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Mr. Smith an eminent Surgeon aged 56
having been detain'd a Night & a Day in the Profession
& returning Home about six Miles on a very cold frosty
Night, after being four Hours in Bed, was seized with an
Insensibility of one Hand which proceeded without any
Pain to the Side of the Face & so forward till it terminated
in a complete Hemiplegiæ with Spasms of the Muscles
of that side of the Face & an involuntary Flux of Tears.
The Complaints that attended were in a few Days
greatly abated and at this Time it being six Weeks
ago the Strength & Appetite are greatly improved, the
Leg & Thigh have so far recovered as to afford some
assistance in walking, the Face is restored to its natural
Shape & Appearance, the Shoulder has recovered some
motion but the Arm & Hand remain totally useless, but
he feels a Sensation similar to that of a Person's coming
near the Fire when extremely cold which we look upon
as a favorable Circumstance. From the first Attack
his Senses & Memory have not been the least injured.
He was bled imediately which has been repeated thrice
the last Time a few Days ago to seven Ounces. The
Serum seem'd as one to four & had a Milky Appearance
on the Coagulum was a tough white Gluten about the
Thickness of a Shilling. -- The Morning he was seized
he took two grains Tartar emetic which did not operate briskly

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Blisters, Mustard Frictions & the usual Modes have been
steadily persever'd in & within this Fortnight it was judged
expedient to try the tonic Powers of the Bark with the Tinctura Guaiacina volatilis --- Has had a Seton placed in the
affected Side which discharged plentifully & now has an
Issue in the Thigh. The Bark has been omitted for a
few Days on Account of a Cough but it has no Appearance
but that of a common Cold which is now very frequent
in this Neighbourhood. On some Nights a most disagreable
Restlessness causes great Debility & depresses the Spirits
much, he says it cannot be discribed for there is no
Pain but is not able to lay in one Posture for any Time
the next Night being a better one restores surprizingly.
He has often taken an Opiate it being the only Thing
that renderd any Relief & a Medicine which he always
found remarkable good Effects from in former Complaint.
Mr. Smith for 30 Years has been very assiduous in
his Profession in which he has had great Practice &
frequently long Rides, has always been very temperate
or even abstemious, is of a corpulent Habit, has often
had inflamatory Disorders & sometimes a chronic
Rheumatism. The Blood was always sizy & he has
been much accustomed to Bleeding.

About six Years ago he was seized with a very
alarming Spasm creating a Dyspnœa & Inability to

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to move & which we find answers the Discription of the
Angina Pectoris. Since that Time he has had frequent
Returns but never so severe. As there has been some
Symptoms of it during this Sickness we think it necessary
to remark it. The particular good Effects Bleeding
have always had induced us not to be sparing in
that Evacuation. When the inflamatory Diathesis was
gone we thought the Bark proper & we looked upon
the Drains as necessary for the Angina Pectoris from [what?]
the [Faculy?] have said of their good Effects in that Disorder.
Tho' Mr. Smith is in as hopeful a Way as can be expected
having had the Advice of a Physician of long Experie[nce]
yet as we wish to have every Satisfaction & are we
convinced of your superior Skill & to whose Labour
we own ourselves greatly indebted we flatter ourselves
you will favour us with a full Mode of Proceeding and
shou'd this not be sufficiently intelligent we wish
to inform you of anything you will please to ask
whereby you may be enabled to give us every Assistance
in your Power. We beg to know your Opinion
concerning Bathing & under what Restrictions it may
be used. I am Sir

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Doctor William Cullen
Edinburgh

✍
Stephen Cleasby
Query
Mr Smith
December 1779.
X. p. {illeg} [143?].