[Page 1]

Nothing new has
happened to Mr. Orr excepting a
Pain in his left shoulder and Hy¬
pochondrium which some days
ago came at the same time ––
the pain in the side soon went off
but that of the shoulder still re¬
mains –– the pain of his right side
had mounted higher and fixed half
way betwixt the right nipple and
lower end of the sternum; but this
likewise has almost entirely gone off
and the only pains which remain are

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[Page 2]

those of his shoulders which within
these two last days have also become
more mild; but change of posture al¬
ways renders them more uneasy; yet
such increase of uneasiness soon goes off
nor does he observe that one Position more
than another makes any difference in
this respect not even lying on his left
side nor standing upright –– some de¬
gree of appetite continues and his thirst
is not considerable and he has had no
shiverings nor Coldness – but notwithstanding
all these favourable appearances I
doubt him much for his pulse continues
quick as ever (100) and is rather stronger
and he gets little sleep, not more at any
time than 3 hours in the 24, and no
rest excepting what is procured by an
Anodyne; and after every little sleep he

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[Page 3]

sweats a little –– your aperient was
given and repeated in a larger quantity
but without purging and brought
on a return of the flatulence and un¬
easiness of stomach so that I have
been obliged to keep his belly open
with Clysters –– his Urine often de¬
posites a Copious Sediment; but there
is no appearances of Jaundice; and
I believe in such Disease there
is none to be expected the inflammation
being confined to the arterial ramifica¬
tions in the liver and affecting neither
the secretion nor transmission of the
bile –– his belly is soft and free
of either general or particular swelling
neither does moderate swelling (↑pressure↑) give
him Pain or uneasiness ––

His Brother's eyes still continue

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[Page 4]

getting gradually better and he is
able now to look longer at one object
without glimmering –– the adnata of
the right under Eye-lid still continues
a very little inflamed –– the iris in it's
motion appears to me to vary the
Pupil too little – however small the
light and however carelessly he may
look or however distant the object to
which he directs his eye the pupil
never dilates sufficiently; and does
not this point out a remainder of mor¬
bid sensibility? But I am perfectly
perswaded from what you point out
that the seat of the disease is in the
elevating muscles of the eyes and eye
lids – does their weakness proceed from
inflammation and does such inflam¬
mation still exist? ––––

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[Page 5]

On Thursday morning last Mr
Hamilton died – upon opening him,
for there was a necessity to evacuate
the water which was in amazing
quantity, I found the liver much
diminished but without any marks
of ulceration – it was rough and
hard as if par-boiled but not so
hard as to deserve the name of
schirrous –– [at?] In the entrance of
the Cystic duct from the I found
a small hard subtance which was
black and rough and of the size
of a Pea and I saw nothing else
remarkable –––– After you
left Paisley I found you had
not been paid your fee and

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[Page 6]

spoke of it to Mr. and Mrs. and
Miss Hamilton and also to your
old acquaintance Mr. Davieson
of Inshinnan –– but was given
to understand that you would ex¬
pect nor take nothing and that you
had formerly attended his father
and had never taken a farthing;
so I found it was use and won't ¹
and could urged the matter no far¬
ther – but the demands upon ↑the generosity of↑ me¬
dical people are unconscionable
and it is not without indignation
I meet with them –– I am sir

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[Page 7]

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[Page 8]

Dr. William Cullen
Professor of Physic
Edinburgh

✍
Mr Taylor
Concerning
Messrs Orrs.
March. 1782
V. XIII p. 330 &ca