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For the Honourable Admiral Grieg---

Having attentively considered the whole history of the Admirals Complaints I
have no doubt- in Judging of the nature of them. The disease was originally a
remittent Fever which is very ready to take hold of the Constitution so as to return after
Intervals from slight- & unheeded causes. The admiral therefore has been frequently
troubled with & is still liable to such returns, but they are so troublesome in themselves &
so hurtfull to the Constitution that every precaution should be taken against them. For this
purpose the measures necessary are to avoid every thing that may be supposed to be a
cause of returns . 2 ¹ to strengthen the Constitution so as to render it less ready to be affect¬
ed by those causes & when neither of these purposes can be rendered absolutely effectual
the third measure is to watch the approaches of the disease & either to prevent its coming
on or render it very moderate when it does. Lastly a measure that may be necessary
is when a return of the disease has actually taken place to discuss it
again as quickly as possible. The chief cause of the returns of the disease may
be the renewed application of the same powers which originally produced it, that is
Marsh Exhalations in warm seasons. During the Summer Season therefore the
Admiral should avoid as much as possible being in the neighbourhood of swampy
or Marshy grounds or should reside in them as short a time as possible & particularly
should avoid being in such asituations in the night time. When a ship is stationed in
the neighbourhood of such grounds it is always better to be on board the ship than
on shore & in some cases it has been found necessary to let down all the gunports
that were next to the shore. Even while there is no exposure to Marshes the
great heats of Summer are ready to give returns of the Admirals Complaints he should
therefore avoid these heats as much as possibly he can & particularly being much in ye
sun. During the Summer season it is proper to observe that very slight errors in the manner of living
are ready to occasion returns of the disease it is therefore necessary to give as strict attention

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to the manner of living. Sudden changes of heat & cold are to be carefully guarded
against all considerable changes of clothing are to be avoided & it is always safest to be more
warmly clothd than the heat of the Season would seem to allow of. In the manner of living
it is especially necessary to avoid all food which may occasion indigestion all the
heavier kind of Animal food are to be avoided but some Animal food is necessary
& it would be dangerous to take entirely to vegetable aliments. These cannot be
safely taken in large proportion & all the cold & flatulent kinds are to be-
avoided. In drinking, Small liquors of all kinds are to be avoided, Even all weak
bodied wines as claret Rhenish & French Whitewines are to be shunned. The Admiral
every day should take two or 3 Glasses of some strong wine such as Medeira Sherry or Redport
dilutd a little with water & his ordinary drink should be water with a small proportion
of these wines in it. He may frequently instead of wine take alittle punch but it
should be made with a small proportion of little fruits & sugar only. It is hardly
necessary to say to Admiral Greig that the least excess in strong drink will always
be very hurtfull to him. Moderate & pretty constant exercise will always be
proper but very brisk exercise will always do harm. To strengthen the Constitution
& to render it less liable to be affected by the causes of the disease beside the exercise above
recommended there is nothing more proper than cold bathing either fresh or salt
Water but at present the Season is too far gone to begin it now & the proper time to
begin it in Russia will be in the month of May when the Winter is entirely over.
It should be taken in the morning only when the body is quite cool & it may be
repeated every day & at best very frequently during the whole Summer. The constitution
may also be strengthened by the use of some Medicines such as I have prescribed on
a paper apart. ² The proper time for taking them is in the Spring as soon as it sets
in in any degree. They are to be taken for a fortnight only at one time but after
an interval of one two or three weeks another Course of them may be repeated &
if they are found to have the Effects I expect in preventing relapses the course after
Intervals may be repeatd several times during the Summer. When in spite of
these precautions the Admiral shall feell any of those symptoms which he has commonly
found to {illeg} of it it will always be necessary to take care that the belly is
regular & therefore to take a dose of the aqua benedicta wc. he has been in use to
employ. When this is done it will probably be open so take a gentle vomit
often 15 or 20 grains of Ipecacuanha helping off with Camamilia Carduuss tea.
This should always be taken in the evening going to bed immediately after it
& when the Stomach feels quite settled the diaphoretic prescribed in the paper
apart is to be taken. The next day the Adml. should remain at home stirring
little & avoiding business. In this way ↑I hope↑ that fits which otherwise might have
come on may be prevented. When however it shall happen that either fits come
by surprise or that business has prevented the above precautions, I believe it
will always shorten fits if a Saline draught as ordered in the paper apart is
taken as soon as any feeling of coldness is perceived. If after that a vomiting
or even a squeamishness with much thirst shall come on it maybe usefull
to encourage the vomiting a little by some draughts of Camomile tea. As
the fits can hardly go off till some sweating happen if this should not
seem to come on soon & that a dry burning heat continues a saline draught
may be useful in putting an end to that & bringing out the Sweat
If at the beginning of a fit or for any time in the Course of it the
feet should be cold it will always be proper to bring them into

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heat as soon as possible by bottles of hot water or boiled bricks
applied to them.