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I presume to recommend the following case to
your immediate consideration. I believe it is a very extraordinary one, & may
cost you some trouble in determining with regard to it. For the procuring
of your advice, therefore, I depend much more on an advocate in your own
breast, than on the inclosed trifle.

I am just now between twenty three & twenty four years of age. Ever since I remem¬
ber my nerves have been weak. There was always a visible tremor in my hand,
which, when my spirits were any way agitated, or my body heated by exercise, became
excessive. About nine years ago (the fifteenth year of my age) I was insensibly seized with
an uncommon sort of weakness in my head. I cannot describe it to you any other
way, than by telling you that I was apt to imagine myself in a dream, rather than in
real life. It much resembled, too, ones feelings after drinking a few glasses too much, be¬
fore being, what is called, half drunk. Much light was very disagreeable to me; in
so much that when I was reading or writing, if the sun happened to shine near
me, I was greatly disturbed; & if he shone on my book or paper, tho not in my eyes,
I was incapable of proceeding. As this disorder came gradually on, & I was at a time
of life little addicted to reflection, I did not observe or regard it, till it had arrived at the
heighth above described. I then took a vomit. I took it at night, went to bed immediately
after it & fell asleep. In the morning when I wakened, I felt exactly like one awaked
from a dream, or from a profound sleep after having drunk too much. Every thing
about me appeared real, which it had not done for several weeks before. About a
twelvemonth after this (the sixteenth year of my age) I was again seized with the same di¬
oder: & after thoughtlessly allowing it to continue for some weeks, I again took
a vomit, & with the same success. All this while I could attribute my illness to
no external cause: no intemperance, no surfeit. I continued well for about six¬
teen months after the second vomit. But about that time, a few minutes after
I had gone to bed one night, I was all at once struck with a feeling, very like to that
which a man has immediately after running his head against a post. Not that I felt

The stupor is greatly increased. I continually feel like one more than half drunk, with
this difference that my passions are not heated. My judgement & memory are greatly im¬
paired. The association of my ideas is always irregular, & sometimes, I think, partakes of
folly. It is intirely lost after I go to bed, & numberless images float in my brain without
order or connection: but as they only slightly float, & I have even then some reflexion left,
they do not determine me to action. Severe fits, of the kind above described, frequently at¬
tack me in bed. Sometimes I have them of quite a different kind. The most unac¬
countable ideas arise in my mind, my heart is chilled with horror, the bed seems
to sink under me, & every thing eludes my grasp. I sleep ill, sometimes scarcely
any, & am almost never thoroughly refreshed. For the last eighteen months, I have
every morning had a most diagreeable taste in my mouth, & always, when I wa¬
ken, spit up a great deal of yellow, glutinous stuff. Moderate exercise agrees well
with me; but much of it gives me a severe pain in my left shoulder. I have fre¬
quent gripes in the belly, & am sometimes sick after meals, tho I eat sparingly. A single
glass of wine affects my head. I have a great inclination to press my tongue between my
teeth but whether this inclination be in my tongue, or in my teeth, I cannot say. I think it is
in my tongue, as it sometimes seems very little & sometimes very large. My temper is
fretful & inconstant. Study distresses me, & passion almost throws me into convulsions.

Such was the state of my disorder about four weeks ago. At that time a new symptom
appeared, & about ten days ago another, both of which contribute greatly to make me
believe that my distress is near a period. The first was a noise in one of my ears. A few
days after the noise began in my other ear likewise; & has continued in both since;

I have now, I hope, told you all the characteristic symptoms of my disorder; tho there are
several others which I might mention had I the benefit of conversing with you; but which I
cannot trouble you with in a letter. I am sorry that I have already made my letter so long, & that
I still have several things which I think it were necessary to add. You might certainly have been
informed of my case a great deal more distinctly, & probably much more briefly, had there
been any one in the medical line here, in whom I could have confided. But there is not one
of ordinary abilities, & besides I am extremely diffident. This is one reason, among many other,
which has prevented me till now from taking proper advice. I had no confidence in any
one but you, & you I was unwilling to trouble. Necessity has now driven me to it, more on
account of others than of myself; & from your humanity I hope for immediate advice, tho I
am afraid it is by far too late.

My business is preaching. I have been in Orkney only about three months. During that
time, I have resided till within these few days, in a solitary island. I have been foolish enough,
for these three years past to study a good deal. But of this I am now incapable, & am much afraid,
that tho I live, I shall be obliged to give up both study & preaching altogether. I was unfor¬
tunate enough too, to marry about two years ago, which has no doubt added to my
distress. The only remedies I have tried are, shaving my head, a blister between
my shoulders about three years ago, ↑& the↑ cold bath which does not agree with me.
I have sometimes, too, chewed a good deal of jesuit's bark. But the
only thing I have persisted in is walking, which I have done ↑ a couple of hours↑ every day
for several years. I remember too to have had leeches on my temples;
but to no purpose. I am perswaded I am not plethoric, neither do I think
that there is any extraordinary course of blood towards my brain. I am of a spare ha¬
bit of body, with rather a long than a short neck. My temper is naturally chearful, &
even in my present alarming situation I am capable of being amused by company. I
forgot to mention that I am frequently troubled with flatulencies. - Till within
these few weeks I apprehended my disorder would end in madness: but the severity of
the fits makes me now imagine, that I shall very soon be cut off by a serious
apoplexy; tho, perhaps this may be preceeded by a delirium. I came to this town a few
days ago, for the sake of company, & of what little assistance the surgeons here might
afford me, in case my disorder should come to a heighth - My nerves are evidently
weaker more than ever; but besides this, there is certainly an inveterate collection
of bilious or other matter in my stomach. What I wish to know of you, sir, is what
you think will be the event of my disorder, whether you think it possible to cure, or

You will recieve this letter on Wednesday or Thursday, the twenty fifth or
twenty sixth curt.. If the hurry of your business will allow you to write me
against the Sunday evening following, it will be an action of great human¬
ity to do it. As the post leaves Edr. for this, early on Monday morning, if
you do not write against that time, I shall be a whole week later of receiving
your letter.

I shall trouble you with nothing more, only to beg that immediately
on perusal you will tear the subscription & date from this letter.
For many reasons, I wish no one in the world but you to be ac¬
quainted with my disorder.

[Revd. Gillies]
A Gentleman in Orkney
Novr. 1778