[Page 1]
To Mr Thos Duncanson of Forres concerning Mr Cumming of Altyre.

I am favoured with yours of the 10th and answer it in course.
I am very much concerned for Altyre of whose character I have heard

---

[Page 2]

heard every thing good and regard him as your friend. You have
done right in giving me the history of hs whole life, but for his pre¬
sent illness, or what may influence it I took no further back than
May 1767 and hardly farther than the end of October last. Since this last
period I dont suppose his breast has been tolerably free, but I do not
think the infection has been as it was 1767 peripneumonic, but
I am disposed to believe it entirely catarrhal. To relieve it I think
you have been employing very different (↑proper↑) remedies but it seems that
something more is necessary. I consider the Vomits as the best
Expectorants that we employ, but it is very likely that he cannot
now bear them so often as might be necessary, and find that full vo¬
miting is not always necessary, but that it does better to give Ipeca¬
cuana or Tartar Emetic in small doses, repeating them every half
hour till some nausea or reaching is excited, but the last unless
very severe is not to be encouraged by drinkinging. This Operation
will commonly loosen the Mucus of the breast and help it up
more easily. I expect that it will also lessen the Night Fever, and o¬
therwise be of service ↑by↑ going downwards and opening the belly. This
remedy may be employed for two or three nights successively, and after¬
wards every second or 3d night as you find occasion. The best time for Ex¬
hibition is at six or seven in the evening & the dose I commonly em¬
ploy is a grain or quarter of a grain of Tartar Emetic dissolved but I leave
you to adjust it to what Mr Cummings stomach can bear. The operation
of this medicine will commonly before bed time and then if you have
no objection to it, from any peculiarity in Altyres constitution he
will probably be the better for an Anodyne. On the day or days that
you are to give the Emetic I would entirely lay aside the use of the
squills. It is possible that these support the nausea he so frequently
complains of. Besides the remedy I have proposed I know nothing so likely to
be of service as blistering on his back or on his sides or successively tho never the
others for as the Pea Issue in his arm continues open I would not think of
keeping any of the blister places open.

---

[Page 3]

You observe that the Pea Issue does not of late discharge so plenti¬
fully as before, and this I think is a disadvantage. You will please
to consider whether they it might not be proper to open a Pea Issue in the
other arm and when it is brought to discharge freely the other might
be allowed to dry up which it seems is disposed to do. I have little to
say about your patients diet - under his present want of appetite he
must have what he can take but certainly with so much fever ani¬
mal food is not the most proper. I would wish to give [acesent?] ¹ food
and all sort of vegetable acids. I have now said what I can ↑&↑ I am extremely
anxious to be useful to your friend and a worthy man. When you think
I can be further useful I shall hear from you and you may depend on
everything in the power of &cc.