeira - sometimes a Bottle in 24 hours,
which was more than I allowed. -- I am thinking
to try the Calx Antimon. Nitrat. this evening.

I have treat this Fever as a Bilious Remittent
as far as he wou'd allow me. Now it seems more
continued & to put on more of the appearance of Typhus.

Mr Home wishing you either to come out directly, or if you
think that needless, to write me your advice. I am &c.