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I now write to you of a patient concerning whom I have more
than once, in the course of a year past, intended, of myself, to write to you,
knowing you are as ready in such a case, to give your thoughts
and advice, as when applied to more expressly by the Patient him¬
self. But indeed the patient himself, in the present instance, is
no less desirous of your assistance than I am.

The Case is that of Mr. Burnside, one of the Ministers of this
town, who had applied to you, as he tells me, on account of some
very considerable stomach complaints, eight or nine years ago.
He is now about Thirty-five years of age, seemingly of a good
enough habit, indeed rather growing full or fat, as his friends
imagined, some months ago; tho not at all corpulent, {illeg}
taking place he considered himself rather {illeg} swelling
[than a truthfull increase?]. At no time have I seen him thin or
slender – you would call him a tight enough, well made, little or
or middle-sized, man; – and in his manner and temper, he has a
considerable degree of spirit and vivacity ↑when in health↑; –– so much for the
general temperament of our patient.

About ten years ago Mr Burnside thinks that, from sleeping in a
place where there was but a thin wall between his head and the
open air, during a very severe frost (which one night in particular
he felt, he says, sensibly in his head) – he became Liable to a
very oppressive headach, which distressed him then for a good
many months; has been recurring at times ever since; and, with
one or two other circumstances joined to it, makes the prin¬
cipal part of his present disorder. –– He has, at times, been
liable likewise, to pains, seemingly rheumatic, in his back, and
in other parts of his body

About a year ago a particular circumstance began to
attend the attacks of headach, and to occur likewise when the
headach was not present, namely a profuse perspiration, in his
head, and especially in the forehead and temples, – with a great and
very distressing sense of heat in the parts. – This did not trouble

Notwithstanding the above mentioned circumstances, Mr B. during the
greatest part of the last year has been going about as usual in the
duties of his office, and in visiting his friends. – In the end of Autumn,
however, he had one greater attack of the Head↑ach↑ and profuse sweating
in the head, which confined him several weeks entirely. In the course of it,
whether from causes in his constitution, – or in the season – perhaps from
both, he was affected for several days pretty smartly, with dysen¬
teric symptoms, which however soon left him. –– At no time has
there been any considerable quickness, --fulness nor hardness of pulse,
that is, no marks of an Inflammatory state.

On Sunday the 7th inst he had to dispense the Sacrament in
his Church. I mention this circumstance because it probably made
matters worse than they might otherwise have been His Complaints
had prevented him from officiating on the preceeding occas↑i↑on of the kind,
& he was not a little anxious to be able to officiate at this time.
He exerted himself therefore to the utmost, with no little difficulty,
and the service of the day was no sooner ended than he imme¬
diately threw himself, as I may say, into bed, where he has contin¬
ued ever since, in a very distressed ↑condition↑ indeed. –– His usual, or con¬
stitutional, headach, and sweating in the head, have been worse, if possi¬
ble, than ever they were before, sometimes continuing the greatest part
of the day, – at others recurring frequently in the day or night, for
shorter periods; and attended always with extreme depression of spirits,
and great apprehensions, (tho not of immediate danger,) for himself and
his family.

But in the present attack of Mr Burnsides complaints one or
two circumstances shewing still more strongly an ailing constitution,
and perhaps a considerable degree of real weakness, have come upon
us. Nine or ten days ago, he began to complain of his throat, which in
two or three days had an alarming appearance, being plainly of the ulcerated

You will readily judge, Dear Sir, that the state of the mind is to
be particularly regarded in this Case. Mr B. has been evidently under
the greatest depression of spirits, apprehending that the state of his
health may lay him aside from the duties of his Office, which, as
he has a Wife and six children is a very serious consideration.
But the state of his health, and of his constitution are by no means good at
present; this headach and excessive sweating in the head, and sense
of great heat, are real and very dispiriting ailments. ↑Tho'↑ he is at pre¬
sent much better than he was ten days ago, these symptoms
still continue, - and as I wished last year, so I wish very much
at present, that you could suggest any thing to us that might
relieve them. –– I need not trouble you with an account of the dif¬
ferent means we have used for present relief. –– But the great
object is to lay down such a mode of life, and management,
as may, if followed out properly, correct this tendency in the

I cannot reckon this Case Complete without adding that Mr B who
came to be Minister of this town six years ago, proved so acceptable
and agreeable to all the best people in this town and neighbourhood,
both as a Preacher and a companion, as led him into a course of
Company, and of full living, often for days, or rather for weeks, or months
together, as he is now very sensible will not agree with his constitution.
No individual in this quarter (for he is now in a manner the only Min¬
ister of the town, your friend Dr Mutter being quite laid aside) – no in¬
dividual whatever has been so much in the way of being invited to
dinners & suppers as Mr B. –– and tho' we cannot call ourselves a luxurious
people, we have abundance of good eating & drinking among us.

This day, and since writing the above, I find his sweating, in the
Head (for I always mean in the head & neck only) has been very pro¬
fuse, & the heat excessive, or at least the sense of it; but his pulse
is so good that I have insisted he is much better. It is little above
90, soft & moderately full & regular –––– He bids me mention a cir¬
cumstance which he has often mentioned; tho' I never could pay any re¬
gard to it, –– that he is sure some of the Sutures of the skull, and especially
the sagittal, – open a little, especially in hot weather, & in the evenings,
as he says. –––– Mr B. desires his best respects, & bids me add that his Brother
in law Mr Hutton Mercht in Lieth will call upon to make proper acknowledgements.

To
Dr Cullen
Physician
Edinburgh