[Page 1]

It would give me the highest pleasure
to be of any service to Governor Johnston and that
I might have a chance of being so I have
studied his case ↑as it is↑ distinctly and skilfully
described by you, and I shall give you the
best opinion I can.

Whether any Siphylitic taint had
any share in bringing on the disease I will
would not determine, but I am clear
from all you tell me that no such taint
now remains and that any attempts that
might now be made upon that supposition
might now be ↑very↑ pernicious. With respect to the
nature of the disease, as it has now subsisted
for five years past I cannot say clearly
nor do I believe that any body else can
say clearly ↑and precisely↑ what it is I believe (↑the nature of it is.↑) I have my
conjectures, but I am not very confident
in producing them, and I would be very
averse to produce them to persons who
I believe would not understand them. I
believe the disease has been suspected
to be of a Cancerous nature, but if it be,
it is of a ver peculiar kind, and at present
the appearances do not look like any¬
thing of the kind. The tumor for two

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years past has neither increased in size
hardness or pain. The discharge which
begun nine months ago has not increased
in quantity nor discovered any peculiar
acrimony nor ↑indeed↑ acrimony in general. The
Ulcers produced by the opening ↑mentioned↑ have not
increased in size, and of late are rather
diminished. The matter discharged
at present looks well, and there are
no marks of any absorption ↑by their being any tumor↑ in any
of (↑in↑) the Lymphatic glands. What I take
to be a mark of the same and in genera[l]
a very favourable Symptom, is the ab¬
sence of Hectic in which I think you
cannot be mistaken. In these remarks
I have said all I can with respect to
the nature of the disease and mean par¬
ticularly to say that it is not a desperate
disease (↑one↑) and that at present it is
growing rather better than worse and
therefore there is encouragement to
take what pains we can to relieve it
and to give fair play to nature which
often relieves us more than we expected.

In this view of things I would willingly
advise but cannot positively propose

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medicines as I must believe that in the
course of five years a great variety ↑and almost every one that could be thought of↑ has
been employed ↑and↑ as without success I dare
say the Governor is quite tired of them, but
I wish ↑if you could↑ you had been more particular
in your accounts of them, in case that
some yet untried might have occurred
to me [Start of margin text]and I find too often that the administration of remedies to be very imperfect[End of margin text]. In the mean time I do not think
of proposing any medicine, but am to
propose a remedy which if not yet
tried I would expect very great advantage
from it. This is a milk diet in which
Asses milk shall be chiefly employed
He must have an Ass or Asses of his own
that their proper feeding and management
may be taken care of; and that he may
have the quantity that is necessary.
He may begin to take it by degrees but
he must take as much as his stomach
easily bears and not less than a pint
every morning and Evening. If his stomach
will bear this quantity, besides the
benefit it may be of in changing
the state of his blood it is likely to be
of great advantage in keeping his belly

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regular and saving the great trouble he
has had with Purgative medicines. I
would have the quantity of Asses milk
mentioned serve entirely for Breakfast
and Supper, but if he finds occasion
to take any kind of bread along with it
I have no objection to it, and (↑if↑) he shall not find
that it disturbs the digestion of the milk
and as to the kind of bread I particularly
recommend what in this Country we
call diet loaf. If the milk should not
readily agree with him it is sometimes
of use to give a little Spirits with it and
sometimes an absorbent powder and of
which I would chuse the calcined
magnesia.

I would not only have his breakfast
and Supper of Milk but I would have
his dinner to be also of the same, only
at dinner I would have him take Cows
milk instead of Asses as the former
if he can digest it well is more
nourishing, but least he might not
digest it properly, I would have him
take it ↑at first↑ always more or less diluted.

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At first let him take an equal part
of fresh made thin water gruel and
mix it with an equal quantity of fresh
Cows milk and sweeten the whole ↑pretty well↑ with
honey, or if his stomach does not bear
that with Muscovedo Sugar, and let
him take this instead of plain milk
with bread, Rice, Barley or Sago.
If he takes it with any of the grain
kind let these be first separately
well boiled, and when he is to use them
let the milk and gruel be warmed
and poured upon the grain. At first
as I have said he is to mix his milk
with an equal part of gruel, but if
he digests this easily the preparation
of gruel may be gradually diminished
till it is none at all, but though the
gruel should be omitted, the honey or
Sugar should not, for one of these will
both favour the digestion of the milk
and the openess of his belly.

In this manner I would for some
time order his dinner, but and
would have him to avoid entirely any
kind of Animal food, but if the

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milk diet especially the dinner should
not agree with him, and that either for¬
mer habits or present weakness should
seem to require a different manage¬
ment I must leave that (↑this↑) to the discre¬
tion of persons upon the spot, or at
least I will say no more on the
Subject till I shall hear from you
how my plan is relished, or how it
succeeds in the execution.

The only other measure I have
to propose is the continuance of opiates
I have a high opinion of its (↑the↑) virtues
↑of opium↑ in the cure of all untoward or as I may
call them malignant sores and if
ever it was of service, in Venereal
cases I believe it was owing to its
general virtues, but to say no more
on this Subject I would advise Governor
Johnston to use it pretty freely, and
from the practice we have had in
Venereal cases we have learned that
persons may take it with great
safety in ↑much↑ larger quantities than was
commonly supposed. Except therefore

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some peculiar idiosyncrasy be in
the way I would have it tried with
Governor Johnston very fully ↑and it is the only means I can propose for↑ [Start of margin text]procuring him sleep[End of margin text] A difficulty
however may seem to be in the way
and that is the costiveness which he
has been so much troubled with, but
with respect to this I must observe
to you that I have not found the
costiveness to be greater from large
doses of opium than it used to be
from a smaller, and that glysters
and laxatives will do almost as much
in the one case as in the other.
It is even possible that the Castor
oil may ↑still be a laxative but↑ be less purgative than it
has used to be. Have you ever tried
the flores Sulphuris as a laxative with
the Governor, you have no doubt tried
Aloetics and I give you this hint that
I have often found a fourth part of Gamboge
added to our Aloetic Mass render that
mass in a pill or two more effectual
and without any greater trouble to the
bowels.

^If I should not be of any service

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to Governor Johnston I have at least by the
length of this letter shewn my great
desire to be so, and if this letter shall
lay a foundation for any further corre¬
spondence you shall find me very
ready and punctual.

With every respectful Compliment
I am with sincere regard

^The only desideratum that I have not
taken notice of is to mend his appetite
but to the ordinary means of this I am
averse to, and I hope for him to swallow
the liquid food I have proposed little
appetite will be necessary. The best
means of mending appetite that I
know of is fresh air and gentle exercise.
I wish I could find that the Governor was in
a condition to employ them. If I could
lay him in a Coach of my contrivance
I could make him bear motion tho'
in the most weakly condition.