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The subject of the following case, which
is submitted to your consideration, is Mr. Waldie
of Hinderside, near Kelso, who lately came to
this Town upon a Visit. He is father in Law
to Miss Ormston of Newcastle, now Mrs. Waldie,
who was your patient some years ago.

Our patient is aged about 58, was always
of a florid complexion, & was brought up to
sedentary profession. About the 28th year of his
age he was siezed with a regular fit of the
gout, tho' ↑he↑ was never of ↑a↑ robust large make
nor, as far as I can learn, descended of gouty
parents. At first the fits were very severe,
& usually cane on once a year, about the
spring; but as he advanced in life, the parox¬
sysms often attacked him once or twice or thrice
in a year, were less violent, & confined to no
particular season. In the year 1766, the
arthritic paroxsysm totally disappeared, &
he was seized with the Hypochondriasis, to

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violent degree; (while I was at Kelso) which how¬
ever was soon removed by a return of the gout
to the extremities. About four years ago the
paroxysms again disappeared; since which time
he was frequently & suddenly seized with cholic
pains, which were always soon removed by
some natural loose stools. In other respects
his health was tollerable, 'till within these
two years. his appetite became impaired; he
laboured under flatulence, was frequently costive;
& began gradually to lose his Flesh. About
15 Months ago, having had some trifling operati¬
on performed, he lost a considerable quantity
of blood; & became unusually feeble; but by exer¬
cise, & goats Whey he soon recruited his former
state of health. In summer 1779 & during last
winter, he was frequently attacked with a
painful swelling in his face which he im¬
puted to toothache. In the beginning of this
summer he was siezed with a pain in his left
shoulder and arm, which disappeared after
rubbing with an Embracation, but was suc¬
ceeded by a dry tickling cough. He went again
to the Goat Whey; the cough however gradually

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encreased, with a pretty plentiful expectoration,
his thirst became excessive; his tongue foul &
he had several symptoms denoting great de¬
bility of Stomach & bowels. For these complaints
he took several pukes, Bitters & Bark &c by
the advice of his family Physician.

About 14 days ago I was consulted. The
cough at that time was as violent as to pre¬
vent his sleep; his pulse was frequent & at the
three different times, that I visited him, was
never under 100, & once at 120, but always
soft. His skin was also hot. His tongue was
fould in the morning; he had great thirst,
& complained of flatulence & indigestion; but
no pain in his stomach. Pills with assafoetid.
Gum. Guaj & Gumm. Ammon. were prescribed
together with Elix. [Purg.?] at bedtime to appease
the Cough. He was allowed animal food to
Dinner, & ordered to Drink a Glass or two
of wine after it. In a few days he set out
to Tyne mouth for the benefit of the ↑Sea↑ Air; &
I did not see him again till yesterday; being
costive he had taken two Doses of salts - He
neglected to take his Pills, having a great aversi¬

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on to them, & being perswaded that he was going
into a consumption he gave over his wine, &
drank a very great quantity of small Beer. He
is now exceedingly weakened; his Ankles have
within a few days become adoematous; his cough
is still troublesome, he has flying pains a¬
bout the chest, which only appear to be confined
to the muscles; his expectoration is mucous &
tough, & sometimes yellow & opake; his pulse
very frequent, & feeble; his skin little above the
natural heat; no nocturnal sweats, nor febrile
exacerbation. His tongue is covered with a
white furr; he has vomited frequently. & com¬
plains of sickness, acidity & flatulence ↑& Constipation↑, but
has no pains at stomach. His urine is
pale, & in larger quantity, his thirst great; his
mind anxious, & his spirits greatly dejected.

For several years past {illeg} he has
lived very abstemiously; & to this alone I impute
the cause of the Gout not appearing regularly,
& to this source also I impute his present
disease. The medicines which he is takeng at
present is Magnes. & Rhubarb in Cinnamon
Water; and as soon as his stomach is settled

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and the Constipation removed, I mean to try
him with the Bark & bitters; using at the same
a nourishing diet, & allowing him some Glasses
of Madeira after every male. However as
soon as your answer is received I shall with
pleasure enforce your directions; & will be
much obliged to you for your opinion
of his disease; the remedies you
would enjoin, & whether in his case
you would advise the use of either Bath
or Buxton - The cough & the quickness of
Pulse I am affraid would make the
former improper. You will excuse
my not transcribing this Letter;
the fly is almost ready to set out,
& his relations are anxious to have
your answer by the return of the
machine against {illeg} (↑Friday↑) ---- The
Fee will be transmitted to you; of the
Gentleman regain sufficient strength he
proposes to wait personally upon you

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Dr. Cullen Professor
of medicine
Edinburgh

✍

Mr. Waldie
September 1780
xi. p. 64. ---------