[Page 1]

Since I wrote last,
notwithstanding the very severe
Winter, Mr. Nielson has continued
upon the whole better than before
he was confined to his present Diet -
his P in general his Pulse has
been Calm and regular and his
heart free from fluttering and
Palpitation - his Stomach has likewise
been always very good - he gets passage
of his belly once or sometimes twice a-
day regularly; and he continues to get
longer and more Comfortable Sleep than
formerly - But tho' he is better there is
nevertheless scarce a full hour in any
day that it can be said he is perfectly
free from the Pains; and every night he
is awakened by them and obliged to be
rubbed before he can again fall asleep -
the P pains likewise sometimes become
very severe and the Pulse quick and smart

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at such times when their Violence is not
abated by Rubbing, the usual temporary
Cure, I am forced to have recourse to the
Lancet; and four such occasions have oc¬
curred since I wrote you last -- one tea
Cupful of blood or at most two (the greatest
quantity that has been taken at a time) have
always given relief - the blood was al¬
ways [sizy?]; but the last time the Crust
was considerably thinner and less tough
than formerly tho' as far as I could judge
the Circumstances in Cooling were as fa¬
vourable for it's formation then as former¬
ly ---- About two months ago
Mr. Nielson shewed me a remarkable
jutting out of his Ribs upon the right
side about a hand's breadth from the
Cartilago enseformis; as if the Cartilages
of the false ribs had yielded and allowed
the ribs to Protrude at their junction with
them - upon Pressing immediately below
this Swelling I found no internal Swelling
or hardness - it therefore was not occasioned
by any Swelling of the Liver which I at first
apprehended - and as he never had any Cough
nor difficulty in breathing it could not pro¬
ceed from any Collection in the Thorax -

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this Protuberance has since become less
and almost disappeared and possibly might
be owing to the (↑a↑) weakness of these Cartilages
and his Constant lying upon the right side
- this Place tho' a Common seat for the Pains
is sometimes entirely free from them at
which times they usually flit to the back
and shoulders ---- the reason of troubling
you at present is to inform you of a Symp¬
tom which has continued for a long time
tho' it was but lately mentioned to me -
it is a partial Sweat which is Cold
and begins every night in his left [leg]
and advances up the thigh and someti[mes]
farther; at the same time the right [leg]
and thigh are warm and free from [[sweat]?]
of any kind - his left leg and thigh are
actually at such times Cold to the feeling
- upon drying and rubbing this Coldness goes
off; but he and he has no pain nor never
had any in his leg and Side nor does he
observe any Numbness -- Mr. Nielson
wishes to have your opinion of his appear¬
ance &c. -- I beg leave to remember (↑remind↑) You
of Mrs. Mc.Laws whose eruption upon the
arms is worse than ever --

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To
Dr. William Cullen
Professor of Medicine
Edinburgh

✍

Mr Taylor
Concerning
Mr Neilson
April 1780
V. XI p. 6 7.