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You will probably remember the Writer of this, who
waited upon you at your own House, two different times in the be¬
ginning of December last, and consulted you chiefly in regard to your
Opinion (after having let you see and feel the place he suspected, w.h
is situated on the right side of the stomack) whether the appearance
and feeling of that part was natural, and the same as on the other
side - and whether you imagin'd there was any Obstruction in such
place? You will also easily recollect, the Opinion you at that
time gave Viz - You agreed with me, that there was some small
degree of bulk, hardness or swelling on that side, more than on the
other - but said that you did not imagine it amounted to a Disease
but might be something natural, in the structure or Formation of
the Muscles of that part - You disapproved of an Issue - thought
repeated blisters preferable - and after discoursing a good deal
you gave me a prescription of Rad. Colomb. Magnes. alb.
Zingiber & ♄. These circumstances, I think will be sufficient
to recall my Idea to your remembrance, and therefore I shall add
no more on that head - but only that at parting, you was so
good as desire me if I thought proper, to write you, and that
you would not fail, to give a suitable return. In consequence
of this permission, I now take the liberty to write You

a few of my Thoughts, relative to the Nature of my Indisposition
and I beg you would not be frightened with the lenth of my
Epistle, for you may make your Answer to it, as short as
you please. It is a large field I am going to enter upon
full of dark, intricate and perplexing paths, where one may
wander for evermore, without being able to attain a distinct
and satisfactory Idea of it - I must take Care therefore
not to penetrate too far into it, which would be labour in
vain - and besides, a long and painful search, would neither
suit with your time not mine, neither have I strenth &
spirits sufficient for it - I shall therefore be as short, as I
can.

The symptoms of my Indisposition, are princi¬
paly -- A general Delicacy of Habit - a particular debility
of stomack - a weak receptive power - slow Digestion - Fla¬
tulency, which I find more in the right side, than in the
left, at least I feel the Operation of it more painful and
uneasie in the one place, than in the other - besides, there
is always, a greater degree of weight 'stuffing', bulk and
uneasiness in the right side, than in the left - but
whether this is to be attributed to a particular relaxation
of the one side, more than the other, and so all the above
Symptoms, to Wind or Vapours distending the parts

or to some degree of Obstruction, in conjunction with Wind, I can¬
not certainly determine -- I never could find, that I had any sour
or otherwise bad indigested Humour in my stomack, and I am
never troubled with the Heart Burn -- to these symptoms I add
habitual Costiveness - langour and lowness of spirits; but
these tho' sufficiently disagreeable, are not the most painful and
chagrining articles of my Indiposition - what I complain
of more than these, and which hitherto has been unconquerable
is - an extra - unnatural degree of sensibility - an high degree
of an Irritable and spasmodick disposition in the stomack
and Bowels - whether in these Organs, or in the Membranious
Muscular and Nervous parts, external from them, I am
not able with precision to say --- I take it, that this
Sensibility is not lodged in the first Coats at least, of
any part of these Organs - because I find no sharp pains
nor Irritation to arise in them, from any thing I either
eat or drink, whatever its nature or quality may be - far¬
ther than the Irritation and Uneasiness consequent upon
flatulency - which inclines one to think, that the extra-
sensibility of which I complain is lodged in the Membranes
or other parts without these Organs, and depends first
upon the sensibility of the Brain, and then upon an
unsound state of these parts. I shall now show You

how this sensibility (in the parts complain'd of) operates, and
discovers itself - but privious to this, I must say something
by way of Introduction.

There are certain parts of a Human Body
which Physicians call the Nerves, and to which they attribute
Sensation, or the power of feeling. I am certain from my
own experience, that there is a certain (↑particular↑) system of Organs in
the Body, that are the Medium of sensation, and by which
it is performed - that by these Organs the Mind Operates, and
gives us to know and feel, all the different Passions and
Affections, of which human Nature is capable - that way
the least Motion or Operation of the Intelligent principle
has a most real and sensible effect, upon these Organs -
that this Motion or Operation, is by way of Impression or
touch upon them - that this Impression is first made
upon the Brain, and thence descends or vibrates along the
different branches of these Organs - and that sensation
or feeling, follows as naturaly and immediatly, from
a certain effect of the Intelligent principle on Animal
Organs, as motion or Vibration and sound does, by
the Action of a Musician, upon a Musical Instrument
- hence according to the good or bad state, the Nature and
Quality, the sensibility or Calousness of the Animal

Organs, will sensation be performed, with more less ease
If these Organs, feel the impression or touch of the Intelligent
Principle too acutely - if they run into spasms, & Commotions
in consequence of it - this seems to be an infallible sign
that there is something in them, or about them, not right
in a word, that they are not in a sound and natural state.

Now to apply this --- The operation of Thought
if long continued - but particularly, when my Mind is affected
with any of the different passions or Affections, which belong
to human Nature, whether from external Objects, or Ideas
this Affection, Operation or Impression upon the Animal
Organs, in the Region I have described (ie in or about the
stomack and Bowels) is felt too acutely - the painful¬
ness and acuteness of the feeling, instantly irritates the
parts into spasms and Commotions - and these again
disorder the parts, and throw the Circulation into confusion.
As I have hinted above - long and fixed application of the
Mind to Thought, never fails to bring on small spasms
or vibrations, in the parts already described, which increase
their sensibility and Irritable disposition, and which long
relaxation only carrys off - besides, langour Anxiety &
Flatulency, to the bargain. When one considers what
Human Life is, and how much & often the Nerves must be

acted upon, by one thing or another, it must be own'd that the
sensibility in the parts I complain of, is very troublesome.

This is a short, and very imperfect Idea, of the
Nature of my Indisposition, which is evidently owing
to a disordered state of the Nerves - The Question now
is, what this disorder, or extra-sensibility takes its rise
from. I shall mention three Causes, to some of which
it may be principaly owing, or rather probably, to a
mixture or combination of them all.

First - A simple, Original Weakness of the Nerves
Secondly - some Original quality in the Blood, Scorbutick
or otherwise acrimonious and discordant to the Nerves -
and Lastly - Obstructions, of the slow kind, with little
or perhaps no Inflamation. ---

I cannot enter fully, and as I would wish, into the Reas¬
onings proper to discuss these points - my Nerves
will not allow me, else perhaps I might write You
some Thoughts, which You would not disapprove of
I shall only say somethings in general, and as short
as I can. ---

First
Presumptions against simple Weakness &ct being the sole
Cause of my Complaints.

The Idea of simple Weakness, does not seem necessarily to

infer, a consequent sensibility. If a part is sound, tho' Weak, why
should a touch upon it, be painful.

Persons of as Weak, and Weaker Stomacks and Bowels, than mine
complain of no such extra-sensibility in these parts as I do.

The Cold Bath, did me no service - and the Hot, no hurt, but rather
the Contrary. ---

No bracing, strenthening, stimulating Medecine, ever did me any
effectual service - sometimes I have found them of bad Consequence.

I have avoided Indolence so carefully - I have excercised my self, to such
a degree, by frequent long journeys upon Horse back, to the extent
of a Thousand Miles - by walking habitualy &ct &ct, as might
have strenthened and hardened any one - but this never carried
off the sensibilty. ---

Secondly --
Presumptions in favour of the second Cause, as having a share
in the production of my complaints. --

It is agreeable to Reason, that if there is any Humour or Quality
in the Blood, ungrateful to the Nerves, that such Humour in the
course of circulation, will irritate them, and gradualy increase
their sensibility. ---

When I was about 3 or 4 years Age, I was seized with an

Irruption of Scorbutick, or other Acrimonious Humour from the
Blood, on the skin - this Irruption was most violent in the
Spring - it appear'd in the form, of large red inflamatory Pim¬
ples, very painful, till after suppuration, when they left the skin
hard and dry - it chiefly affected my Limbs, Thighs, Hips and
Arms - at times after suppuration, it had some degree of itching
but not infectious - and it continued more or less, till I was
about 12 Years of Age, when happening to take a sore
throat, when our Family Physician at that time gave
me some Mercurial Medicines, which brought on a salivati¬
on - after which this Irruption disappear'd. ---

In November 1771 after I came home from Harrowgate; one
day, after my return [home?], from my forenoons ride, having
felt the Cold exceedingly piercing, I was seized with a spasm
or Contraction between my shoulders, pretty painful, which
continued some Hours, with a Coldness - in the Afternoons &
Evening the spasm went off, and I felt frequent Heats,
Chills and shiverings, principaly in my Back - next day I
felt myself better - but was much troubled, with a violent
itching between my shoulders - when I went to bed, I caused
these parts to be inspected, and I was glad to find, there
was a large Irruption all over my shoulders, of the small
kind, intermix'd with some large inflammatory pimples.
This continued for some Months, during which I found my

self considerably easier and better every way - after this it
disappear'd, excepting some of the large Pimples, {illeg}
[of?] which ↑more or less↑ in general, always continue to appear on my
Back and shoulders. Sometimes after rubbing with
the flesh brush, a transient imperfect Irruption will
appear upon the stomack & Bowels, chiefly on the left side
with a small degree of itching, but before Morning it is
gone. -

This seems to indicate, that there has been, and may be, some
thing in the blood and humours, discordant to the Nerves.

At times, and in aforenoon only, I have passed Urine
of a White Colour, like thin Milk - which after settling
deposited a sediment, of the same Colour, as pure as Chalk
and of a substance very like it - but this not always
nor in great quantity. After riding 8 or 10 Miles, there
is some times a considerable degree of sediment in my Urine
of a mixt Colour, Red and White.

I am apt to think, that whatever is in the Urine, was
originaly in the Blood & Humours. --

Since my Nervous Complaints began, I have experienced the extra-¬
sensibility, in other parts than where it is now lodged - and
at that time, I had nothing of it, where it now is.

First of all, many Years ago, I began to feel a Complaint, on

the left side, a little below the pap, without the Heart & Ribs
tho' ↑{illeg}↑ perhaps it might have some Connection with the former
The symptoms of this Complaint, appear wonderful to me as
they equaly shew an extra-sensibility, of the Action of the
Intelligent principle, and external Agents. ---

The pain in this place, was habitual - seldom, or rather
never Acute - but heavy, oppressive and corroding - affecting
the spirits, and spreading a langour over the whole frame

- In Winter, the external Cold affected me with such uneasiness
in that place, that no Cloaths or Covering were sufficient
to keep off the painful sensation - I felt the Air, I drew in
at my left Nostril (when in a Cold state) affect it with pain
- the putting on a Gold Glove on my left hand, had in¬
stantaniously the same effect - the same instantanious
effect, from taking any thing into my Mouth, either very
hot, or cold, but especially the later - Mental labour, and
exercise always increased it - it was worst in a state of
inaction, and after Meals - in a word, it was subject, to
a great susceptibility of Impression, to pain & small
spasms, from the various Affections and Operations of the
Mind. Gentle Exercise gave the greatest relief, and after
many fruitless tryals - a Blister, and keeping it open
for some Weeks entirely carry'd it off; with all the above
symptoms, and it has never return'd --

I have had a complaint exactly similar, in the Muscles
of the left Breast higher up, which join to the shoulder
and Arm - rubbing constantly with the flesh brush, and
moving my left Arm in walking, instead of my right
has removed this also. --

Several Years ago, all the symptoms of sensibility, which
I now complain of, in or about my stomack and Bowels
were lodged in the Heart. A glance of thought, a simple
Idea, the most triffling Affair, would have affected the
Heart, with strong sharp spasms and twinges - pal¬
pitations - irregular flowings of the blood &ct. At that time
riding upon Horse back, brought on these symptoms
also - and by the way, the Steel Mineral of Peterhead increas'd
this Disorder. I made tryal of many things, but cannot
say what removed this disorder of the Heart - one thing
is certain, that to this moment, from the time I took
a Voyage to North America, I never felt the least de¬
gree of it. -

The shifting of these Complaints - their removal from one
place, and attack upon another - seems to indicate the
Blood to be in fault, and that Obstructions in the small
Vessels, were perhaps another consequence of this -

Thirdly - presumptions in favours of the last Cause of Extra-¬
Sensibility Viz Obstruction.

An Irritable Disposition of Nerves, when arrived to a certain
degree, will necessarily throw them into frequent spasms &
Commotions - and these again must necessarily alter the
natural situation of the parts, and hinder the free and
regular Circulation of the Blood - every ones Blood has
something of Impurity and Viscidity in it - such Blood
being often stopt by the Operation of the spasms, & creeping
slowly thro' the distorted vessels, must by the lenth of time
stagnate in some parts altogether, and so form Obstructi¬
ons. --

Obstruction when once begun, and seated, is a very suffi¬
cient Cause, for a still higher degree of Extra-sensibility
- because the Nerves in the parts affected, and by sympathy
and Connection for a considerable way distant, must be
be more and more disordered and irritated, from the
unsound Humours, with which they are loaded - And
when they are affected at their Origin, by any Cause op¬
erating upon the Mind, and this affection or Impressi¬
on is communicated along their various branches, and
reaches those which are in an unsound & obstructed state

it cannot be but this touch upon them , must be painful
and this pain occasion, extra Commotions in them.

The Appearance and feeling of the right side of the stomack
are both some what different from the left, and this has
continued for Years, and I think first began, after using
the Cold Bath. --

After writing an Hour or two, especially if such experience re¬
quire a good deal of Thought, I feel a degree of uneasiness
and disorder considerably more, in my right side, than
in my left. --

Exercise upon Horseback is painful, raising sharp spasms
in the stomack and Bowels, or parts already described - &
otherwise disordering me much. --

Sometimes I have thought, I could discern, a certain Yellow¬
ish tincture in the Colour of the skin of my Face - es¬
pecially after washing, and while drying & rubbing it.

Very often in a Morning, I have a foul tongue, and of
↑a↑Yellowish Colour. --

As I have already observ'd, I never could find that {illeg}
I had any thing of a Bilious, Acid, or otherwise bad
Humour in my stomack - & I am always costive.

Does not these things seem to indicate - that there is perhaps
a scarcity, a viscidity, of the Bile - and that is is not
properly seperated or secreted. --

Some of the Circumstances I have mention'd, are trivial
if not impertinent - but it is generaly accounted one
of the symptoms of this disease, to be more or less Whim¬
sical - and it is proper this should appear in my Case
also. ---

The sum of all these presumptions is - That I conjecture
(for certain Opinion I have none) my Complaints
take their rise First - from a system of Nerves and
fibres not the strongest - but by this I do not mean
that they were or are, too loose and relaxed - but rather
that they were [Origanly?], of a substance perhaps too
refind, and in consequence too springy and (↑or↑) Elastick.

Secondly - from some Original Quality in the Blood and
Humours discordant and ungrateful to the Nerves, and
gradualy increasing their sensibility, or power of Feel¬
ing --

By lenth of time, such a system of Nerves, supported
by Fluids of such a quality, and rendered more ungrate¬
ful by accidental Causes, would necessarily attain

to a great degree of sensibility - when this sensibility
rose to a certain degree, it would be painful - this pain
would produce spasms - and these if long continued, would
bring on Obstructions - and Obstructions would render
the Nervous symptoms, obstinate and unconquerable
- which last (the Obstinacy of my Indisposition) I have
found true in experience, no method having been of any
avail, to remove the sensibility I complain of, a hairs
breadth. ---

After all, I am very sensible, that this Representation no
better, than meer uncertain precarious conjecture. The Human Body
is a Machine, so Curious and Complicated, that it is impossible to
know it aright, or comprehend the various Causes that operate upon
it, and the manner and consequences of such Operation - and besides
the symptoms of many Disorders, and mine in particular, are often
so indistinct undecisive and of such a mixt Nature, that no Clear
satisfactory Opinion can be founded upon them. Perhaps the
true ground of my Complaints, may arise from simple Weakness
and Relaxation of the solids, particularly of the digestive powers.
Some of the symptoms, I can easily account for, from that Cause
tho not all of them - and I am inclin'd to think, that some
Physicians, have perhaps erred greatly, in refering all Nervous
Complaints similar to mine, to the head of Weak Nerves.

lax fibres &ct. &ct. But on whatever Cause or Causes, my Com¬
plaints, especially the Extra-sensibility, may depend, I think
I am sure of one thing, and that is - that the Climate of this
Country is in the fault, particularly in the Winter time - and
that it does more to continue and confirm, Nervous Com¬
plaints, than all the Physicians in Great Britain, and the
most faithful observance of their prescriptions can do, to re¬
move and eradicate them. This consideration induces me
(being at perfect liberty) to take a long sea Voyage (which is
thought good in Obstructions) and try for some Years, the effect
of a more equal Climate. I propose to go, either to the Isle¬
and of Bermudas, or to New York, or the neighbouring
Jerseys - but here I am at a loss - for were I certain that
my Complaints depended upon simple Weaknesses & relax¬
ation of the solids, then I should be apprehensive of the
consequences of the Climate of Bermudas. Perhaps it might
be too hot, and further relax, my already (supposed) relaxed
Constitution. Bermudas, is situated in 32 degrees of North
Latitude, and enjoys by all accounts, a most serene, Equal
and Temperate Air, it not being so hot there, as on the
American Continent under the same degree of Latitude, by
reason of the sea Breezes I suppose - but not withstanding
to a Constitution entirely relaxed, it might perhaps
prove too Warm, and increase instead of abateng the Disorder.

On the other hand, if my Complaints do take their rise, from any¬
thing in the Blood disagreeable to the Nerves; and from Ob¬
structions, then I should expect great benefits from such a
climate as Bermudas. ---

Thus I have given You my sentiments, relative to the Nature of my
Indiposition, in a manner more Crude and Confused, than I could
have wished. I might have entertain'd you, or rather tir'd you
with a great variety more of speculative and plausible Reasonings
and vain Conjectures - with more facts and true observations, wh.
perhaps would have been of service to You, in the formation of your
Opinion, and perhaps not - I might also have digested better
what I have now wrote you and divested it of many impro¬
prietys and inaccuracys - but I cannot afford the attention
this would have requir'd. I shall suffer for what I have already
done, and it is improper to suffer too much, for any thing
I hope therefore you will make a favourable allowance for me
and look upon my Letter, with the mild Eye of candour.

I have run out to a great lenth, in spite of my
resolution to be short - but it is impossible to be brief upon
such a subject, and do it any sort of Justice. Altho' then
I have been very tedious, yet I desire you may be as short
as you can in your Answer - and that it may be as easie

to You as possible, be so good as give me your Opinion simply
in regard to the following points, without adding the Reas¬
ons or Grounds, upon which it is founded, as I shall make
a shift to guess at them, when I see your Opinion --

First. - Whether you think, there is any Obstruction in the place
I let you see and feel when in Edinburgh, on the right side
of the stomack. --

Secondly. If you think there is - then in what part of the
Body it is situated. --

3dly. A proper Regimen of Food and Drink - and what Me¬
dicines are proper, to remove such Obstructions. --

4thly. Whether the above Regimen, is sufficient to correct a
Scorbutick quality in the blood? - and if not, to subjoin which
further may be necessary for that purpose, particularly in
regard to Vegetables - both as Medicine, and part of Diet. -

5th. Whether You approve most, of the climate of Bermudas
or New York, my Constitution and Complaints considered?

6th. I have been at sea before, and so know pretty well, how
to manage my self in regard to Health - but if you know
of any thing, which You may conjecture I am ignorent of
You may let me know it. --

7th. On Supposition you approve of Bermudas, You may

give me any hints, that You think may be servicable in
that Climate. ---

Inclosed I send you two Guinea Notes - for altho you was so
good, as to desire me to write you and you would answer my
Letter without farther fee - yet I am not so ungenerous as
take advantage of this. Perhaps at another time, I may
write You, without sending Cash, but upon the whole
shall take Care to allow you a reasonable Compensation
for your trouble, such as I can afford. You may direct
your Letter for me, Mercht. near the New Wynd Montrose.
I shall be glad to receive your Answer to the few points above
as soon as you can send it conveniently, intending soon
to set out for London, and by sea.

Dr. William Cullen
Edr.

1773