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I received yours of the 14 February and should have given
you an account of the operation of the Solution
& Tinct. Martis in my last, had there been any
alteration. But as Mr Irwin had continued to
take them with similar effects, I thought it
less necessary. He immediately discontinued the
use if the Calomel & has been since taking your
presciptions regularly. The Tincture sits easy
on his stomach, & the solution continues to
procure a free discharge of urine & a gentle stool
every day. The swelling of his legs is inconsi¬
derable & the itching some what abated. As the
weather has been some time past very mild
he has left town; and has been able to ride
on horseback; in consequence of which I think
he has caught cold. For on friday last in the
after noon he was seized with a pain in his
knee, which during the night swelled & inflamed

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a little; and soon after the other knee, both elbows
& the wrist of one arm were affected in a similar man¬
ner. I visited him today & found the pain much
abated, but there still remains a little inflam¬
mation in one knee & some pain in the other
joints. His pulse is full & about 80 which is 15
above the usual standard. His tongue is moist
but whitish, his therst is not increased, or his
appetite much impaired. During these three
nights he has perspired freely. His joints are
covered with flannel, and as I was not willing
to make any change in his medicines till we
heard from you he continued the Solution & Drops.
In my opinion every symptom indicates a very
mild acute rheumatism which is a circumstance
by no means unfavourable as it shows the tone of the
vessels are (↑is↑) much augmented. But you will consider
the case & inform me what is proper to be done;
& he likewise desires to know your opinion con¬
cerning Bath or any other watering Place du¬
ring the Summer.

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D.r Cullen
Edinburgh

✍

Mr Irwin
March. 1779
9. p. 140