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I have considered this case with all the
attention I can bestow, and am sorry to find it
a difficult one, as both the series of causes
inducing it must have hurt the constitution
and the nature of the disease very purely
Epileptic now established is always especially
often some continuance difficult to remove.
I am far however from thinking it incurable
and I shall propose some measures which
have of late succeeded with me beyond expectation.
The prescription I have put upon the inclosed
{illeg} it is to to be put into the hands of
a physician or Surgeon who will direct the
proper managment of it in the following
manner.

After the Lady has had her two usual
fits for two nights successively, She is on the

Let me {illeg} here that care is to be
taken that the Lady be not told that any
sickness is to be expected from the dose, and
that her feelings are to come from her without
any questions asked about them by the
bystanders. If it should happen that the
dose produces any reaching, this is not to
be encouraged by drinking warm water, or
any other means of exciting Vomiting.

On the second night of taking the powders
let the Lady take after it, a draught as pre¬
scribed in the inclosed paper, but let this be
adjusted to her constitution by a Physician
on the spot, who knows it better than I do
and as I propose that such a draught is to
be taken every night while she continues
the powders I desire that the dose of
Tincture Thebaic be diminished or increased
as the Physician on the spot shall judge proper.

If Dr. G. Skene is the physician I have
the utmost confidence [in his?] judgement. If the
use of the draughts induce any unusual cos¬
tiveness, let this be corrected by laxative
glysters, and not by purgatives if they can
be avoided.

The course is to be continued till another
fit comes on, and if (↑tho'↑) they should come on, if they
[are no?] worse than usual, and especially if less
[severe,?] and that there is but one fit instead of
two I would have the course continued for another
[interval?], and upon the same conditions even
for a third, but at that time I should wish to
have Dr. Skenes account of the whole circum¬
stances of the disease, and the affects of the course
I have prescribed.

During [this current?] {illeg} if there is
no objection to it that [I dont know?] of, I would
have the Lady [abstain from?] Animal food, from
all fermented liquors, & other strong drinks. If

{illeg} be
{illeg} and be {illeg} to avoid cold.
let her also lie alone and let every possible
care be taken to keep her mind free from every
[emotion?]