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I Received your very agreable & usefull
letter of the 24th in course And since you
doe me the honor to wish my conjectures on the
very singular case of which I sent you the most
exact description I could get, I will freely own
to you that I look upon it as Inflamatory and
that the spasmodick apearances are the consequence
not the cause, whether the Kidneys were originaly
Disposed to Inflamation, or that Disposition has
been Required we will never be able to find out
But that they are now in a situation from which
they suffer on evry change of habit that tends
to Increase the quantity or momentum of the blood
is too evident as well as the Risque she runs
–– I have seen strangury alternate with hot
painfull erisypelatous eruptions on the face
and Inflamed eyes, but I can find no reason
to supose any thing of that Kind is in
fault here, the Lady had sore eyes some time
agoe after haveing catched cold, but they gave
way easily to blistering & some purgative, &
she is not subject to that or any other ailment
but that in her Kidneys: {illeg}day she Remember
that her kidneys were easier when her eyes
were Ill, But I learnt one thing from asking
her about her eyes, that the blister the man put
on raised a violent strangury and pain in her
Kidneys which lasted several days all

The decoction you propose will I hope
be usefull and shall be tried but if we
could be sure from the absence of pain
and Other Apearances that the Inflamatory
tendency was over for the present I should
like to have your opinion whether we
might venture cold water to the part along
with the Bark which I dare say there can
be no Risque in, however Doubtfull the
cold Aplications may be: we often help
Inflamed eyes by Bark & cold bathing the
head The young Lady in question is
Lady Mary Lindsay Lady Craufuirds Daur.
though I dared not say so in My Last which
she was to see I know the secret is safe
with you & I think it right you know

Doctor William Cullen
Proffessor of Medcine
in the University
of Edinburgh