[Page 1]

although it is so long ago as the 15th
of November since I had the favour of a letter from you
with directions for Miss Stewarts treatment, it was only
towards the end of last month that I had an opportunity
of putting them in practice; you may remember that in
consequence of Mr Woods examination, you had reason to
conclude that there was an affliction of the uterus, ↑&↑ of the
schirrous kind; & that you order'd her to try a course of
the solution of corrosive sublimate, with a decoction of
sarsparilla & mezereon, from the time you saw Miss
Stewart in Edinburgh till she came here in January her com¬
plaints underwent little or no change. She is & has been
for many years almost constantly disturbed with flatulence
& spasmodick complaints of the stomach, her menses
also for the three periods preceding the last, were in much
smaller quantity than usual, & returned at an interval
of twenty days; about 4 weeks ago, just after the menstrual dis¬
charge was over, she begun the use of the corrosive sub¬
limate, dose the 8 part of a grain, given at bedtime; the
effect it had upon her is to occasion an uneasy sensation
of heat in the stomach & a burning heat of the skin which
lasts for at least four or five hours, it does not increase
any of the secretions, on the contrary her skin has been
remarkably dry & her bowels costive during the whole
course, excepting on the days that she took the mezereon,
she begun the use of it along with the mercurial course

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[Page 2]

the effect of it used to occasion a burning heat of the stomach
& bowels, which always ended in a Diarrhea. I tryd it two
nights without the mercury & found it to have the same
effect, so was forced to give it up for the simple decoction
of sarsaparilla, she has now continued the mercury course
for 22 days, during that time I think her appetite much
impaired, she complains very frequently of severe pains
of the back, down her haunches, & thighs, with tension &
pain of the lower belly above the os pubis, sometimes
sore to the touch; which seems to be the effect partly
of flatulence & partly of a uterine affection, no tumor
can be felt even when the tension is off, (but this ↑last↑ I am ob¬
liged to take upon the report of other people); on satur¬
day last the menses appeared in an unusual quan¬
tity & continued all Sunday & yesterday, they now
begin to wear off, as she has necessarily given up med¬
cine for the time I take this opportunity of inform¬
ing you of the effect of the mercurial course so far
as it has been carried, & to know whether you would
wish to have it pushed any farther, the prepar¬
ation made use of is a solution of the corrosive sub¬ limate in water saturated with sal ammoniac
which I understood to be what you meant to prescribe
the mezereon I know from experience to be good, a
dram only was put in a chopin of the tartar decot¬
ion, the greatest attention has been paid to regimen
in every respect; in a constitution debilitated I may
say wore out by so many years continuance of stom¬
ach complaints, the article of diet is necessarily in
great measure regulated from past experience

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one effect of the mercury has been to occasion a considerable
degree of watchfullness in the night, occasioned by a burning
heat all over her which lasts from 4 to 5 in the morning
- pulse in general about 70 & regular, her colour sallow
with somewhat of a yellowish tinge, She has also a lan¬
gour & depression of spirits which seems increased of late
I mean to defer any further use of medicine till I have
the pleasure of hearing from you & Mr Wood.

I am much obliged to you for your kind enquiry af¬
ter my health, I have the comfort of enjoying a much
more considerable share of it than I had any reason
to expect when I had last the pleasure of seeing you
I shall always think myself much obliged to you for
the friendly attention you paid to me when I requested
[your?] advice & believe me to be always most sincerely

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[Page 4]

Dr William Cullen Physician
Edinburgh

✍
Sir Alexr Douglas
Concerning Miss Stewart --
February 22. 1780
X. p. 119