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M.r Russell is aged Sixty, years of a slender
make, and Constitution rather delicate. For these
Thirty years he has been subject to a spasmodick
Asthma and cough for which he twice consulted
Doctor Cullen. The Doctors opinion and Advice at
that time are transmitted along with this, as they
may recall M.r Russells Case to his Remembrance
{illeg} these two years his Complaints seem to have
taken a new Turn - About the Beginning of the
year 1776 in a severe season he was seized with an
irregular interrmitting Fever that continued about
three weeks or a Month and went off almost of [easily?]
he being at that Time an improper subject for medicine
Ath Alltho his stomach was extremely impaired his
Recovery was quick and he was free of his Cough
& Asthma and enjoyed better health than he had done

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for many years before. He continued in this way
little last Christmass when the Cough ↑& Asthma↑ returned and
was exceding severe attended with a great Ex
pectoration of a very viscid matter: and (for) these Com
plaints he took a Solution of Gum: Ammon:
and they went off but were succeeded by frequent fe
verish Complains and great Sickness of the Stomach
the feverishfitts are very irregular in the Time
of coming on and Continuances but seldom miss
attacking him after eating tho in this Respect he is
advised to be extremely moderate and not to mix
different kinds of Food: when the fitt is upon him
his Stomach and Bowels feel as if greatly distend¬
ed and upon rubbing them much wind is Belched
without affording any Relief. His Sickness
at Stomach is severe at this time but most of all
so immediatly after Stool, when it approaches
nearly to fainting: As he has been almost extremely

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free of the Cough and Asthma for some time past
he was advised to try the Cortex beginning with small
quantitys, & finding it of Benefitt to him he has con¬
tinued it this fortnight past and now takes a Dram
of the powder twice or three a Day in a Cup of
Camomile Tea: His feverish Complaints are less
frequent but still attack him after eating and he
has the Sicknessafter Stool.

Mr. Russell used to be very much affected by any sud¬
den Change of Weather whether from Good to bad, or bad
to Good but is of late much less so

he was at first when his feverishfitts ware very frequent
much reduced in Flesh but within this month past it
{illeg} mended in that Respect. His appetite is not bad
{illeg} he never indulged it much at one Time and he ab¬
stains from Supper finding himself always worse
when he eats any. His pulse in the Interval of the
feverish paroxysm is very regular

His Urine is extremely torbid and in less quantity

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than usual after standing some Time it drops a co¬
pious lateritious Sediment. his feverishfitts never
are preceeded by a [grewing?] nor followed by a sweat
and he seldom sweats at any time. He has sometimes
a severe fitt of Cough and he spitts with it freely enough
he is always easiest in the open air either in a Carriage
or on Horseback but the Effort of mounting a horse
or even of Stepping in to Carriage fatigues him exces¬
sively and brings on a feverishFitt and Breathles¬
sness; Indeed for many years he has not been able
to walk a hundred yards ↑even↑ on plain Ground without
stopping for Breath -

He observed his Feet to swell a little, about the Time
the Cough and Asthma left him but it never came
higher than the Ankle and begun before he used the
Bark and it is remarkable {illeg} is more observable
in the morning than at night -

Beside this Oedematous Swellings of the Feet he observes several

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soft Tumours scattered up and down His Legs and
Thighs and about the small of the Back but these
disappear a few Minutes after he lyes down in
But attended with such faintish fitts - not at all regular in
his Belly sometimes quite costive & at other times rather
lax

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✍

Case of
Mr Russell
March 1777
V 17 p 110 &

Mr. Russells Case