[Page 1]

I sent the enclosed to the Ladys mother
who is very Intelligent to know whether
I had stated the case properly And she
bids me add that the first attack the
young Lady had was after haveing
taken a Dose of salts which vomited
her & wrought her severely: this I
Dare say has nothing to doe with
the present situation but I think it
Right to state it to you as to evry
thing else she says it is perfectly right

–– Your patient Coilsfield you would
see Died sometime agoe; Doctor James
Paterson a very good young man whom
you knew assisted me in opening the
Body – we found in his gall bladder
a Galstone as big as a small Nutmeg, &
but, one, the bladder & parts twixt that
& the Rectum were in a gangrenous state
from the Inflamation raised by the fit of the
gravell of which he died after passing two
stones; but there was not a particle of sand
or gravel in either of the Kidneys from
which he had so often pasd stones and we
were at a loss to guess from whence his

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[Page 2]

the pain & consequences that caused his death
proceeded, when searching the bladder we
found a stone very large & very hard
sticking in the ureter just where it
pierces the caule of the Blader – and a
polypus substance as hard as any tendon
fixed in the heart [[&]?] extending full six
Inches into the {illeg} with a nob at the
end of it as large as the last joint of the
thumb, which Accounted fully for the
constant Iregularity of his pulse – this
substance surely was not formd after death:
you will forgive me for not mentioning
the name of the young Lady who's case I
have enclosed you, as I have the comand
from her not to doe it.

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[Page 3]
✍

Doctor Cullen
Physician
Edinburgh

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[Page 4]
✍

A Beautifull young Lady of about 21,
naturally sprightly & active, and to all
apearance evry way healthy; Regular and
without the least symptom of Nervous or
Hysterick complaints, moderate in her way
of liveing, with a good apetite & easy Digestion:
has since some months before she became a
woman complaind of a pain in the Region of
the kidneys, which some five or six years ago
became very violent & spread all over the neigh¬
bering parts, ocasioning pains in her sides a short
cough pains in her Bouels a strangury and
tenesmus with a total supression of urine
& great Degree of fever –– She was than in
France & was Releived by bleeding Glysters
fomenting & leeches to the part originaly affected

–– She has ever since that time had more or
less Uneasiness in her kidneys, with little urine
when the pain became considerable, but flouing
in sufficient quantity when the pain abated

–– Riding, walking much, & particularly
Dancing, of all which exercises she is fond
constantly make matters worse; Altho adicted
however to complaining, she bers her Distress
without saying any thing about it, till almost
three weeks upon when being very Ill she
unknown to her mother consulted me through
a female friend, as she would not consent
I should see her for fear of Discovring

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her situation to her family I orderd her
to be blooded & her blood was buffy, her bouels
were emptied by an Injection, and afterwards
by some mana & crem. of tartar, the parts were
fomented, & she grew easier, her urine (which
Dureing the violent uneasines was very scanty & high
colord but full a copious Brick dust like
sediment) became plentifull & of A Natural
Apearance –– She took largely of a saline
mixture of vinegar saturated with salt of
tartar & some Spiritus Nitr Dulc, and
Keeping quiet became in a few Days
easy, till about a week agoe when she had
Another Attack in which I saw her, it
was not so violent as the one I have first describd
she was pretty easy when out of bed but when¬
ever she lay Down it came on, and her pulse
which in the Day time when pretty easy
was about 84 rose above a hundred and she
continued Restless till towards morning when
she begun to sweat & turnd easier: her
bouels were emptied leeches put oposite the
Kidneys ↑& she went into the warm bath↑ - she became easier, & the Menstrua
haveing apeard two Days agoe she is now
pretty free of complaint –– there has
never been any sand observed in her Urine
I have statted this case as Near as I can
gather it & should be happy to have your

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Opinion as to the cause, probably consequences
& particularly as to the management – I
should have observed that towards the monthly
period she is always more Uneasy, Even when
cautious as to overexercising herself
the Releif given in the violent fits by
emptying & fomentations seem to justify that
method to which perhaps opiates may be obliged
to be added, but if the pain could be got entirely
removed would tonicks particularly cold
Aplications to the part be of use - if there
is any thing sticking there, they would not,
but I would Gladly hope that is not the
case,

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[Page 7]
✍
Dr Campbell
Concerning a Lady
V. XV p. 389.