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As Mrs Gordon's breast has formerly been weak and
liable to be affected by cold we must not be alarmed with an
accidental attack tho it has been more than usually severe.
This is the view I would take of her late disorder and hope it does
not imply any disease that is to continue. However I think
every precaution is to be taken against any return or conti¬
nuance of such ailments and for this purpose would pro¬
pose the following measures.

The first and most necessary precaution she can take is
to guard against cold. She is therefore to guard always against
being much heated by the sun, by warm chambers or by exer¬
cise or if she is at any ↑time↑ accidentally heated that she avoids
being at the same time exposed to any stream of cold air.

She is at all times to avoid any dampness or moisture and
particularly about her neck, feet or legs and for the last to
wear always worsted understockings and if she walks out in
the country to wear thick shoes. She should in general
be warmly cloathed and upon the first approach of cold weather
she should put on a flannel shirt next her skin and wear

it for the whole of winter and perhaps for the whole of life after.
She must take care at no time to change any part of her accus¬
tomed cloathing to a thinner kind.

These are necessary precautions against the action of
cold but it is also necessary to take measures for enabling her
to resist the power of it which is to be done by her being
much in the fresh air and in gentle exercise. She may
frequently walk out but there is much hazard in walking
if either the weather is cold and damp or if she is heated
or fatigued by the exercise and particularly if her breathing
is in the least hurried by it. In short walking is not
an exercise suited to ailments of the breast and it will be
proper and necessary for Mrs Gordon to ride as much as
she conveniently can either on horseback or in a single
horse chaise taking care always at the same time to
be very well cloathed from head to foot. This kind of
exercise she should employ as diligently as she can till
Winter comes on but then she must use it with more
caution and only when mild and tolerably dry weather
admits of it. In riding, short airings are better than

sitting at home but little benefit is obtained without ri¬
ding out to some length and therefore Mrs Gordons jour¬
ney should within the bounds of fatigue be always as
long as she can conveniently make them.

These measures shall I hope prevent any return
of her ailments but her precautions can never be abso¬
lutely certain and therefore it is proper for me to say
how her ailments if they should return or threaten
to return are to be treated and cured

Whenever Mrs Gordon is affected with any cold
of her head or breast let her keep at home and ra¬
ther warm for some days and if the cold is not very
slight or seeming presently to yield let her take a
gentle vomit of Ipecacuana and after that to keep
pretty warm for a day.

If the attack of the cold should be more considerable
and affect her breathing as it did in the spring let
a little blood taken from her arm more or less as
the difficulty of breathing or degree of feverishness may

direct. When a bleeding seems necessary it will always
be desireable to have it done before vomiting.

When bleeding and vomiting have been premised
if any difficulty of breathing should continue or threaten
to recur in the night time let a blister be applied between
the shoulders but this is to be healed up immediately with¬
out turning any part of it into an Issue as a fresh blister
will always be of more service than an Issue, at least I
would not advise an Issue till I shall see more occasion for it.

If Mrs Gordon should be so unlucky as to have any such severe attack
as she had in the spring and that too continuing to recur upon her her
chief dependance for relief must be upon alternate bleeding vomiting and
blistering but in case of slight attacks I have prescribed a mixture
which I hope after once vomiting or at most after one bleeding & vomiting
may serve to discuss her complaint. She is to take a spoonfull at lying
down at night and if it makes her a little sick it will do her the more service
and if it does not make her at all sick the dose may be two spoonfulls or
perhaps more.

Mrs Gordons diet may be a middle kind by no means very full but
neither very low. When ailments are present her diet should be light
and sparing and at all times her suppers should be very light.