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In order to obviate Costiveness, I was oblidgd to
have Recourse to an Injection which did not work, and by remaining
in my Bowels Relaxed them, particularly the Rectum; you know
I am subject to the marisci, next Day I took a little of the
Crim of Tartar which by operating twice, brought down the Piles
so that I Could not return them, they soon became very painful
and oblidgd me to go to Bed they gradually Increased and
became Large as a wallnut, the pain most violent so that I
slept none tho I took thirty five drops of Laudanum.

I am yet no easier and my Pulse at times Feverish.
Have tryd Fomentation with milk and water also a
Poultice of Bread and milk without any Relief, I proposed
Leeches but as I have seldom seen them do much good I would
be glad of your opinion whether to try them or not I prose also
to take a little of the Electuary of Cassia with some Crim of Tartar
If you think of anything else be so good as let me know
for I am in the greatest Pain Imaginable. I woud be afraid
to use Sedative application. Your answer by the Bearer will
very much oblidge your affectionate Humble Servt

Doctor Cullen Physician