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To Mr Cheyne about ------------------

I am sorry I cannot give a favourable opinion. Strong marks of tenden¬
cy to Consumption which having proceeded a certain length almost impossible to
remedy. It does not appear however to be so much confirmed & no good could be
got if we admit the supposition. But every precaution & every remedy which can
be with safety employed. During the rigour of the season, principal¬
ly avoid cold, with out keeping too warm. But in such a season as this better
lean to the last. Even when the season is milder as now there is some
appearance of it, for a month or 2 the weather cannot be so mild as to
admit of going abroad, especially as she can go only on horseback. In
her weakly state, more harm by cold, than benefit from air & exercise . If
she live till a safer season, air & exercise will be among the most
useful remedies, & sailing greatly preferable to riding on horseback.
For guarding against cold, the flannel shift she wears, is very proper, & she
must not lay it aside in any weather. The milk diet she
uses is certainly the most proper, & should keep to it as strictly as
possible. If upon any occasion it should be found that the milk is
not properly digested let her instead of plain milk take it mixed
with an equal part of thin water gruel well sweetened with sugar or honey
if her stomach bear it. This we call artificial asses milk & it
is commonly as easily digested as the real.

Issue in her back was very proper & she should not have let
it dry up. I know indeed it is often so painful as not to be easily
suffered & then must be taken out. But it is at the same time abso¬
lutely necessary that a Pea Issue should be put into another place. I
hope the one put into her arm still continues there & discharges well
If it do not I would advise a fresh Pea issue to be put into
the other arm or into the nape of the neck. The keeping up of

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such a drain is the Lady's best chance for a recovery.

Tho her expectoration is often difficult, Pectoral medicines are
very often unsafe. The mild mucilaginous & oily may be employed
in any quantity her stomach bears, but the Gums, Balsamics &
& all other of a heating kind should be entirely avoided, as a judi¬
cious Doctor seems at present to do. Gentle vomits are among
the best Expectorants & I leave the employment of them to your
discretion of the Gentleman on the spot, but my opinion is that
she is now too weak, to use then with any freedom. I think it
very proper to maderate the Cough by Anod. & every night at
bed time I would go a good deal farther than has been yet done
they may suspend the expectoration for a part of the night but cannot
entirely stop it, & the avoiding of the cough &the giving of sleep are matters
of great importance.

The suppression of the Menses, unfavourable but it was to
be expected & cannot be helped till the return of a much better
season & therefore I prescribe nothing for it now.

The only medicine is the Decoction below, being one of the best
means I know for dissolving tubercles or healing ulcerations.

For --