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Yesterday I received your Letter, & Mr. Wilson & I communicated
its contents to Mr. Wood. We are all much obliged to You for giving us so full,
and circumstantial an opinion - Your deferring other business to oblige
me was particularly exceedingly kind, and you have my warmest
acknowledgements, not only for that favour, but for many others -

As You seem to apprehend that Master Wood either labours
under, or is strongly predisposed to Phthisis Pulmonalis; I am desired to
give You a more complete history of the pectoral symptoms - On
perusing the Case previous to my first visit - The delicacy of habit - the
sizy appearance of the blood - The Hectic heats &c made me
inclined to believe that he had Phthisis Pulmonalis conjoined
with Catarrhus Vesicæ - But after conversing with Mr. Wilson, a
very ingenious apothecary, and visting our Patient I changed my
opinion about the former Complaint -

I have examined the sputum with great care - it is ropy -
it swims in water without breaking into separate parts - & has
neither the deep green tinge, nor the fetor that is frequently
perceived in the sputum of Hectic patients - I tried it in the
Vitriolic acid, & the Caustic Lixivium according to Mr. Darwins
directions, & it answered to the test of pure muccus - He
never has any salt taste in his mouth, & his breath is uncommonly
sweet - He never has any pain in the Chest, except now & then,
a little soreness upon coughing - & he lies with equal ease on
either side - Upon the most particular enquiry I cannot find
any tendency towards diurnal, or evening Exacerbations. He
does not feel more cold, nor has he a greater inclination
for the fire at those times of the Day when the Exacerbations
are observed to come on - His Eyes have not a pearly appearance,
Nor have his teeth the dead whiteness mentioned by some

writers - His Urine never deposits any lateritious sediment - His
Cough is not more troublesome at one time of the Day than at another -
It is pretty loose & is neither violent, nor very frequent - He coughs
like a person in the last Stage of Catarrh. It is not the short
tickling cough of tubercular Patients. The family are not inclined
to Scrofula, or Phth. Pulmon; but they are very subject to
habitual Coughs - How long Master Wood may have had one is
uncertain - He brought it from Town last May. He was
treated with Demulcent, & Mild regimen, but Bleeding
was not thought necessary. Upon his coming into the Country
Bleeding, & saline medicines were prescribed, & they relieved
the Cough - Ever since it has been in its present state.
When I was desired to visit him he had just given over
his last mercurial course - His strength was exceedingly
reduced - His spirits were very low - appetite almost
gone - Pulse about 100 debile - frequent - & very quick - I
recommended a bland, nutritious diet. Milk had been
tried & disagreed. He was desired to continue the
artificial Asses Milk for breakfast - A Bowl of Soup,
or a Jelly in the forenoon - Bland animal food for
dinner & a few Glasses of Wine - The Bark, & Elixir of
Vitriol were continued. This was about three weeks ago.
His general health & spirits are better - His relish for
food is much increased - He is not heated after dinner, nor
does his food disagree with his Stomach - His Pulse is
neither so frequent, nor so quick since he began this diet.
It is about 90. His bowels are not so irritable - He now

makes water only once in this Night, & always without Pain. In the
Day time. he makes water twice, & sometimes it is voided without
pain - At other times he feels a little -

I hope this further account of the Symptoms, & treatment that
has been adopted since You were consulted will give You additional
satisfaction, & that it will either incline You to adopt your former
opinion with more confidence, or will dispose You to change it
with more certainty. For several Days upon Coughing our Patient
has perceived a substance to move upwards from the Region of
the Stomach, & upon going to Stool it moves downwards from the
same place. The Cicuta was laid a side because with the Vertigo
it produced a swollen head - Mr. Wilson is of opinion that
the Uva Ursi was more serviceable for his urinary Compt.
than any remedy that has been adopted - But it increased
the Pains, & the inclination to make water - Might it not be
tried in small quantity and increased gradually with a
probability of success?

The Apothecary in London was desired to declare
confidentially whether whither our Patient ever had any
Venereal affection, or not, & the Gentlemans answer was
that he never had any -

Master Wood gets up in the morning with the rest of the Family - Rides
out on Horseback for several hours whenever the weather permits, and
manages a spirited Horse. At dinner he does not eat so heartily as the
rest of the family, but his dinner (↑food↑) agrees very well - He sits up - all Day
without being much fatigued, & has generally a good night. Since he has
taken twelve Drops of Laudanum at Bedtime his Spirits have been
better in a morning - Tho' the lowness of spirits - the irritability of Bowels
the quickness of pulse - & urinary Compt. be relieved - Mr. Wood thinks
his Son gains no strength & this distresses him exceedingly - For my part I am
confident he is better & I think You will agree with me - How far the
Mercury may keep him back I cannot pretend to determine. But his
System seems to abound with it - For upon the sudden diminution of
temperature his Mouth & tongue became very sore, & continue so

I durst not advise sweating or any other debilitating means to evacuate the
mercury. He takes Decoction of China Root & Sarsa. His flannel
shirt is removed twice a week, & his feet are put into warm water
every Day. Mr. Hunter, & Sir W: Fordyce never hinted a single syllable about
Catarrhus Vesicæ & it gives me particular pleasure to have my opinion
corroborated by the Authority of Dr. Cullen - The Bark is laid aside & the
vegetable mucilages will be preferred to the Animal - The weather
is at present very severe, when it becomes milder our Patient will
set off for Bristol. We shall defer the Cicuta till we have your further
opinion. I recomd. the Trochisci Bechici cum opis of the Edinburgh Dispensatory
for his Cough. But the soreness of his Mouth prevented its being used -

After drawing up the Case I sent it over for Mr. Woods perusal & he desires
the following addition may be made. Mr. Wood is a sensible man, & he has made
physic a part of his Study - But his anxiety for his son makes him fear every
thing - And I am in hopes yt. he magnifies the dangerous symptoms - For
the last two Days his urine is better than it has ever been since the Compt.
began - Both his ancles swell at Night

Mr. Wood I would add desires me to mention that the artificial Asses milk
was taken before his Son arose - His breakfast for some time has been
an Egg beaten up with Milk, and Tea - The Elixir and Bark is still continued
at the Young Gentlemans own request till your opinion is returned
again. According to your desire I ordered it to be omitted. When he makes
water in the night as well as in the Day it is now and then attended
with pain - Mr. Wood determines to wait for your answer before
he sets off for Bristol. I hope I shall frequently have the happiness
of following your advice -

Dr. Cullen
Edinburgh