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To
Dr George Skene Physician Marishall College
Aberdeen

I have a Letter to day from Skene transmitt¬
ing a your account of his son's case & as he very properly
directs I send my opinion directly to you.

Attending to the external Cause & the absence
of all marks of scrophula I presume this ailment is pure¬
ly topical & I would treat it as such but the feeling's he
had before the accident & the difficulty there often is
in ascertaining the scrophulous Diathesis will
give some reserve in the prognostic. In the mean
time the nature of the topical affection is to be studied
carefully. As the pain is greatly abated & you speak
of no inflammatory symptoms I hope there is no sup¬
poration formed or going on but while there is swelling
& pain from motion or the hanging of the leg & one part is
more painfull than the others on being touched there lies
a suspicion of suppuration & it is to attended to - that
it may be opened as soon as it can be tolerably ascer¬

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tained. I think your measure of an issue a very proper
one as it is one of the best means of taking of the Effects
of Contusion and strain but with a view to scrophula or
white Swelling I have not found it of any service. I have
more doubt with regard to the Mercureal Ointment. I
have no experience of its use in old strains. In scrophulous
swellings it does no service, where the Muscles are losing
their tone it may do harm & its going to the mouth might
be inconvenient, I am clear therefore that it should be used
as you propose very cautiously. The Sassafras Tea
is very proper & if I mistake not will do as much as
the Sarsaparilla but I have no objection to the last. The only
Addition I can offer to your practice is the use of a
Formentation as ordered below. I would employ it
twice a day but if it shews any tendency to fret the skin
I would confine the use of it to once a day & when the skin
is become dry after the formenting it may be anointed with
a little of the [Unguentum Emolliens levater complioratum?]. I would
apply no kind of Poultice to the Part unless there were very
evident marks of suppuration going on. As the Boys
Health is entire I suppose you have made little change
in his Diet. At any rate you will keep it light but if
there is no suspicion of scrophula & other circumstances
rather point to a topical ailment & suspicion of Suppur¬
ation I should think a mild Diet the most proper
for him. Skene desires we may keep a Correspondence
on this subject & I shall expect to hear from you soon.
You see now where my doubts & difficulties lie
& will therefore be able to solve & [obviate?] them. My compliments
to your associates & believe me always

For Mr Skene