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This Application is on Account of a Gentleman,
Father-in-law to John Gale Esqr. of Whitehaven,
who consulted you in Person this summer at Edinburgh
in Relation to some complaints proceeding from gouty
Matter.

Christopher Wilson Esqr., the subject of this
Letter, who is now near 84 Years of Age, was attacked, about
12 Years ago, with the Gout, of which he had regular Fits
every spring & Autumn until about six or seven Months
ago, when the Disorder began to be irregular, sometimes
attacking his stomach, at other Times his Lungs and
Head. These attacks were always carried off by a slight
Fit of the Gout in the Extremities. About three months
ago, he was suddenly seized with a Difficulty of Breathing
when walking in his Garden, which has continued ever
since, and is now the principal Complaint for which he
solicits your Assistance. He cannot lay in Bed in an horizontal
Position, neither can he sleep with his Legs laid up when his
Body is erect. He now sits up Night and Day; and all the
sleep he gets, which is but little, is in a chair, with his
Body inclining forwards, & his Legs hanging down,
which has occasioned a considerable swelling of the last
named Parts. About a Week ago he complained of a
little Pain in one Foot for about 12 Hours, during which
Time the Dyspnoea was much better. Two or three Times
in the Spring he was seized with an acute Pain in the Breast,
attended with difficult Respiration, for which he took a spirituous
Tincture of Rhubarb, well stored with Aromatics, that he always

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kept by him: This Medicine always afforded immediate Relief
by producing a slight Fit of the Gout in the Extremities, which,
however, did not inflame. He has tried this medicine several
Times since the last Attack, but without the usual Relief.
Mr Wilson is descended from healthy Parents, who never had
the Gout. He has enjoyed a very stong & vigorous Constitution
and took great Care of it, being remarkably temperate, both
in Respect to Eating and Drinking. He mostly drank Water and
seldom took more than two or three Glasses of Wine a Day.
He has spent a good Deal of his Life in the service of the
East-India-Company, in which he was a Captain for
many Years, and acquired a plentiful Fortune with
an excellent character. When he quitted this service, he
bought a large Estate, & amused himself with Hunting, but
in Process of Time he grew tired of this Diversion. The
Beginning of his Gout may be dated from the Time of [his?]
leaving off this Amusement, for it was observed that h{illeg}
eat as heartily as ever after he quitted his usual Exercise. Not
long after the Difficulty of Breathing came on, Dr Brownrigg,
who practised many Years at Whitehaven with a great Reputation,
was called to Mr Wilson, and gave it as his Opinion that the
Dyspnoea was spasmodic, & proceeded from a Gouty Cause.
He first ordered the following Draught. This had little
or no Effect; however, on increasing the Dose of Elixir
Paregoricum to 100, & 120 Drops, the Dyspnoea & Anxiety
became less for about 10 or 12 Hours after taking each Draught,
but afterwards became as bad as ever. This medicine was repeat¬
ed 7 or 8 Times, & afterwards discontinued. The Doctor like¬
wise ordered a Solution of Gum Ammoniacum , on Account of
some thick viscid Matter which Mr Wilson now & then expectorated.
He only took a few Ounces of it, & then grew tired, since which he has

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taken no medicines, except a Table Spoonful of Oleum Ricini occasionally
to keep his Body open, which is apt to be costive. For many Years he has had a slight
Cough, & Discharge of tough - viscid Matter from the Breast, but they are both
very inconsiderable. His Pulse has mostly been strong, slow, & regular, but
these last six days it has been quicker, weaker, and now & then irregular.
He is seldom thirsty. His Urine is sometimes high-coloured, but mostly of a
natural appearance: Sometimes it deposits a Sediment of the Colour of
Brick-Dust, & at other Times like Coffee-Grounds. His Appetite is
very bad. Seldom any moisture is observed upon his skin. When the
Difficulty of Breathing is at the worst, a Dish of Hot coffee will always
make it better. The Dyspnoea, which is this Gentleman's greatest
complaint, except old Age, is always present, & may be easily ob¬
served on sitting near him; but it is much more severe at one Time
than another, the Paroxysms often coming on very suddenly, & frequently
going off in a minute or two. These violent attacks, for many weeks at the
beginning of the Disorder, always came on about two or three o'clock in the
Morning, & obliged Mr Wilson to get out of Bed. They seldom went off then
{illeg} less than two or 3 Hours, after which he continued to breathe pretty
freely unto the same Time next Morning : But now these [attacks?] are
not so regular, nor so violent, & of shorter Duration. During these Fits
there is no Wheezing, or Noise from Infarction, but a quick & laborious
Breathing. He has rode out several Times lately, being carried from
his Room to his Carriage by his servants, but has received no Benefit
from it. No external Application has been used, except Friction of the
Feet & Legs. He lives on Broth, Eggs done soft, Chocolate, Milk now
& then, coffee, &c. but takes very little of any thing. He drinks Water, wine
& water, Barley-Water, &c. - This Gentleman, tho fond of Advice, has
never had Resolution to give any Method a full Tryal.- Now, Sir,
if you can strike out any easy means to lessen the Dyspnoea, and
spin out the Life of a Patient, who is in his 84th Year, you will
give Pleasure to Mr. Wilson, & to your unknown Friend

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To
Doctor Cullen
Professor of Medicine in the
University of
Edinburgh