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I duly received yours concerning Mr Maxwell of Barn¬
cleugh, the Patient about whom I last consulted you; and who is
now recovering in the most favourable manner, so that I need
not trouble you with entering into any of the particulars of his
Case. The Kino, even when taken very moderately, had sensible ef¬
fects as an astringent. - I was sufficiently mindful of your doc¬
trine concerning the use, or rather the abuse, of purgatives in
such cases, - which experience fully confirms. -- I only once ad¬
vised for Mr Maxwell, one of the mildest, to be taken par reprises,
at a time when there was reason to apprehend; and he himself
strangly apprehended (having been once a medical man) that there
was bile stagnating in his intestines. - The natural dirrhœa too
had not then given any particular trouble; nor did it ever in¬
crease to any considerable height. - He is now constantly riding
and walking out; - and recovering his strength daily; quite
free from Diarrhœa, piles, or any troublesome symptom. - I have
not failed to peruse, or rather to re-peruse, the Chapter in your
last Edition upon Piles. Though I find you are very explicit in
your observations on that subject, in some of my notes from
your clinical Lectures delivered long ago. --- But I trouble
you sometimes with saying unnecessary things, and on some oc¬
casions, I have apprehended with too much freedom, each with the
indulgence you give me.

The principal intention of me writing you to-day is to speak
about Mrs Maxwell of Kirkconnel, whom I have been called to

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Visit twice since you was writ to; - and have seen her six
or eight times in the course of the winter, before After the
full and advice and opinion from you and Sir S. Thriepland.
which has been received, it may seem unnecessary to write
you so soon again; but Mrs Maxwell, when I last saw
her, made me promise to write immediately; - and just as I was
sitting down I have a letter from her son, mentioning some
additional circumstances, - tho' he says his Mother is continuing
easier. --- I must observe to you that she has been in
such a low and complaining way, that circumstances of
very little moment, give her a good deal of uneasiness. ---
Almost all along she has been entirely free from fever. - She
has been complaining almost constantly of pains in one place
or another, particularly in the small of her back; about her neck
and head; - tho' she desires me not to omit mentioning that
she has no headach. --- The sweatings, which at the beginning
of her disorder, were sometimes profuse, have of late, and indeed
for a considerable time past, been very moderate in comparison,
and occurring but seldom. -- My visits in this Case have been but
occasional. For the greatest part of the time Mrs M. has been under
the management of her stated Surgeon, or other medical friends,
by whom I was frequently receiving messages about her; but in¬
deed ↑for the most part↑ I never saw much room from practice; that is for ↑much↑ more than
general management, even when I was with her. -- None of her pains
were ever so permanent, or so determined, as to make me advise
any

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applications whatever to the parts affected. - The mustard poultices,
once applied, were a measure of her own, when nobody was with
her. --- About a month ago, the Erysipelas occurred, to a high
degree for the time, preceeded for a day or two by a good deal of
heat and increased frequently of pulse. It went off in a very
speedy and favourable manner. - At that time I advised a very
moderate dose of an Antimonial once, with the Saline Draughts
as a matter of form; and, as she complained then that she
had wanted stools too long, I desired her once to take some
Rochelle Salts. -- It was very plain that before this she had
been living too fully; tho' I must observe that she has been
very moderate since. -- The appearance of the Erysipelas has
furnished Mrs Maxwell with much matter for thought and ob¬
servation. I was inclined to consider it probably as an ac¬
cidental occurrence, but she now refers every feeling, and
every the slightest appearance on the skin to it, -- and says
that from the great heat and smarting ↑in various places↑ (for she complains
little of pain at present, except in her loins) - she fully ex¬
pects that more of it is to appear. -- For eight or ten days
past her tongue has been a little white in the middle
which it never was before; but quite moist; and her
pulse commonly about 70 or under, some times rising
in a hot fit, to 90 at most. ---- You will readily conceive
Dear Sir that all the remarks to be made in a case of this
kind, might be much more easily communicated in conversation

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than by letter. --- I shall therefore only add one remark, - that of the
State of the mind is to be taken into consideration, it may be observed
that Mrs M. who is now between 50 and 60, - since she became a widow,
which she did above 20 years ago; and, during her Sons minority; - has
been a person of uncommon exertion and good conduct in the man¬
agement of the family estate; {illeg} which, with great application and
I believe much anxiety, she has managed with no little success. -
For these two or three years past her eldest Son has taken the
management of his affairs into his own hands, so that it may be sup¬
posed Mrs M. has been left with little or nothing for her mind to
exercise itself upon as formerly. ---- She has now begun to use the
Medicine you advised. - On many former occasions as well as in the
course of this illness she has used Gum Guajacum. -- -- She has
perpetual Blister at present between her shoulders, advised I be¬
lieve by Sir St. Thriepland; - which discharges freely. --- I have often
advised Mrs Maxwell to get out of bed; and she has tried it
sometimes, but says that she has been always the worse for
it; - but I hope now that mild weather is to be expected she
may be able to get up more freely. --- When you think it ne¬
cessary to write or can say any thing Mrs M. will be expecting
to hear. -- I am always