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Master Wood, late a Westminster scholar, aged 17 years, of a fair
complexion, spare, & delicate habit is affected with a complaint of the urinary
passages. His urine when first made looks like whey, & throws down a considerable
quantity sometimes 5th. or 7th. part of a seemingly purulent sediment, which has
sometimes a bloody rim upon the top, & at other times a small clot, or two of
blood at the bottom. It is voided with a slight degree of pain at the end of the
Penis, or in the Glans, upon squeezing out the last drops - There is no inflamm¬
ation at the end of the Urethra, nor any pain to the touch in any part of its
course from the Bladder to the Glans - As he voids urine the first stream
is almost colourless clean. It becomes more, & more turbid as it flows, & the last
drops are like a brownish bloody sanies, which when it falls upon his Shirt
stains it as in Gonorrhœa. There is no discharge of matter, but as it appears
in the Urine. He takes exercise walking or on horseback without pain - Rising
suddenly from a sitting posture gives the pain, which is always at the neck (↑end↑) of
the Penis. This Complaint made its appearance first about nine months ago,
when recovering from a violent Cough attended with fever, which affected him
while at Westminster. For the remains of which he was sent into the Country
early in May, a good deal reduced in his general health, with emaciation &
symptoms of hectic fever. Some degree of a dry Cough has remained ever since
which is more especially excited when walking briskly or running - His tongue
shews a brownish fur. Pulse varying from 100. to 116 - Till within this Fortnight
appetite good, sleep natural, & strength improving - Since that time as will
be particularly observed below, he has been much reduced by the exhibition of
Mercury - His bowels which are always weake have been much more so
during the course of this illness - Saline medicines & {illeg} Bark could be
made to agree with difficulty. Mik & Malt liquors purged him - Upon
first coming into this Country in may last Dr. Thurold prescribed riding on
Horseback, suitable regimen, & saline draughts for the remains of the fever
& Cough, & afterwards Emetics, Venesection, & James' powder for the same
Intention - The Blood had a buffy covering - afterwards for the affection of the Urinary
Passages he took the Bark in various ways, with Sarsa, - infused in Lime
Water - & in substance along with mucilaginous drinks - He afterwards took
small doses of Balsam: Copaibæ - Sir W. Fordyce, & Mr. J. Hunter were at this
time consulted by Letter. Sir W. considered the disease as arising from, or connected
with Syphilis. He proposed first to endeavour to abate the Hectic symptoms by
frequent bleedings, saline medicines & regimen, & afterwards to use Mercury internally
Mr. Hunter took up the Case as Scrofulous, & proposed the frequent use

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of the saline tepid bath, Sal Soda, Cicuta, & a Blister to the Loins. The means for
reducing the Hectic were adopted, & afterwards the Sal Soda & Cicuta were given, & the
tepid bath made use of. A Blister was not applied - These Gentlemen were soon
after consulted in person - Sir W. seemed now to be convinced that the Complaint was
not Venereal. Mr. Hunter was surprized that he should have thought it scrofulous -
They considered it as arising from weakness or relaxation - They supposed their
might be an ulcerating surface, but no ulcer. They prescribed frequently
repeated doses of Sal Polychrest, & Rhubarb . Cortex Peruvianus in Decoction
with the Saline Mixture - Mucilaginous Drinks - & sent Master Wood back into
the Country with directions to persevere in the use of the opening powders
to take the Cortex in Decoction, or in Substance - & to bathe in the Sea - This
Course was prosecuted for three months. The Complaint remaining unmoved
Mr. H. proposed the injection, or stroaking of Oil into the Bladder - This was
used owing to the aprehensions of the young Gentleman. Sir W. proposed small
doses of Calomel & changed it afterwards, on account of the weakness of his
Patients bowels for the external application of Mercury in small quantities -
This was used about six Weeks, & an ounce and a half of the strong ointment was consumd
The ointment has only been left off about a fortnight. During the latter
part of this Course an Infusion of Uva Ursi was given. These were the
effects of the Remedies. The Cough & Hectic were abated but not subdued by the
means recommended by Dr Thurold - The bark in its various modes of
exhibition produced no effect upon the Fever, & Cough, nor upon the affection of
the Urinary passages. The Balsam Copaiba although given in Doses only of 5
Drops increased the pain of micturition, & purged him much. The Urine was always
less loaded upon using the tepid Bath. Cicuta produced no evident good effect
nor the Sal Soda . Sal Polychrest, & Rhubarb purged, weakened the Bowels
& emaciated greatly - Sea Bathing, & the use of the Cortex were often interrupted -
from the weake state of his Bowels, but when these had been made better by
small Doses of Anodynes at night, & by small doses of Ipecacuanha with Laudanum
his general health was improved, & his strength & spirits returned -

The application of Mercurial Unction with the necessary confinement attending
it, caused loss of appetite & strength, emaciation, & an increase of purulent
appearance of the Urine. Uva Ursi seemed at first to be useful, but was
left off from an apprehension that the pain & bloody tinge were increased by it -
Upon the whole no means that have been used have produced any permanent
good effects upon his Complaint - It It has varied its appearance, & we have
sometimes flattered ourselves that we were getting ground but hitherto
in vain -

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The above account was written three weeks ago with an intention to consult
Dr. Cullen immediately, but master Woods health declined so rappidly that it was
determined to wait a little time before consulting the Dr. - that it might be
known whither these symptoms were the effect of the the mercurial course, or
of the Disease, & as he has in some measure recovered his appetite, &
strength, & spirits. It is hoped the alarming symptoms were the effect of the
Mercury - The appearance in the urine remains as before. Lately he has
taken twice a Day 15 Drops of Elixir of Vitriol, & two tea spoonfuls of the
Tincture of Bark in decoction of Sarsaparilla & China root - His
diet is of the most nutritious kind - He takes vegetable mucilage
in all his Drinks, & his strength & bowels are certainly improved
His Bowels will not bear Milk - Dr. Cullen is particularly desired
to say if he should expect any advantage from Bristol, or from change
of Air -

I have only transcribed the Case - it was drawn up by
an old pupil of yours Mr. Wilson, who has attended Master
Wood with unremitting ↑care↑ from the beginning of his Disease -
As soon as may be convenient I shall be happy in the favour of
your answer - We shall expect it with impatience - And, as
this is the first time I have had the honour of writing to you
since I left Edinburgh, give me leave to remind you of
the flattering marks of attention, & friendship that you once
shewed me - That I never deserved the attention, or friendship of
Dr. Cullen may be true, but that I never did any thing to
forfeit his good opinion I aver - I always had, & still have the
highest esteem for Dr. Cullen, & I always paid great deference

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to his superior abilities, & extensive learning.

With my warmest acknowledgements for the instruction
I received by attending your public & private Lectures, I am,

Dr. Cullen
Edinburgh

✍

Master Wood
February 1786
V. XVIII P. 41