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I am of the same opinion as before that Mrs Condies com¬
plaints depend upon the Piles & the irregularity of these has produced
the whole Spasmodic & Nervous affections of her Stomach and intes¬
tines. If the disease was was still purely hæmorrhoidal I should confidently
expect a recovery but it is to be feared that the Alimentary canal has
lost its tone to a great degree & various schirrosities may be pr↑o↑duced
so as to render the event doubtfull –––

In the meantime I am clear about the management
of the Case. The Belly must must be kept constantly soluble & the pains
which are spasmodic must be be kept down by opiates ––
For the first I would trust to the Sulphur as ordered below giving
it very constantly but more or less according to Circumstances.

I would assist this & perhaps also answer other purposes by
Regenerated Tartar directed as below ––––

If these are not quite sufficient they must upon occasion be
assisted by Glysters for which as to the best I refer to former experience
When other Glysters are not employed I would frequently at bed time use it
tow (↑two↑) ounces of sweet Oil & if there is any external swelling I would anoint
it with equal parts of Axung porcin & Ung Mercurial Tinc terebinth parati

While these medecines are employed I would earnestly advise the
free use of Opiates it appears to me that the dose of twenty five draps is
greatly too low. Let it be increased & by degrees to whatever may be

With regard to her Diet much care is to be taken but
unless I was upon the spot I cannot order it better than Dr Menzies
has done & to whose direction & Judgement I can trust a great deal