[Page 1]
For Mr Edmonstone's Sister in Law

I'm of your opinions, that I cannot to any useful purpose
say any thing about her fever as it must be over before
you got the answer of. I must therefor suppose her
in the same state as before it. The fever may make
some change of constitution, as I have had spas¬
mod affect cured by it tho they had subsisted
long before, but cannot say as to your friend.
I in the mean to advise to the first part of
your letter. Dyspepsia depending on a debility
of the whole habit appearing chiefly in the Stomach,
no reason to consider it as Symptomatic, & while
the Uterine system is so regular, not Hysteric,
except in being affected by passions. Whatever
it be, difficult to cure, as, a disease of the habit
to change that, & to correct congenital debility
confirmed by accident since, & the more difficult
as the mind is weak as the body & is easily affected
by passions. All this an unfavourable Prognosis
sed nil desperandum &c.

We must especially restore or support tone, &
that by Tonic medicines, Exercise, & perhaps
Cold bathing.

As Tonic Medicine, bitters [might be?] useful but you can use
only the bark, & the best form is the cold infusion
ordered below. The Triture is of more consequence than you `
would

---

[Page 2]

imagine. The vitriolic acid is properly used with
Bark, but give it separately for when joined to the
cold infused, it precipitates the bark. Give
the infusion first, wash it down with a glass of cold
water moderately acidulated with spirit vitriol tenuis.
Proportion the doses according to (↑as↑) the stomach bears
them but never more than for 2 or 3 weeks at a time
You may observe to your friends [&?] that these do not
entirely restrain vomiting but necessary to strengthen
the stomach, & render the vomiting less frequent or [violent?]
& at last remove it altogether If this medicine
do not agree, try the Limatura ferr. præparata.
The formula below. Most stomachs bear larger
doses than was imagined & if she bear easily the
dose here prescribed, increase by degrees till she
can take ℈j for a dose twice a day. The only doubt
to regard to the use of it is her state of menstrua¬
tion, & if the Chalyb. increase it, be more cautious
in its use but the effect of Chalyb. ambigious as
sometimes astringent instead of aperient. Employ
the Chalyb. for a month together & about a fortnight
before the monthly period it is to be begun. Increase
the dose slowly, & lay it aside entirely during the evacua¬
tion & if no effect up on that evacuation be observed;
as soon as it is over, renew the Chalyb., & continue in
as large doses as she easily bears for a fortnight more.

These are the Tonic remedies but they must be long con¬
tinued & other means used before the returns of vomiting
are entirely prevented & in the mean time when vomitings do

---

[Page 3]

return some other measures are necessary. No ob¬
jections to the Chamomile tea for washing out the
brown bile disturbing the stomach, but never go far
in thus encouraging vomiting but after washing out
the stomach a little, stop the vomiting by an Opiate.

I agree with you the habitual use of Opiates [might?] do
much harm to the stomach but this must not hinder us
to employ them to the degree that is necessary to remove
Spasmodic affectations, therefore I would employ them
both to check the violent vomitings [when?] come on, & prevent
their returns [when?] can be foreseen. This difficult in a
case as this of daily vomiting but in such I have
succeeded by ye Stomachic drops ordered below, about
an hour before dinner. If the Elixir render the
medicine very disagreeable, lay it aside & give the
Laudan. alone. increasing it as necessary & [born?] &
the trial this way [might be?] farther, & oftener, or seldomer
as your discretion shall direct. In a violent fit
of vomiting & the Laudan. given by the mouth be
rejected, then give it by glyster & in the dose
necessary.

Obviate costiven. One of the best Laxat. for her is
Magnesia, but this must not be employed so often
when taking the Chalybeate, & in place of it give
an Aloetic pill.

Exercise Riding when strength & weather allow
& even sailing but let it be something of a voyage

---

[Page 4]

Cold bathing attempting it attend to two things
1. breast be sound, free from cough or suspicion
of obstruction
2. be taken [when?] indoors, bringing on the cold gradually
i.e. by employing first one part boiling water to three
parts spring or sea water & afterwards gradually diminishing the proportion of the boiling water & c.

Her Diet must depend up on her particular ex¬
perience than by any general rules I can give
but tho solid let it be light, & always little at
one time allowing that to be compensated by the fre¬
quency.

Neither a putrid nor an inflammatory diathesis to
be suspected, & the disease is to be considered as an
affection of the [mocs?] powers.

For