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You may be assured of my attention to any friend of yours
& I wish I had now the prospect of that attention being
usefull to a person in whom you take so much concern -
but I am much afraid the Lady is in a dangerous at
least an uncertain condition. I am afraid that
matter has fallen (↑is forming↑) upon the Lungs and tho she is not
hectic she is in danger of ↑becoming↑ both hectic and Con¬
sumptive. If this is so (↑the tendency↑) you know how difficult
it is to obviate it but I wish to view it in
the most favourable light possible and ↑hope↑ that as
it began with aguish appearances this ↑Disorder↑ may
be still latent and support the Symptoms
The measures that appear to me most probable
for the greatest Relief are ↑1st↑ to endeavour to
obviate Inflammation & consequently suppu¬
ration as much as possible - The Bleeding
you tryed was a probable measure and the
sizeness of the Blood both proves this and in¬
dicates a repetition if the pulse and strength
any ways admit of it I would advise a small
bleeding to be repeated several times at such In¬
tervals as the Effects may suggest to your discre¬
tion

2. I would apply a blister to the back and either turn
a part of that [into?] a perpetual blister or open
a pea issue in her arm

3 - If you can observe any ↑regular↑ Intermission or Remission
in the frequency of the Pulse to lead you to suppose
an aguish disposition still later & I would have
you try an Infusion or decoction of the
Bark

I should say further the foundation of her present
Complaints which is probably a great relaxation from
dejection of spirits particularly indicates the tryal
of the Bark.

4 - It will be very proper to attend to her Cough
and support her Expectoration this you may
do by any of the mild pectorals that she can
best bear, but the most Effectual Expectorant
is a gentle puke which you will therefore
repeat as the Circumstances & your good Judgement
shall direct.

5. If not withstanding the cough proves remarkable
fatiguing I think it may be very necessary to give
rest by a Dose of the Soap Pills but while
there is any hope of discussing the matter
lodged in the Breast I would avoid the
Opiate as much as possible

6 - I think the Asses Milk should be continued
as a very proper Remedy and if the Lady can
confine herself entirely to a Diet of Milk & Grain
I think it may contribute greatly to her Relief -
As I am perswaded that every Kind of Animal
food may be hurtfull.

I need not add to this that all drinks
that are heating should be avoided and I
can say that a little wine wt water or made
into whey appears to me less heating than
animal food -

8. At a better season of the year I should
advise your Patient to take what she can
bear of fresh air & Exercise, but at

present she is more likely to be hurt by Cold than to be
benefited by any Exercise she can take. If she can
[conveniently?] employ and easily bear a Chamber
horse it may be of service - I wish with all my
heart that this advice may be of service to your
patient wherein I can be further usefull you
may always freely command yours