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I received yours this morning
& shall follow your directions concerning
Miss Marr – I am now to ask your Advice
about a poor man who is a neighbour of
mine – Gabriel Dun aged 70 – There is a
considerable yellow tinge over all his Body
particularly in the Tunica Albuginea of the Eyes

His Abdomen is much swelled & Tense
with some little degree of fluctuation, but there
is no particular hardness in the Region of
the Liver nor has he much pain on pressing
it – Pulse about ↑80↑ & rather feeble, little appetite,
thirst at times, Belly free, Urine about a
pound & a half in twenty four hours very high
coloured with a yellowish tinge & much
lateritious sediment, no bitter taste of his
mouth, but he spits a good deal of a white
tough matter; lies easiest on his left Side
never starts from his sleep – Towards night
there is some little swelling of his Feet

The yellowness appeard two or three
months ago, but there was no perceptible

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swelling of the Abdomen till within these
three or four Weeks – He had laboured under
Jaundice to a great degree for almost a year
near thirty years ago, therefore at first tho'
I had my fears I was fain to hope that
perhaps Gall Stones might be the cause
of the Disease – , in this view & as he had
no pain in the Region of the Liver I gave
repeated Vomits & as I thought with some
little benefit but upwards of two Months
ago when I found the Disease obstinate
perceived a fulness & tension in the Region of
the Liver I prescribed Plummers Pill in
small Doses & ordered some ☿ Ointment
to be rubbed on the Region of the Liver
but he exceeded my order & rubbed in rather
too much, but as soon as his mouth became
affected I ordered him to stop the use of the
Ointment & Pills his mouth continued
sore for three Weeks – When I perceived the
swelling of the Abdomen I ordered an
Electuary with Cream of Tartar Syrup of Squils
& Oil of Juniper, & as he complained much
of weakness I {illeg} gave him a cordial
mixture with Bark – The Electuary gave

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him loose Stools but did not promote a
flow of Urine & I could not easily have
persuaded ↑him↑ to have taken the Cream of Tartar
dissolved in Water – About a Week ago I
Omitted the Electuary & ordered the following
Solution, Sp. Nit. Dul. an ounce and a half Spring Water an ounce
Sal. Tart. half an ounce; of this he takes two tea
spoonfuls three times a Day, sometimes
in Gin Todie & sometimes in Chamomile
Tea – I was thinking today of trying
Squils; hitherto I have been prevented
from their use in quantity lest they
should make him sick, & indeed but for
this I would have tried Cicuta; he is
low spirited & I knew he would have
thought if that effect was produced
that the medicine would was doing him
hurt as I also Ik knew he would have supposed
had I tried any of the Drastic Purges

I have my fears that there are
Hydatidis, Only if the Liver be diseased
it is of little consequence, except preventing
the relief which tapping if judged expedient
might give – If possible be so good as write
tomorrow – You have inclosed but a trifle
but the poor mans Circumstances are but
indifferent & his Wife with a Hemiplegia
a burden upon him ––

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Mr. Potts & Miss Marr offer Compliments & return you
hearty thanks –

lb />Doctor William Cullen
Physician
Edinburgh

✍

Dr. Keith
Concerning Gabl. Dun
Feburary 1787
V. XIX. P. 52.