384 Edward Livingston Youmans. 



the severe winter, and am now getting more strength, but 

 my breathing continues very short, and I have evidently 

 the use of a much diminished portion of my lungs. What 

 the summer may do for me I cannot say, but I hope some- 

 thing. There is, however, hardly enough left of vigour to 

 justify the hope that I could again safely cross the At- 

 lantic ; and if I did I fear I should be rather a burden than 

 a helpful companion. But all the same, your invitation is 

 pleasant, and most cordially appreciated. 



November //, 1884. 



... As for myself, I think I can report my health as on 

 the whole considerably better. The recent fine autumnal 

 weather has been very favourable, and I have been able to 

 increase my exercise and gain corresponding strength. 

 The state of my lungs puzzles me, as there seems to be 

 some change of symptoms, and I am much inclined to in- 

 terpret them favourably ; but I shall soon consult one of 

 our best authorities on pulmonary matters and get at the 

 present significance of the case. I am every way ex- 

 tremely well except the lung irritability and constant 

 shortness of breath. 



I am able to take pretty long walks if at a moderate 

 pace, but the slightest quickening of movement sets the 

 heart to pounding, which I suppose means a demand for 

 more arterialization of the blood than the lungs can give. 

 I still talk of going away, but how to get away and where 

 to go are not easy questions to answer. 



No doubt imperfect arterialization of the blood 

 was the most serious feature of the case. From the 

 desperate attack of pneumonia combined with pleurisy, 

 in 1881, Youmans had never really recovered. The 

 continued and incurable adhesion of the lung to the 

 pleura robbed it of half its efficiency, and under this 

 wretched mechanical difficulty, in spite of the delusive 



