[Page 1]

[Page 2]

[Page 3]

[Page 4]

Mr Mathew Bell of this place aged 74
And who about ten years ago consulted you in an
obstinate case of Jaundice was in the begining
of June last seized with a most violent Rheu¬
matism in the right Arm but particularly in
the Shoulder- The Surgeon who attended him
had recourse to the medicines commonly used in
such complaints but with no evident advantage-
Blistering and Copious Bleedings were made use of
in the begining and a strick observance of the
Antiphlogistic Regimen has thro' the whole of the
Disease been rigidly adhered to with a little suc¬
cess- About the middle of July a very profuse
for Cullen

sweat was produced by giving large doses of
Dover's Powder from which he had a most consi¬
derable remission of Pain this however was only
of short duration and was succeeded by a sudden
attack of his old complaint the Jaundice which
continued for some days-

I was consulted for the first time about
two weeks ago- The temporary relief which was
derived from Dover's powder induced me to push
its trial a little further but in much smaller
quantity than had been given to him before
To twenty grains of the powder I added five of
Gum Guiac. more effectually to keep up the
perspiration and this dose was given for eight
nights successively I also ordered Cupping Glasses
to be applied to the Shoulder affected for the pur¬
pose of emptying the blood vessils about the Joint-

In both intentions I succeeded but did not
observe him to be materially benefited by either

I would go no further in my own judgement
and proposed consulting you which the friends
readyly aggred to but am sorry that they have
been so parcemoneous of their money-

It may be necessary to mention that
Mr Bell has through the whole of life been
remarkably healthy and that he has never had
almost any complaint except the present
and the Jaundice when you were consulted
that in this illness he has been quite free from
fever and that his Appetite and Digestion throug↓h↓
the whole of it has been good-

During the night he has generally been restless
and some nights ago a slight Delirium was ob¬
served but without Pyrexia I at first thought
that this might be occasioned by the Opium
contain'd in the powder and therefore ordered them
to be discontinued but this made no alteration
the delirium still continued at times during

the night. This led me to think of accounting for it in
a different manner and I am apt to think that it may
arise from too great a flow of blood to the brain oc¬
casioned by his confinement to bed where he lays with
his head remarkably low-

His friends are anxious and expect to hear from
you as soon as possible- I have the honor
to be with the greatest esteem and regard

Mr Kellock
C Mr Bell
Septr. 1783.