[Page 1]

Since I last wrote you my Complaints
have put on a very different appearance - In my first Letter
to you I observed that bringing up wind gave my Pain, which
Symptom I could not easily Account for -- This Day five weeks
past, in the Morning at Breakfast, I felt an uneasiness about
the under part of the Osophagus, upon Swallowing the Bread
& Butter, The Same uneasiness at Dinner, Tea, & Supper --
[w]hich has Continued ever Since, some Days it is more So then
[o]thers, and Always worst at Dinner, and although my Breast
be pretty easy before I begin to eat, yet before I have done
It feels quite weary with a degree of pain & tenderness which
[C]ontinues from half to more then an hour Sometimes after I
have done eating - At other Times I swallow with more
ease and am not Sensible of the pain Continuing.- The original
Pain in My Breast is precisely in the Same place immediately
Under the Cartilago xiphoides, This pain you'll observe was
four weeks in that place before I found any uneasiness in
Swallowing, but the bringing up Wind always did and Still
[C]ontinues to give me Pain, and I think the pain feels as if it
[w]ere partly in that part of the Diaphragm through which the
Osophagus passes, and in the Osophagus itself where it passes

---

[Page 2]

the Diaphragm - The uneasiness in bringing up Wind is
only [omited?] when the Diaphragm is moved both upwards and
downwards before the Wind makes its escape, as I can bring
wind Continuously out of my Stomach without feeling any Pain
I am Seldom troubled with the Pain in My Breast through the
night - For two or three nights before I complained of Pain i[n]
Swallowing, It was rather more uneasy than it has been Sinc[e]
one Night in particular, about 5 weeks ago it was so unea[sy]
that I could sleep none, & felt within the [Liructs?] of half a {illeg}
immediatly under the Cartilage - I am Sometimes ↑almost↑ quite free of
the Pain in my Breast for a whole Day nay Since I was
first Seized with it, ↑which is now upwards of 2 months↑ Sometimes nigh two Days, unless [after?]
in in Time of eating which always gives me more or less Pain -
I am frequently troubled with belching of Wind particularly after
Dinner - I have frequently had a Pain in the Joint of the {illeg}
as [Humin?] Since I complained of My Breast and formerly was
often Subject to a Pain below the left Clavicle which I have not
felt Since my Breast turned uneasy - I have likeways withi[n]
these 2 or 3 weeks felt slight wandering Pains in different Plac[es]
of My Back, Chest & Shoulders which went of immediately
The Pain in my Breast has sometimes when going of degenerate[d]
into a warm heated feeling, which has spread over part of the Sto[m¬]
ach, I likeways feel it uneasy when I press my finger in upo[n]
the Ensiform Cartilage

---

[Page 3]

I farther observe as to my swallowing that {illeg} when the
food Comes to the Place affected I feel a Small degree of Straitness
but rather more of tenderness which last is farther Confirmed
by either Solid or Liquid passing that place /unless more [then?]
Blood warm/ giving the Sensation of being quite Cold, and
when a little plain wine is swallowed it {illeg}tes a Heartburn
feeling, but this I have not tryed these Several Weeks, neither
do I ever Swallow any thing entirely solid but when mixed
with Liquid - Upon the whole both as to the Pain of my Breast
& Swallowing I cannot say they are either better or worse th[en]
when first Seized with these Complaints - I have never had
any Tendency either to ruminate or throw up any food ---

About 20 years ago I was Seized with a Pain ↑previously↑ in the
Region of the Right Kidney which I apprehended would turn
out to be a gravelish Disorder - It continued more or less
uneasy for 10 or 12 years at Times so painfull that I could neither
sleep on that Side nor ride a hard trotted horse, when it went
away I was Seized as youll remember in the ↑January↑ 1773 with a fixed
Pain in the Colon on the left side which Continued for Many
Months - It was likeways painfull when touched, that is gone
I have been long Subject to the Marisci with frequent Colics
and looseness, but less so of late then formerly -- At present I often
am troubled with a Creeping & Coldness all the way down the back
Bone chiefly whetn I lye down and in the Morning - My urine
is frequently thick and deposits a pale Brick dust Sediment
Though for Days it will continue quite Natural - I am always

---

[Page 4]

Costive unless I use a little Flowers of Sulphur : which {illeg} Sometimes
gripes me & gives more than one stool -- My Stomach is pretty
good and with the Exercise which I take through the Room
I sleep better then might be expected -- Mrs Innes will acquaint
you as to my Diet both in quantity & Quality -- I have taken no
Medicine -- I rather lose then gain flesh, but do not observe any
great difference for these several weeks -- I shall not trouble you
with any of my Conjectures as to the [return?] of my Complaints
but leave it to your better judgement to determine Quis Morbus
Quæ ratio Sympt: Prognosis & Mitti: Med: ¹ - I must now My
Dear Doctor beg your Pardon for this tedious & Confused Account
of My Complaints which I could easily arrange in Medical
order, but at present am inclined to be rather indolent and have
Just jotted down what occurred without any previous Reflection ↑or Recollection↑
I will not ask your positive opinion immediately upon the per¬
usal of this Letter, till such Time as you have thought maturely
upon the Case -- As I find my Breast ↑easily↑ affected with Cold, I do not
think of being in Town while the frost Continues -- a few Lines
therefore from you when Convenient /which you'll please Send to my
house in Chapel Street/ will oblige Dear Doctor