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Your letter, which I received on Saturday
night, was equally agreeable to Mr and Mrs Dickson
and to me. So far from regretting that you had
not advised any thing new, they expressed much sa¬
tisfaction in it, as giving me the proper confidence
in pursuing the measures which you approved of.

---- After I writ you matters grew much worse,
The fits, (which still attacked Mr D in the morn¬
ing) being indeed very severe, - and not much
relief afforded by any of the remedies which I
mentioned, for even {illeg}bleeding seemed to fail, which
was twice repeated, though no more than four
our five ounces were taken each time, the state
of his pulse not seeming to require more. ----

On Wednesday night I gave twenty five drops
of Laudanum but with no visible effect. On Thurs¬
day night (having spoke of Musk, though not ex¬
pecting much benefit from it) I added ℈1 of this
medicine to our anodyne draught. -- But, though

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the fit came two hours later next morning, it
was still more severe than any of the former ones,
and it was expected by himself and all his friends
that the next attack would carry him off; -- his
strength seeming (I say only seeming) to be greatly
exhausted. -- On the Friday evening I determined to
make a stronger push with our opiate, and acc¬
ordingly directed thirty drops of Laudanum, adding
still the Musk, to be {illeg} given at two in the morning,
and to ↑be↑ repeated at eight. -- This was done, and
with a very complete effect, for he passed the night
comfortably, and escaped the fit entirely on the Saturday
morning, after having ↑had↑ them the five preceeding mornings.
Thus gave me great hopes; and on the Saturday night
I directed the same measures, which were pursued
with the same effect. -- our remedies did not seem
to be attended with any inconvenience, or bad effect
whatever, though I must own that he did not appear
to be gaining ground. -- On Sunday night I wished
to make one only of our antispasmodic draughts suf¬

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ficient, and I directed it to be taken at four in the
morning; but some degree of breathlessness made him
call for it an hour sooner, and he became easier &
again upon taking it. --- Perhaps you may say
why did not you give your draughts twice and at
the same hours as the two former nights, their effects
having been so good? -- In answer to this -- I wished
to give such remedies no more than was necessary,
and the circumstances of Monday (i.e. yesterday) shewed
that something more would be required. -- During the
whole of the day, though he had nothing like a fit,
yet he continued ↑was↑ pretty breathless; and, at seven
in the evening, a paroxysm more violent, and
of longer duration than any former one, attacked
him. -- Notwithstanding his advanced age, the
evacuations which he had already suffered, and
his seemingly reduced condition in point of strength,
I saw clearly, from the strength & fullness of his
pulse, that nothing but bleeding could {illeg} relieve
him. --- Fourteen ounces were immediately drawn
which soon moderated the violence of the fit; but

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after three hours, the difficulty of breathing being
still at times considerable, & his pulse as firm
and frequent as at first, -- I caused fourteen
ounces more to be drawn. -- The quantity of
blood in all appeared, on measuring the cups, to
be fully 28 ounces. -- Before midnight he was
completely relieved, and he has had a very easy
night, his pulse, to day, being slow, and good in
every respect. --- I should mention that between
the first and second bleeding last night, he brought
up several mouthfuls, of what was chiefly
blood. -- A large blister, which was the fourth,
had been applied in the afternoon.

This is the first bad asthmatic case that
I have treated. You see well with what difficulties
and uncertainties it is attended, and how
much I may need your direction. I beg therefore
Dear Sir that you will let me know whatever you
think material concerning it, & believe that I am
with very sincere regard

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To Doctor Cullen
Physician in
Edinburgh

✍
Dr Gilchrist - query
Mr Dickson -
February 1776
Vol. IV. p. 122&124.