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I was duly favoured with yours concerning
Miss Aitken, who remains in the same situation
as when I last writ you. Tho' you advised us
to no new measures, yet your opinion has been
quite satisfactory to the family in shewing what
the measures were from which only relief was
to be expected.- Do you think a Seton in the side
would now be adviseable? - Tho' I had forgot it,
yet it seems I had several years ago urged it
very strongly, but without being able to make
the patient submit to it. -- She observed since we
received your letter that she had been afraid you
were to advise it. -- On several instances lately,
of delicate young women too, - I have taken a
good deal of pains, and have ng succeded, in
getting them to submit to Setons -- in preference
to perpetual Blisters, which in general are so
painful and troublesome. ---

But tho' the observations you favour me with
in Miss Aitkens case might lead to it, I will not
trouble you with any more about her at present
having now to mention one or two circumstances

The said is the - advice you gave to Mr McDowal
in 1779, I heartily wish you may be able to say
or advise any thing for his relief. -- All this win¬
ter I have been urging some long excursion and
change of Climate. I should be happy if he
could be preserved by any means for he is
a worthy young man & much respected here.

--- I have been obliged at this time to write you
less deliberately than I wished. -- but you have enough
or more than enough -- I am always with much truth

Being interrupted a little when writing on the opposite side I add
here that on the first coming on of frost, which happened here in
the first week, I think, of November, and was pretty smart for a
night or two, Miss Aitken was so severely, and so suddenly affected
↑with↑ the pains of her left side, cough, Asthma &c -- that we thought she
must have died if the frost had continued. -- She has however
stood the severity of the season, since, much better than we
expected, though almost always very ill. -- Indeed, for a great
while past, she has been considered as one past all hope of recovery.
and an expression which she uses herself sometimes is that she
takes a great deal of dying -- Tho' she has not even yet a hectic
or consumptive countenance, yet and for a considerable time
has been as thin and wasted as she could well be, yet she has
been of late a great deal weaker than ever she was before. --
Her pulse is sometimes very quick; though often moderate
for one in her situation. Yesterday at noon it was 104.
at seven in the evening 108 or 110. Her menses for a
long time have been very irregular, sometimes not appearing
for a year or more, though at the two or three last periods
they have come regularly. -- I have only to mention farther
that she has frequently for these two or three years past been
liable to pretty smart attacks of a Diarrhœa, and sometimes
swelling of the legs; but these symptoms have sometimes appeared
to be rather accidental, than so strictly to be termed colliquative
as they are in ordinary cases of Consumption; But upon the whole
I fear we must say that if nature or art effect a Cure in
this instance, it is more than we have ↑any↑ reason to expect either
of them should be able to perform. -- But the last Case concern¬
ing which I corresponded with you, - the young Gentleman at Drumlanrig
was by most people accounted a hopeless one. He continues in perfect health.

To
Doctor Cullen
Physician
Edinburgh