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For Miss Simpson.

I suspect a steatomatous growth on the omentum
mesentery. a disease of very difficult cure but sometimes
subsists long without any danger. The danger to be
chiefly apprehended is chiefly a hectic which comes on &
the emaciation in this case with some other symptoms
give suspicion of that tendency. But other circumstances
make me think the hectic has gone no length. Only
with a view to the Hectic can Goat whey be of use; for it
cannot be of any I think to the chief disease & it retards
or prevents other remedies: There are few others I own
can be proposed with confidence but very safe attempt
should be made & therefore I propose Cicuta & Mercury.
For the Cicuta the best & surest form is the powder of the
dried leaves, dried secundum Pharmacopoeia Edinburgensis; or so as to retain their
colour & smell. The dose at first gr. ij twice a day but if
these have no sensible effect, gradually but not too slowly
increase the dose, till they give sickness, giddiness or tremor
& doses that have such effects are to be continued for some

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time for it is only after the use of them for some weeks
that any considerable effects are to be expected. At the same
time with the Cicuta I would propose to employ some mer¬
curial preparation in an alterative way. Let it be
the common mercurial made of well triturated mercury &
as in our dispensatory, without any laxative or purga¬
tive added to it. She should have half a grain
every night & morning taking care that run neither
by stool nor to the mouth; & with these precautions
it might be continued for some weeks, providing also that at
the same time no strong symptoms of hectic arise, or
that the mercury does not prove heating. If the mer¬
cury do not threaten the mouth, she may go abroad
especially in a carriage in the middle of any days
that are tolerably milk but avoid but avoid mornings and evenings:
& if the mercury in the last threaten the mouth she
must keep at home altogether.

During this, her diet should be of milk & farinacea
I would not forbid a little animal food at dinner but
it should be little and light. Take fruit or garden
things very sparingly. For drink, water not quite
cold is best; with some times a little wine in it.
Malt liquors of all kinds hurtful. From what
I am told I dont find She is troubled with Ascarides
as formerly, but as she has formerly, so if they should
become suspected let her take the following.