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knowing your goodness & the
kindness the Doctor & I have Experienced
on many ocations from you I have
taken the liberty of writing you by
his desire. Beging you would be so
obliging as favour him with your advice
in regard to his health. As he is so
much Indisposed at present he is not
able to write himself I believe
you know he has been troubled with
Gout for seven years past. The last
severe fit he had was about two years &
half ago – he has had several threatenings
since that time but nothing to confine
him above a day or two – but for these
five or six months past he has been
very much troubled with Cramps or Spasam↑s↑
which he thought might be owing in a
great measure to the Gout not coming
out in the usual way. About three
weeks ago he complained of a great
fulness about his body & breast with
much oppression in breathing which
increased so much by Exercise that

The swelling in the Legs is not the conseq¬
uence of former pain it came on without
pain he has had no pain in them till
yesterday – He Complained of chillyness
which was succeeded by a warm feverish
fit. & a violent Inflammation all down
the inside of the left thigh the pain
was so violent that he cryed out the great¬
est part ↑of↑ the night. & is nothing at all
abated to day –– The Inflammation is half
up his side & Continues ↑to extend↑ under his knee
it feels hard and is sore to the touch –
He complains much of a feel of weakness
& is Constantly Changing positions
between the bed & the Chair trying for a
easy posture. He has had this restlessness

I wish I may have given you such an
account of his Complaints as may make
you understand them fully –– I have read
it over to him and he says he thinks
it is Exactly the appearance his Complaints
puts on. Since I wrote the above he
has had another very restless night
the Inflammation I mentioned in the former
part of my letter is extended almost quite
over his Legs round his sides & across
his back. He Complains much of the [pain]
of it & says it is Exactly like the p[ain]
of a blister when rising –– he thinks
it is quite ↑an↑ External Inflammation –
and his stomach & bowels are easier
since it came on – He would be happy
to have your opinion with regard to his
Complaints – Whither you think the
whole of this an Effect of Gout –– or
if you think it is a swelling disconnected
with the gout –– since this Inflammation
came on he is of opinion it is gouty
Within these ten days his nose has
discharged a few drops of blood two

Doctor William Cullen
Physician
Edinburgh