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For Mrs Ewart

The weakness Mrs Ewart complains of is to be imputed
to the loss of blood and other causes, it is a general affection &
marks no purticular disease and it will be mended as far
as her time of life will allows of by the measures we
are to advise. For Mrs Ewarts case it is the ailments of
her breast which especially demands our attention and I hope
that even these are now in a way of mending but they are
not yet so entirely gone that at this season they can with
safety be neglected. I would therefore advise the following
measures. As soon as she is at home let a blistering plaister
be applied to the pained part part of her side and let a
part of it be turned into a perpetual blister. If this discharges
well and gives her little trouble it should be continued till
next summer but if it eithers gives her much trouble or disch¬
arges little it is to be healed up and a seton is to be put
into the same place or near to it. As soon as the perpetual
blister is established I would have her take the opportunity
of any good weather that may occur to make a journey
for a week or two; which I think is necessary before winter
comes on and the only effectual means of discussing her
complaints. I hope it will discuss them but if it does not
I would have her continue to take some exercise in a
carri↑a↑ge every day that the weather will allow. At all
times she must take great care to avoid cold and as

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one means of this I advise her to weare a flannel shirt next
her skin both night and day and from henceforth throug
the whole winter. As she has been disposed to a plethoric state
and had a large hemorrhagy as a mark of it & as at present
I find her pulse tolerably full & a little frequent I would
on any marks of fullness appearing and especially on any
increase of the symptoms of her breast take a little blood from
her arm, more or less as symptoms may seem to require.
Both on account of my fears of plethora recurring and on
account of the present date of her breast I must advise her to
use a spare and light diet. I would not tie her up very
strictly but must say in general that the less animal food
the better at dinner she may take broth neither strong
nor fat & sometimes a bit of light meat especially while her
appetite allows her to take a little of it only but she should ↑be sparing
& should↑ fill up her meal with some kind of grain. At supper she
must take no kind of animal food and therefore not an
egg. Fruits and as much of any kind of vegetables as her
stomach easily digests are very proper for her. For her relief
I depend upon the Issue her exercise and regimen and think
few medicines can be of service to her but she may be the
better for taking twice a day a aupfull of cold infusion
of the Bark with as much of the Elixir Vitrioli as her taste
will beare and besides this she may twice a day take a
glass of water with the same Elixir. When her cough
is frequent and more bound than ordinary she may

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take anodyneat at bedtime but always along with it as
much of the Antimonial wine as her stomach will bear
without much sickness or nausea. I would however employ
the Anodyne as seldom as possible and try to alleviate
the cough by the Trochisci bechici nigri I expect little
benefit from either Musk or G. Ammoniae. If Mrs Ewarts
↑ailments↑ should continue till winter some other remedies may
be proposed but that must depend on the circumstances
than present.