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I should be glad to have your
Advice, as soon as your conveniency will
permit, for Mr Alexander Wright a sub¬
stantial burgher in our town. He is
between 40 and 50 years of age, rather short
than tall, of a thin, spare habit, but till
lately very healthy. In the beginning of
winter he complained of loss of appetite
with an uneasiness about the region of
the stomach, for which he got some of
the common stomachics and laxatives,
and I believe received some relief from
them. I heard little more of his ailments
till about five weeks ago, when I found
his belly considerably swelled with a
sensible fluctuation, and his thighs
and legs likewise very considerably
affected with an oedamatous swelling
He had already, out of his own head,
almost purged himself off his legs

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by repeated doses of [physic?] as it is called,
so that there seemed no room left for
farther prosecuting the cathartic mode
I therefore adopted the milder diuretic plan.
I first tried the common squill-pills, 10 or
15 [grains?] night and morning, interposing two
or three drams of Crem. Tart. through
the day. The squill pills I afterwards
dropped for a Mixture or Julep of
Acet. Scill. with some regenerated
Tartar in Aq. Menthe &c though
our patient, who is not very fond of medicines
has scarcely on any day taken one third of the
quantity prescribed, yet the OEodema of the
legs and thighs is almost entirely removed.
His belly has likewise yielded a little, but
not much. There is no particular tumour or
hardness to be felt in it, but the fluctuation
is very perceptible. He can still button
the waistcoat that he wore when in health,
with some difficulty, but cannot let it re¬
main buttoned. There is no fever or hectic
symptom; his pulse yesternight at 9 o'clock
did not exceed 68. He has no difficulty in lying

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on either side or on his back. His appetite is
little, and he complains a good deal of pains
in his belly, which are always worst about
an hour after eating. His urine was at first
scarce and high coloured; of late it is less
so, and he thinks it equal in quantity to
his drink; he has no thirst and drinks
little. He used to ride out in horseback or
in a chaise, but the severity of the weather
for the last 2 or 3 weeks has allowed him
little exercise. His belly, legs &c have been
frequently chafed and rubbed with dry
warm flannel.- Entre nous, I understand
from some of his nearest connexions, that
he has been of late addicted to dram drinking,
to no great excess, I believe, but perhaps more
than a weak stomach and sedentary life
will permit: I hope the terrors of his pre¬
sent situation have made him relinquish this
practice. I have confined him chiefly to a
vegetable diet, which indeed seems to agree
best with him. He sleeps tolerably well.

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Dr Cullen
Edinburgh

✍

Dr Mitchell Concerning
Mr Wright
May 10th 1779
V.IX.p.174.