[Page 1]

I am extremely sorry to be under the
disagreeable necessity of acquainting you, that altho'
Mrs Smalwood has hitherto strictly adhered to your
Regimen & Prescriptions, yet the disorder daily increases
apparently - Upon our arrival home she continued very
ill for some days seemingly totally relax'd, a want of
appetite, and a quiet dejection of Spirits; but thank God
the two latter she has got much the better of since
Tuesday last but the irritation in her Bowels still
continue with some violence; and to add to her misery
and anxiety the other Breast is so much affected, that it is
full as large as that she complains of when at Edinburgh
don't apprehend by Mr Coltherd that there is any particular
Swelling or Lump in it, but that the glands of ↑the↑ whole Breast
are immedietely Swell'd - I am happy in saying she
as yet perceives little or no pain but a great deal

---

[Page 2]

of uneasiness & particularly for these two or three last
nights from the Breasts being so much Swell'd that
she cannot lie on either side when in bed - The Arm
Pitts I am told still contines uneffected which is not
the case with the glands from her Left Breast (which is
the first she complaind of) they are Knotted, & Corded ,
to her Shoulder Blade, and her Arms by no means free.
The right Breast began to shew itself effected imme¬
diately upon our return home which with the unhappy
Complaints she then Labour'd under in point of health,
deter'd me, & the Surgeons, from even hinting any thing of
an exterpation; as two or three days amply convinced
us that the exterpation of the one wou'd answer no end
without the other - I must also acquaint you this situ¬
ated Coultherd was afraid to make an incision for the
Issue, least an inflamation shou'd come on which might
be attended with disagreeable consequences as she was
then so extremely ill in point of strength. The Lotion
she was directed to was her breast with inflam'd and
irritated it so much that after three or four times apply¬

---

[Page 3]

ing it she was oblig'd to decline it - I have now
Gentlemen, in the best manner I am able laid before
you her present Melancholly & deplorable situation
If you can recommend or advise any thing to [indee¬
vour?] to alleviate or palliete her present anxiety
your directions will be punctually observ'd and your
immediate answer will infinitely oblige

---

[Page 4]

Kirko[swal]d near
Penrith Cumberland

Doctor Cullen
Edinburgh

✍

Featherstonhaugh
of
Mrs Smallwood
May
1778.
VIII. 108.