[Page 1]

[Page 2]

[Page 3]

[Page 4]

Mr John Shanks ↑Mercht.↑ a Gentleman about 30 years of age of a
thin sparse habit of body & rather narrow chested subject to Coughs in
winter & at other times used to complain of pain in his breast in
a slight degree, which was generally relieved by blooding, accus¬
tomed to live pretty freely but not remarkably intemperate- He had
a Cough & pulmonic complaints 6 or 7 years ago which were soon
relieved by the usual remedies & has never been so bad as to be
confined to the House since- In the end of Decemr. last was seizd
with Cough more severely than usual & uneasy sensation at
his breast heat and frequent pulse- Jany 1st was blooded- took
a doze Salts- had an emetic- some [Nitrous?] powders- confined to the
house- complained of pain in the Breast- Blooding repeatted the
9th not very sizy a Blister applied to Sternum which seemd to
relieve him- Cough & other complaints better so that he went out
for some days- about the 20th Cough returned- had ammoncal Solu¬
tion spat up thick mucous at times pretty freely, but pulse
very frequent being never under 80 in the morning & encreased
to 110 & 120 in the evening- pain pain in lower part of thorax right
side to which a Blister was applied which made it shift & easd
it a little- inclin'd to sweat through the night & wasted very

fast. The Blooding was not repeatted as neither pulse nor other com ↑appearances↑
indicated Plethora- He is at present much emaciated. He sits up in
the Day sleeps tollerably, has little Drough- can take some victu¬
als & drinks milk in the morning without any inconveniency. Of
late has some Disposition to Diarrhœa- Mr Wallace with whom
I am now in partnership has seen him all along & thinks he has
been much at a stand these some days I have not seen him of late
being confined myself- this morning was told he was a good deal
troubled with Cough & did not spit up any- pulse above 80- yet he
he had got good nights rest & two stools thro the night- he has not
consulted any Physician here & {illeg} wishes much to have your
advice as soon as possible- I believe he has no hereditary
taint- I hope you well can form a proper enough idea of this Disease
tho' I have been obliged to draw his case hastily & perhaps not
so accurately as it should have been- As I am writing
you at any rate I shall use the freedom to give you an account of
my own disease & if you can give me any hint from the slight
account I shall give you of it, how to manage it or point out
any method I should ffollow either by Regimen or Medicines
I shall esteem it a singular favour- Towards the end of the year
I had great weakness of stomach- reluctance to all kind of ffood &
[wearedness?] & uneasy sensation- I took a vomit & used Bitters ↓expecting it↓

woud go off as usual- for I have been all my life of a weakly consti¬
tution & very subject to a Disease you have so excellently marked out
& distinguished viz Dyspepsia however my disorder increased &
I at last perceived I had got the jaundice this was the first week of Jany
it seemd but slight & went off on taking a puke & laxatives I went about
8 or 10 days but never recovered any appetite when I was again siezed
with severe sickness & to relieve myself took two or three vomits wch. I
believe weakd & damaged my stomach too much- for many days
coud take no nourishment & was weakened to a great degree I re¬
covered gradualy & in 12 or 14 days after getting my belly opend
with aloetic pills & soap the jaundice disapeard almost entirely. I
got my appetite & turnd strong & went about for 10 days when I
perceived the Jaundice again attack me to a great degree so
there seems a total obstruction of bile skin & urine very
deep tinged & faeces clayish colourd & this still continues. I
can all along ↑in↑ this attack, take some victuals tho very
sick ↑at times↑ but not like nausea- I keep open with Aloet. pill
I tryed soap ʒij a day did no good but sickend me- some
little thirst- & as the weather is so severe confind myself en¬
tirely to the House- I never had least pain about the liver
nor any where- would be quite costive if I did not take the pills- in short
this third attack is not like to leave me but I have troubled you ↑too↑ long
with this account-

Dr William Cullen
Physician
Edinburgh

Mr. John Shanks
Febry. 1784