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For Mr Lochead Junior

I have again considered very fully everything
you said or wrote to me & from the whole I am fully perswaded that
your ailments are wholly & purely a Rheumatic dispo¬
sition & habit I never knew such prove mortal & think there is no
hazard of your life but is very liable to prove tedious & ↑if↑ in the
mean time it is urged on by improper management it may fix for
life, give a very unhappy one & even to put a person in great
danger of suffering by other accidents. These are my real
Sentiments with regard to the Issue of your disease and at the
same time I am as clearly of opinion that it is not yet fixed in
your constitution & thus by good management against the
middle of next Summer you may be as well as ever you was
in your life. But observe ↑well↑that it is by good
management & by that only steadily and strictly observed for the
whole of next winter & Spring, for tho you should be sooner
well or seemingly so you will be very liable to a relapse from
slight accidents till you have got a Summer over Season to confirm
your strength --- The particulars of which your management
must consist are the following

In the first place your great care must be to gaurd against
cold & that is so difficult to be done in this climate that your
safest & most certain course would be to pass the winter in a better
somewhere in the South of Europe. If that is not convenient you
must take the more care in this country. You should wear a
flannel shirt, woollen drawers & worsted

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understocking and all these both night & day, You may
shift them at pleasure but taking Special care that what you
are to put on be very thoroughly dried, while the weather is tolera¬
ble mild you may go abroad but only in a carriage taking
particular care to keep your feet warm & knees by an additional
cover. You must never be in a Carriage with a sideglass down
& ever with regard to the foreglasses be cautious. Gentle walking
is not bad for you but it should be for this winter in your chamber
only --- I would not confine you to that entirely but you must go
abroad in a chair only & in the forenoons only & tho you are to go
in a chair you cannot with any safety be out of your own chamber
or house or house ¹ after dinner. In prudence you must be
exposed to no accidents & in every respect you must gaurd
against Cold which we often escape tho exposed to it but it also
siezes us when least expected & especially the Valetudinary.
I think I need not direct you to avoid doors & windows & every
streak of Air but you may not observe that a very warm
chamber is almost as bad for you as a Cold one let the room
you sit in be free from [sifts?] or draughts of Air & let it have
a constant fire but always a small One so that it is never
much heated & take care never to sit opposite as we speak
upon the fire. If your room is managed in this manner your
cloaths both by night & day maybe light & that is best for you.
If at any time you wish for an additional blanket let it be
laid upon your feet only ---

The next article of your care must be your diet I lay much
stress on this but I can tell you very shortly how it is to be
managed You must abstain from every kind of Animal food

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Fleshy fish, Or Eggs, & Insist on this without Exception.
I would allow you a little broth at dinner but I would rather
you should let it alone. Milk in every shape except that of butter
& plain cream you must take the most part of your diet &
with that any kind of grain as Bread, Barley, Rice, Millet Sago
or oatmeal & these may be prepared in any shape you like best
so these you you may join potatoes & the most part of Roots
& greens only be more moderate in the latter. All kinds of
fruit are also allowable if you never take much at a time
& take these that admit of it rather boiled & baked than raw
you may take a very little butter to your bread but I would rather
rather have you let it alone & take honey Jelly or Marmalade
This diet may feel light to you at first but I hope you will be soon
reconciled to it --- I think it it absolutely necesary ↑&↑ I am
perswaded you will be stronger with it than ↑with↑ Meat --- For
Drink you must take T↑o↑ast water Watergruel, Whey or Tea
but no kind of fermented liquor or Spirits in any quantity
or in any Shape. Believe that this diet is of consequence
observe it strictly & you will be well.

I would wish to give you exercise in a chaise as much
as you easily bear & the weather will allow but you must
never push it the length of fatigue & you must avoid either very
cold or very wet weather --- I have spoke above of your walking
walking which I think you cannot practise with safety
but on ↑a↑deal floor --- I think your Joints are by no means
yet fit for any kind of Rubbing tho when they shall be much
freer of swelling it may be very proper.