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Inclosed is the representation of the Case of a Sister
in law of mine. About three years ago, I sent the Case of a sister of
hers to you. That Lady died long before your answer came of the fever
she was under At the time I had the honour of writing you. My task is
very painfull, to attend such near relatives & worthy friends, with very
little hope of my endeavours proving successfull. I am under great
Apprehensions of Tubercles in her Lungs. Thes I have not mentioned
in the Case which her husband has seen, as it might have brought
on a dissagreeable explanation. I take the opportunity of offering
my most gratefull thanks for the very freindly mention you have
made of my conduct in your answers to some Cases I have repre¬
sented. I am conscious it proceeds more from your humanity than
my desert. - I hope it shall be an inducement to me to apply my
self with all the diligence & attention in my power to the study of
relieving my fellow Creatures --- Will you be kind enough to send
your answers ↑open↑ to Mr John Cheyne in Leith to whom I have wrote
to cause ↑take↑ a copy of your directions, that as there are two sloops going

betwixt Leith & Shetland there may be a copy sent with each, as one
may be longer detaind than the other. With offer of my most respect¬

full complims. I am

Doctor William Cullen
Professor of Medicine
Edinr.

Edmondston
Q.
Mrs Scott.
March. 1779.
9. p.

Mrs. aged 29 years. She has been married five years, has had no
Children. Her father a healthy man, her mother tho not unhealthy has a de¬
licacy of the nervous system (a family misfortune) that has often subject¬
ed her, as it does all of similar constitutions, to be hurt by what would give
little disturbance to others more robust. This inheritance she has imparted
in some degree to all her children, tho this lady seemd to have less of it than
the others. Excepting this failure of constitution, she was a healthy Child, well
nursed, has ↑had↑ all the diseases incident to Childhood & youth, such as measles,, small
Pox &c. came well through them all & has enjoyd a good state of health, except
the two following exceptions., viz. when about 14 years of age she was for some
time a good deal troubled with swellings in her Legs, & at times outbreak¬
ings in them. These in a year of so left her. - About three years ago, without
any Causes she could assign, she felt swellings in some of the conglobate
glands on the side of her neck below the ear. They continued painfull a conside¬
rable time, at last broke, after the application of poultices, & discharged some
Ichor & ill formd matter for some time. The sores heald & broke out again
for several times, & have now been whole for a twelvemonth. She neither had
when young, nor can I learn that any of Her family were of, scrophu¬
lous habit. these are all the bodily complaints she has had since she was a
woman. - Her mind indeed has often been greatly afflicted by the death
of three sisters, all women, & other dear friends, which no doubt would im¬
pair her health somewhat, but she did not feel any lasting bad effects.
Only her complexion which before was ruddy from that time has been
paler. These misfortounes begun in her fathers family about 8 years ago.
Her menses have been regular since they first appeared which was early.

The above is as distinct a state of her health as I can learn down to the Month
of October last. - At that time she was on a visit to some of her friends, & being
a good deal exposed to be out at night she catched cold. The symptoms in the be¬
ginning were, a slight cough, gravids & a little sore throat. These complaints
being triffling, as she thought, for several days, & not affecting her health
in any matereal way, she was no way attentive to them, nor confined her¬
self any closer to the house than before. But after this they soon became
more severe, the cough turnd more frequent, was very dry & after coughing
long she would get up a little thin viscid phlegm. Her disease now plainly
appeard to be a Catarrh, but seemd not to be owing to contagion, as it was
not then, or afterwards, epedemic in the place where she was, or in any other
part of the Country. It certainly proceeded from obstructed perspiration.
Her appetite now began to decline, her digestion became irregular, generally
costive. Under these circumstances, she was confind to the house, was blooded
took cooling laxatives, was blisterd; for the most part abstained from animal
food & confind to the anti phlogistic regimen. These applications & regimen
were designd to take off the determenation to the Lungs & the inflammatory
diathesis of the blood.- The cough being exceedingly troublesome during the
night often depriving her of her rest, necessity obliged me to have recourse to Laud¬
anum which after the above applications seem'd to have good effects in pro¬
curing rest & by that means recruiting her much. She was now somewhat
relievd & being answers to be at home she took her passage in a sloop, was
keepd from cold in her; But it is probable she got cold in travelling as she
had a mile or two to go by land before getting home. She was now re
movd to a great distance from any assistance in the medical way, & her
complaints not becoming worse, they apprehended her disorder to be a cold
which with care might be keepd at bay till the warm season came on
which would remove it. However during this time she was not neglected

had a perpetual issue put in herback. Still being very costive, means
to obviate that were used, the cough abated very little, her appetite bad & gene¬
rally sweat much in the night time. She was not keepd too warm nor had
been - Such things were sent as the distance of the place could ↑admit↑ & from the
representation of the Case. - In this way she continued ↑after going home↑ for about two months
her complaints neither increasing much or diminishing. In the beginning
or February she in a few days turnd considerably worse & her complaints
have been aggravating since. I was calld to her about a forthnight ago.
I have related as attentively as I could the beginning of her disease & its inter¬
mediate state, which I shall call that ↑the↑ time I did not see her. It now remains
to inform you of the situation she is now in. - Her strength is much im¬
paird, her flesh considerably wasted, Her appetite bad (but does not throw
up any thing) the cough frequent & troublesome tho not so much as it has
been. Her expectorations which has always been difficuilt & little in proporti¬
on to the Cough, is not at times freer & the phlegm of a better consistence.
I can discover nothing like pus in it.- Of a very costive habit to obviate it
she has got Glysters every second day, as any other method of opening her
Belly would be uncertain in its consequences & might increase her weakness.
She has Hectic fits, & great sweating which before happened only during the
night, but now keeps no regular time, only she is Easiest in the forenoons.
She sleeps little even with the help of Laudanum which she has got to
the length of 20 drops. For these eight days she has been mostly confined
to bed.- Within these three weeks she has had two fits of looseness, it went
off in a day or two. Her nervous system is a good deal affected having
within this month had several fits similar to hysteric people.
Her spirits at times are exceedingly sunk. Her menses have been regular
since the commencement of her disease, only the quantity has been much

less ↑rather last interval been considerably longer than the preceedings↑ She has not had, nor has never any fixed pain in her breast or sides,
Only she cannot lye on the left side without increasing the Cough much.
She has not had any shortness of breathing during her disease --