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I beg leave to introduce to you the
bearer Mr Mcduff a patient of mine, whom I have ad¬
vised to consult you about a very troublesome com¬
plaint in his bowels which he has laboured under
for some time past - About 6 months ago he was
seized with a pain across the belly about the um¬
bilical region - which was attended with loss of
appetite and an obstinate costiveness - it was
more than two months after it first came on be¬
fore I was acquainted of it and then in such
an imperfect manner that I did not know what
to make of it - however I prescribed some Ol. Ri¬
cini which gave him some ease in the begin¬
ning but he gave it up before it could have
any great effect; and meeting with a friend of
his (a great pretender to Physic) he was advised
by him to take a large dose of Calomel & Rhubarb
and immediately after it above four ounces
of Glauber's Salts divided into 8 doses, which

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he took, one after another, as fast as he could swallow
them - this instead of removing the costiveness had
a contrary effect - so much that he was some -
times near a week without getting passage - in this
way he continued for several weeks without saying
any thing of the matter to me - at last he told
me - and I endeavoured to cleanse the guts of the
hardened scybala by emmolient clysters; and
supposing the disease to proceed from a relaxed
state of the intestinal canal, I ordered him a
small dose of Rhubarb & Sal Polychrest every
day about 12 oclock in a little chicken broth;
but this not suceeding according to my wish
I continued the clysters and changed the other
medicine to some Ol. Ricini given every
night at bed time with a dose of Laudanum
tho' this has relieved him a good deal he com¬
plains that the medicine sits heavy on
his stomach and sometimes cause him
to vomit –– I make no doubt this medicine
if properly persisted in would have removed
his complaints - but unluckily his temper is
too unsteady to persist long in any medicine
or

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regimen ––– he says he generally feels most pain
about mid day – and immediately after dinner
complains of his stomach and bowels being
much distended with Wind, which he passes
plentifully both upwards and downwards -
He was formerly a very hard drinker - but of
late he has given it up almost entirely ---

I have been much more particular than I
needed to have been - had I not known the
propensity he has of concealing his
compl[aint]s, particularly from his
Physician - upon this account I
am afraid you must take the trouble
of giving him his directions in writing -

I am very sorry to understand that our
patient poor Miss Farquharson has veri¬
fied our prognosis so soon - tho' indeed there
was no prospect of her ever getting the better
of her complaints - had she lived even some
months longer ---- I beg best compliments
to Mrs Cullen - and am with the greatest
respect

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Dr. William Cullen
Physician
Edinburgh

✍
Mr Farquharson
Concerning Mr Macduff
January 1700
V.X. p. 161