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Since the 13th of December
Mr. Nielson has kept close to a Milk &
farinaceous diet and I think with consi¬
derable advantage - as he had not been ac¬
customed to it and his stomach was subject
to Windiness he was afraid he would not
agree with it; but he has been disappointed
and finds it attended with no inconvenience -

His Pains are still ↑too↑ troublesome and
he continues to be unable to ly upon his
left side - he is likewise frequently distressed
with a Throbbing in his breast - and once
almost every night, in the interval of
his sleep, is under a necessity of sitting
up and getting well rubbed - nevertheless
all his Complaints are considerably lessened
- his Pains are not so severe nor constant
and he gets more comfortable rest and

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much more sleep than formerly and common¬
ly he awakes refreshed from it --- the
Chief Seat of his Pains is exactly opposite the
kidney upon the right side and ↑the↑ Rheuma¬
tic inflammation affecting the kidney
accounts as I imagine, for a symptom
he desires me to take particular notice of
to you viz: that when the pains are most
uneasy he makes most urine –– from
this they extend themselves upwards and
foreward upon the breast, but without having
ocassioned any Cough or uneasiness in breathing
and sometimes downwards upon the
lower part of the belly following the Cour[se]
of the Spermatic Vessels and affecting
both Chords with uneasiness -- but this
last symptom has always been soon relieved
by warm dry Clothes Cloths -- these pains
often shift from ↑the↑ one place to the other
and from sometimes going off they end in sickness
- but when in all the attacks of Pain
or sickness his pulse never fails to
become strong, irregular and throbbing

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accompanied too with the throbbing at his
heart which is very distressing to him -
whereas when free from Pain or sickness,
which he now frequently is, his pulse is
always soft, regular and Weak - but it
is very seldom quick for I have only obse¬
ved it four times above 80 or 84 in
the minute since he followed the present
Regimen –– two of these times he was
blooded once to 12 ounces and the last time
which was a considerable time after to 8 ounces
and both bloodings had an immediate effect
in Calming the pulse and relieving the Pains
{illeg} the other two times of the quick pulse, the
[bl]ooding was omitted and he continued ve[ry]
uneasy for almost 6 hours when the pains attacked his belly and ended in a gentle loose¬
ness which likewise calmed his pulse and
relieved him - and this leads to a question
which is one cause of troubling you at present -
whether we should be officious in Catching
an opportunity of taking a little blood from
time to time - or if laxatives would weaken
less and answer the same purpose? - his blood
had a strong crust and upon monday his nose
bled a little and since upon this diet instead of losing
he has plainly gathered strength.

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To
Dr. William Cullen
Professor of Medicine
Edinburgh

✍
Taylor query Mr Nielson
January 1780
X. p. 148.