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His Age is about 70 – He had orriginally a firm heal¬
thy Constitution - his Person being of the middle size &
formerly well made & pretty plump - He had always
a remarkably fine flow of animal spirits - and was
little troubled wt. any Disease except the Gout, which
for a long time past has been familiar to him –
Its Visits for some years at first were frequent &
certain - but then, always confined to his lower Ex¬
tremitys - so that it is now many Years since he
lost (in great measure) the use of his feet - For more
than five years past the Paroxysms have been less
frequent, but more centrical. The Uper Extremitys
were more affected & now & then before forming
there, it appeared in form of a Collic & once threat¬
ned his Head by Occasioning Giddyness - but never
anything more - His Intellect was always clear
& all the facultys of his mind Vigorous - he was, & is still,
able to go thro a long & intricate series of Calculation
mearly by the strenght & clearness of his memory
without any other help –– The Disease, I believe,
may have been Hereditary - but his manner of
Life I dare say has contributed much to produce or

In the Winter of 1774 he was sometimes troubled
wt. an asthma & swelling of his Legs of both which
complaints he was relieved by using the Pill: Scill:
Since that time his Body has kept always open
and he was pretty Healthy - free of Gout asthma
& swelling - till within this half year, that these
Complaints seem to have got a succidaneum - At
irregular periods or intervals, he passes along wt.
his Stools a thin, Brownish or Bloody-collour'd Matter
and this frequently, & for several days together - It
comes away involuntarily (in some degree) & tho
it is not in great quantity keeps him constantly
going to stool, which fatigues & deprives him of Rest
thro' the Nights - It ↑is↑ attended wt. something of a Pro¬
lapsus Ani which, I suppose, by hindering the con¬
traction of the sphincter, may occasion the thin matter

Very little has been done in the way of medicine since
this Complaint took place (on acct. of his own diffi¬
dence of it) - I have been inclined to treat it as pro¬
ceeding from relaxation, of which a Paralysis or Body
shaking of his Body & of his head especially, I think ↑is↑ like¬
wise a mask - but this is no new thing ––– and I have
been apt to think the discharge itself (if moderate) not
otherways unsalutary - because it is observed his ap¬
petite & spirits are better when it is upon him - But
with regard to this and the following queries I beg your
opinion & advice

1st. Whether it is salutary or not & how
far to be encouraged, or checked –

2d Whether this Periodical or rather remit¬
tent (for he is not many days free of it) Bloody Discharge (since
it is not inconsistent wt. Costiveness or hardness of the natural
excrements) does not proceed from the intestinum Rectum
& Hemorrhoidal Vessels - and so may be a species of the
Internal Piles

3d. Whether a Laxity of the Intestinum

4th. Whether Tonic medicines are
not proper - and what is the best method of moderat¬
ing the or restraining the bloody discharge without pro¬
duing Constipation or that hardness of the natural Ex¬
crements

5th. What should be done for the Pro¬
lapsus - it is not very considerable except after going
to stool –

I have endeavour'd to mention every matterial Circumstance
in the Case & hope you will understand it from this im¬
perfect Representation - With respect to his Pulse it has
all along been good - a slow, regular, full Pulse - It used
to be so strong as to seem to force up ones finger at every stroke
at present it is as much so as common. & He has neither
Heat or thirst more than Ordinary - his appetite is rather
weak & his food sometimes uneasie on his stomach –
At his time of Life it is not expected he should be freed
of Complaits - but if you will advise us what is the best
method for prolonging it, or procuring present relief in the
circumstances above stated it will much Oblige