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In consequence of your well merited medical reputation
I beg leave to lay before you the state of a friends health for whom
I've the highest Esteem and to desire your advice upon it on the usual
termes. The Gentleman is a Mr. Heynitz Director of the Mines of
his Prussian Majesty. The first part of the Case is of his own stating
the last a Narrative of what has happened to him under my Care in
wch. I have told you only facts without opinion wch. I hope will have
your approval and be satisfactory as well as lay the foundation of
a future Correspondence between us when opportunity Offers. I am
sorry the Narrative is so very long but the continual calls of my Profession
would not permit me to make it shorter on wch. acct. I hope you will
excuse it together with its Errors and that you will permit me
without me without further Ceremony to subscribe myself

To
Doctr. Wm. Cullen
Professor of Physic in the University of
Edinburgh.

To the narrative, made by Mr. Heynitz himself of his own health, till he
put himself under my care, wch. was in novr. 1781, I am desired to add my acct.
of it since; wch. according to the best of my remembrance and the minutes I have
kept, is as follows. At the time he first called me, he had been more or less
suffering with his old complaints for near a twelve month before, during wch.
he had been treated by another Physician, without being at all benefited. He
symptoms wch. then affected him were a frequent vertiginous disorder in his
head, sudden and violent contractions in one limb or other, a weakness
of his stomach, flatulence and uneasyness in his belly and a costive habit,
without having any variation in his pulse or urine from a healthy state
all which he looked on to be nervous, and ascribed them chiefly to his having
been formerly too frequently bled, which had prejudiced him much against
submitting to it again. I therefore first order'd him a blister to his Back,
an Emetic and a gentle stomachic purge; and afterwards Pilulæ Cærulei
every morning, with an aloetic pill occasionally at night, which was followed
with dram doses of the Peruvian Bark in powder, three times a day, first
alone, and afterwards with the flowers of cardamine, all which he continued
with a spirituous aromatic Epithem to his head for some weeks, without
its being varried at all, except in the change of the Aloetic pill for small
doses of Castor Oil, by means whereof before the end of the year he found
himself much better.

In the middle of Feb: -82, he took a fresh cold, was feverish, giddy, had
a stiffness in his neck, and wandering Rheumatic pains; from which, he was
relieved by small doses of the emetic Tartar, camphorated Julep, nitre and
anodynes.

In March his stomach was affected with pains, his startings were trou¬
blesome, at times and he was much troubled with flatulence, which was relieved
by frequent doses of 20 drops of Oil of aniseeds, on sugar.

In april his wandering rheumatic pains being very troublesome, he took the
Elixir of Guaiacum in the same manner forty drops twice a day for ten
days; and then, followed it with the Bark for a like time, with good Effect.
About the end of May, the involuntary contractions and giddyness being
more frequent, his stomach weak, and his flying pains very troublesome,
tho he had a dislike to all aperitives, except aloetic pills, he was prevailed
upon to take a dose of Gum Pill quickn'd with a few grains of calomel, and
as his usual Eruption on the skin did not appear, to submit to an Issue in
his arm, and drank the spa waters for 6 weeks; on desisting from which he
took twice a day Pills composed of steel filings, cream of Tartar and Bitter
Extract, and used a shower Bath of cold water, by means whereof, he was
so well recoverd, as to make a Journey of several weeks, and to need no other
medical assistance for six months, tho' he sometimes felt such sensations,
as convinced him that the cause of his involuntary spasms was not quite
eradicated.

The latter End of Febr:- 82 he had a pain in his Loins on the left side
which was looked upon to be Rheumatic, the effect of cold; and was often
electrify'd for it, through flannel; but a great heat, and difficulty in making
water with sickness at his stomach, coming on; it was suspected to arise

from Gravil, and on the 3d. of March, the Electricity the Electricity was laid aside
and Pills of Camphire, soap, Rhubarb, and nitre prescribed in its stead, and con¬
tinued till the 22d. of april, when the pain and disury being very urgent, he was
reluctantly prevail'd on, to let 12 Ounces of blood be taken from his arm, and to
use emollient Glysters, with a warm bath; as well as to take an Emulsion of Gum
arabic, nitre & castor oil every three hours, to the night dose of which, was occa¬
sionally added 20 drops of Laudanum; in all which, he regularly persisted till the
24, at which time, the painfull symptoms growing more and more urgent, he consen¬
ted to a second bleeding, took a camphorated emollient anodyne Glyster and for
common drink, drank a diuretic Tisan, made with the roots of Marshmallows
Liquorish and the leaves of Bears Grape. In the night of the 25th. I was
called to him in great haste, when I found him labouring under a vast anxiety
agitation and dispondency, for which looking upon it to be entirely nervous, and
the effect of the anodyne tho' the Patient himself charged it on the bleeding; I
recommanded a Cordial only, prepared with the yolks of two Eggs, well beat up
in half a Pint of Hungary wine, and gave him 2 Table spoonfulls of it, every half
hour, which not only quieted the irritation, but also procured him good sleep, and
enabled to pass the next day tolerably well. Yet on the 27th. the pain in the
back and in making water became again pressing; when he had prescribed him
half an ounce of Ounce of Oil of sweet almonds dissolved in the yolk of an Egg, syrup
of Marsh Mallows & Lemon Juice of each three drams, white wine one Ounce
of nitre ten grains, and Laudanum 20 drops - which procured him a good night,
and enabled him to make water freely; One the surface of which, he shew'd me the
next day, the Oil swimming, which was given in the draft the night before
and that not perfectly recover'd from the white opaque colour, it had acquired
from its mixture with the Egg, in which manner it was asserted to me by the
Patient himself, and all his attendants to have passd the Kidneys, without having
had any Effect on the intestines, which remained costive, and made a dose of Rochel
Salt necessary, the night after the operation of which, and for two nights after,
he repeated the same draft, but without the Oil passing the Kidneys & separa¬
ting again on the surface of the urine, as 'twas asserted to have done, the first
time; and without having brought with it gravil, or other matter, to which the
before described symptoms might be reasonably ascribed. Further to sheath
the salts of the urine, and prevent their irritation on the passage, he not only
used jalep morning & night; but had every thing he drank soften'd with it - used
emollient & anodyne Glysters frequently, took small doses of a camphorated oily
Emulsion, drank of Seltzers or Bristol waters as they could be got for common
drink, went into a warm Bath, but on the second of May was bled again . In
consequence whereof, in the night after bleeding, a great quantity of truely purulent
matter came away, mixed with urine; together with a great deal of Mucus, like
the Mucus of the Bladder, part of which so coalesced together, that by passing a
stick under it, it might have been lifted out of the Chamber Pot, like a piece of
wet leather, while the greatest part of the pus that was with it, separated from
it, and sunk to the bottom. For this affect in his urine, he not only persisted
in the use of the above cooling diuretic beverage, and gentle aperients, but took
also, small doses of Balsam of Capivy at night, and the Uva Ursi in powder,
with its infusion in the day time; and that for 14 days successively; when
finding him grow weak from the greatness of the discharge, and disgusted

at the taste of the Capivy; a Decoction of the Peruvian Bark was given after
the powder of Uva Ursi, instead of its infusion, and the Castor Oil instead
of the Capivy. which some days after for conveniency sake, was again chan¬
ged for Pills, made with three drams of the Extract of Uva Ursi, two drams
of the Extract of Bark, & one of Myrrh, of which 12 Pills were formed of
a dram; and taken 5 three times a day, and a glass of spa water after
every dose of them, by means whereof, by the middle of July, he was perfectly
freed from this unnatural discharge in his urine. About a fortnight after
which, he had a slight attack of an Epidemic Diarrhœa, which was soon
cured by small doses of Ipecacoana, Rhubarb, and Anodynes, and he found
himself so perfectly recover'd in the month of August, that he then undertook
a Journey of many weeks, on which he had a small return of his disury, and
of the discharge in his urine; which by the help of the last prescribed Pills
did not last above four or five days, and has not returned again from that
instant. During the time of the affect of the kidneys, it has been remarked
that the affect of his head, and the involuntary catchings very rarely affected
him, tho' since that has been perfectly passed, they have gradually been on
their return, and are now at times so strong, tho' of but a moment dura¬
tion, and come on so without notice, that they excite the most distressing
apprehentions, and demand your particular attention of which that you may
Judge the better, I must observe to you, that the Patient thinks them chiefly
to arise from his stomach, as they often come on after drinking a little [rhine?]
wine, or eating fat or indigestible aliments, and that they have been frequent¬
ly prevented from coming on, by the stomach being coverd by spirituous
& aromatic topics; and sometimes also after feeling uneasyness in his sto¬
mach and bowells by the application of leeches to the fundament wch. having
often had a tendency to the Piles, constantly relives his head, and sometimes
also the stiffness in his neck, the which is very apt to be troublesome to
him; and next to the startings and giddyness of his head, he begs you parti¬
cularly to make the object of your consideration. In the course of his
Illness, having often been alarmed with his involuntary spasmodic startings,
when he has been otherwise very well; for which as often remedys have been
prescribed, I shall close this tedious account of the disorder by adding, that
besides the remedies mention'd in the preceeding narrative, he has at times ta¬
ken the underwriten, but I must say, none of them so regularly, or for so
long a time, as might have been necessary, to produce those happy Effects,
wch from their known nature we might with reason have hoped for so
then; nor has he since he left France, even so restrained himself from atten¬
tion to busyness, as is certainly necessary in Complaints of such a nature.
The remedies he has used not mention'd in the above narrative, are Extract of
Asa fœtida alone to the dose of 15 grains at bed time, the same united with a
grain of Aloes, and afterwards, with a grain of Camphire and Opium, Extract
and powders of wild Valeryan root in full doses. Extract of the flowers of Ar¬
nica to the dose of two scruples a day, - And a simple Infusion also of its
flower by way of tea - Pills with flowers of Zinck from 15 grains to a scruple
for a dose - And in the time of the fit, sometimes 20 or 30 drops on sugar

one dram of very pure well refined Animal Oil, dissolved in an Ounce of Vitrio¬
lic æther - or a few spoonfulls of water, in which have been mixed sixty drops
of a Tincture, made with half an Ounce of Musk, and an Ounce of Russia Castor
infused in sweet spirit of nitre, spirit of Lavender and Spirit of Sal Volatile of
each an Ounce - And with an Eye to his Rhumatic & Eruptive complaint, it has
been recommended to him to take a pill of Calomel & Camphire of each a grain
every night at bed time, which he did only for a few nights, not long enough to see
its effects - Lastly he has lately used the Baths at Freijenwalde, which are
artificially heated, and prepared with a water from a natural cold spring, arising
near the Alum works in that neighbourhood; the Waters of which, are evidently
Aluminous & Chalybeat, since which, I think his spasmodic Complaints have
been more frequent, and stronger than before, tho' tis impossible to say, if it be
the Effect of the Water; but I fear it is, as they first became so, during the use
of the Bath.

Dr. Baylies
C. Mr. Heynitz
Septr. 1784
& Advice