[Page 1]

This troubles you with the case of a
young Gentleman who lost his health, in
Jamaica. In that country he had undergone all¬
most all the disease incident, to such a climate
& about six months before his departure thence
he began to feel a weakness in his knees in so
much that he sometimes received falls, he then
got the aid of crutches which with the increasing
weakness of legs & ancles proved useless & was
forced to betake himself to a chair & be moved by
assistance of which time a Contraction of the
Sinues of the hams came on, -- during all the above
time was suffering, the complaints arising from
excessive relaxation, & from Bilious complaints

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cannot say the complaints in his legs was in con¬
sequence of any of the particular Disorders he
had in the Island -- He arrived at Liverpool
in August 1776 & came here soon after where
I saw him, he was pale much emaciated, his
legs, or rather knees contracted so that his legs
could not be extended farther then Eight angles from
them but could draw them towards him at pleasure
his ancles were freely moveable but he was him¬
self utterly unable to move them -- his apetite was very puny tho no particular complaint
in his stomach or bowels, belly regular in general
Tho' sometimes ↑irregularly↑ affected with a chilliness
attended with a cough spitting of tough phlegm
and succeeded by a transient, warm fit when the

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cough generally ceased -- he was ordered the foll¬
owing, his legs ↑hams & ancles↑ were to be rubbed with flannell
half an hour two or three times a day, in the
evening his legs to be put into the tepid bath,
for a few minutes, a volatile stimulating, lini¬
ment was applied to the Os. Sacrum & his belly,
when requisite to be opened with a small dose
of Rhubarb -- & his diet to be light & nourishing,
& two or three Glasses of wine allowed thro the day,

Of the above directions the bath & liniment, were
not complied with, -- the others were continued
for a good many weeks with very little benefit,
A Physician then gave a set of prescriptions
which were punctually complied with, & which
are enclosed ¹ but after being continued a due time
were discontinued - he being very adverse to the

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draught & complained much of the purging it
occasioned --- He was then sent to stay at my own
house where I found his feverish paroxysm come
generally on towards evening attended by the
cough & spitting considerable quantities of viscid
phlegm both which lasted untill towards
morning, slept ill, when he cooled without
sweating, but sometimes a gentle moisture &
has a little Sleep after which in the morning
his pulse natural which continued so thro the
forenoon & pretty free from cough untill to¬
wards evening a chillyfit & cough returned, which
last the cough wa generally appeased by a natural
vomiting of ↑thick↑ Phlegm & some very acid fluid -- &
return of fever & so on, pulse when feverish,

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about 95. no headach, belly regular in general
tho' more inclined to costiveness then heretofore

He keeps his bed generally untill the afternoon
when he rises & sets up untill sickness and
coughing makes him return to it, & pretty often
gets a little sleep in the forenoons -- no pains
in his breast or sides or Abdomen -- He was
then put on a course of the Columbo ↑in large doses↑ which
was continued for upwards of six weeks but,
without any material change or alleviation of
symptoms. About ten days ago his Medecines
were changed to the Bark with Sal. Amon.
Crud. a formula of Squills & Saponis & an
emetic, this last was given in the formula of
[Specachuan?] wine but without proper effect,
yesterday, upon the approach of his Evening

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sickness fifteen grains of Ipechuna Pouder
was given but with the effect of only producing
a slight Nausea & no great degree of vomiting
then he usually has -- the Phlegm he expecto¬
rates has lately appeared greenish, - in other
respects his last ordered Medicines have pro¬
duced no alteration in the Symptoms, related
page 4th tho' the Family seen to think his
feverishness not so violent as before -- it must
be observed the contraction of the knees have
relaxed by this time so far as he can extend
his feet at least half a yard more then he
could at first & has recovered in a very small
degree the exercise of voluntary motion over
his ancle --- It was omitted to have

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mentioned within these last three weeks, the
phlegm in his throat has almost caused a noise
in breathing answerable to an Idea from the
word Gurring -- The Gentleman whose
case is related is about 21 years of age was
of a ruddy complexion & full habit of body

Since his Arival in Scotland he has regular¬
ly taken ↑in the morning↑ about half an English pint of milk
as New from the cow as possible mixed with
about three or four teaspoonfulls of honey and a
Two Tea spoonfulls of Rum,

✍

Dr Ravenscrofts
friend.
January 1777 -------
V. VI. p.85.