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Case of Mr Lumsden
June 1776 Vol. Vth ~ p95

✍ Case of Mr Lumsden

About 3 years ago he had a bad and tedious fever
during which his Pulse was somewhat irregular and very
feeble, tho the fever from its other symptoms, could
not be strictly called either nervous or Putrid. {illeg}
He recovered by means of large evacuations by stool
procured by James's Powder. The great debility of
his pulse seemed the only extraordinary circumstance
attending this fever, but I have since found that the
strength of it during his ordinary health bears no
proportion to his apparent strength in other respects
& when under any disorder both it & his spirits sink
to a considerable degree.

His way of life is regular, he rises early and
tho his business confines him a good deal to the house
yet he takes a good deal of exercise chiefly in the
morning. He was many years subject to frequent &
copious bleedings at his nose, which for some time past
had left him, but in spring last he contracted a trou¬
blesom cough which continued long and in the Course
of it he spit up sometimes a little blood, but as it had
not much the appearance of proceeding from his Lungs &
was in very small quantity, Dr Livingston & I both concluded
it came from the fauces & regarded it little. For his

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Cough he got Sperm.Ceti. Juleps with [Syr. e Mezon?] but
the symptoms which distressed him most was a difficulty
of breathing so considerable, that in the morning & fore¬
noon he could not walk the least distance without
panting and being attended obliged to stop some times
attended with a great degree of motion low down in the
Thorax like a palpitation. Along with this he had at first
a pain about the left hypochondrium, we blistered the
part and took some blood from him and after the
Cough left him suspecting that perhaps the disorder
might proceed from a nervous cause, I ordered him some
fœtid pills & Decoct. C. Per. & a good deal of exercise on horseback.
We were led into this opinion by the lax state of his habit & the
degree of dejection which he is subject to during any illness ↑&↑ from its
attacking him only in the forenoon when the stomach is emp¬
ty; for after dinner, especially if he drink a glass or
2 of wine, he is pretty well & can walk without much incon¬
venience, neither is he seized with it in bed nor affected by
[differ. of post.?] in lying. We advise him sometimes to try a pret¬
ty full breakfast or to take something in the forenoon in order to ob¬
serve whether the state of his stomach made any odds but he found
little or no benefit from this. Some days he is better & some
days worse without any known cause. Is losing flesh & his co¬
lor a great deal altered. Have proposed to him to lay aside bu¬
siness some weeks ago & go to country for exercise & amusement & as
he has a present an opportunity of being in Edinburgh your opinion &c
whether Nervous or owing to any more fixed cause.