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Having now and formerly considered ↑both↑ the
former history and present State of Mr Halkerstons
complaints I own it would be difficult to account
for the various appearances and revolutions which
have happened in his constitution. ↑[Not?]↑ but upon the
whole I am of opinion, that the foundation of all
his complaints both formerly and more evidently now
is a weakness and mobility of his Nervous System
which is liable to every variety of derangement and
↑ready to give ↑the appearance of↑a general Cachexy↑ In particular the alimentary ↑Canal↑ is liable to suffer,
weakness is ready to appear and Spasms to happen
in every part of it. From imperfect digestion and
assimilation acrimony is likely to prevail and both (↑not only↑)
from this source of imperfect assimilation but also from
the Stagnations which weakness gives occasion to and

This is my Idea of Mr Halkerstons State of
body. It is a State however which as depending upon
original and constitutional faults and as having
now Subsisted for a long time must now be difficult
to mend but I hope that a proper management
may do ↑a↑ great deal to all obviate consequences
and alleviate his distress and in Short to amke
life pass on ↑Still↑ to a great length with tolerable ease
and comfort.

For this purpose the fundamental measure
would be to restore Some Strength to the Nervous Sys¬
tem but I believe it is not to be done now by Medicine
and Some of the medicines which might be employed

Instead of remedies for strengthening his constitu¬
tion Mr Halkerston must employ & depend upon
the effects of gentle exercise very frequently used
and in no way more properly than in easy jour¬
nies. It is probable also that he might be the better
for a cold bath of a very moderate kind. The
cold applied being never under 70 degrees of Fah¬
renheit's Thermometer & rather a little warmer
or of such a temperature as may be produced by a
mixture of one part boiling water with four parts of

Besides using strengthening means Mr H
must avoid every debilitating cause & such is
a cold & damp climate. In this Respect Scotland (↑In ye respect every part of Britain ↑)
is extremely bad ↑for him↑ in winter & not good enough
for him even in Summer because it is liable
to more frequent and sudden changes than the Air
↑of the↑ Continent. ↑In Winter↑ The South of France might answer
pretty well but the South of Spain is still
much better in winter & somewhere to the
North of France would be best in Summer
tho I believe with some little care to avoid the
mid day heats he might bear the Summer of
Spain very well & especially if he could continue
During Summer to retire to a mountainous si¬
tuation.
it is all damned nonsense ¹

These measures respect his general
habit but a great deal of care must be directed
by him ti the management of his alimentary
canal. His Stomach must be accomodated
with such mild & bland nourishment as it
can most easily digest. So long as it agrees
with milk there is nothing more proper for
him & this with bread or the dry grains such
as Rice or Barley will make a diet which will
be one of the most secure & at the same
time ↑will↑ support him in as much strength as
his constitution admits of. If the Milk at any
time proves of more difficult digestion it will
be mended by water gruel or a decoction of
Rice and Barley mixed in an equal part with
it & the whole well sweetened with Sugar or
Honey. This will be especially necessary with
↑Cows or↑ Goats mild but will hardly be necessary with

Besides Milk & Grain it is probable that
in a warm climate Mr H. will bear some milk
& quite ripe fruit but he must be very cautious
in taking these very freely as they may very
possibly prove tooo cold for his bowels

Mr H. knows very well that it is absolutely
necessary for him to have regular & easy stools
to prevent all stagnation & consequent acrimony
So long as this can be obtained by Sugar or
Honey mixed with his milk it is the most
desireable means & if it should fail it is pro¬
bable that a moderate use of ripe fruit will
answer the purpose; but if this also still fails
or proves inconvenient he must have recourse
to medicines for the choice of which I

In spite of all we can do by the mildness
of diet & avoiding all stagnation in the bowels
to prevent acrimony it is to be feared
that some may prevail & for preventing it
I know know nothing more probable than
the dose of Seltzer water taken from ye 9th of
an ↑English↑ Pint to a Quart english every day.
When this water can be had from the natural
Springs it is to be prefered but in any
place it may be imitated by disolving from
ten to twenty grains of a pure salt of Tartar
in a pint of water & impregnating ye same
water {illeg} the fixed (↑by a proper apparatus↑) wih a quanty of fixed
air taken from chalk.

I Should have said above that no thing
contributes more to support appetite & di¬
gestion tho & to prevent all the ba (↑any load from↑) falling

Mr. H. seems to have been relieved from
some of his compts by the bleeding of Piles
but I cannot think there is any fullness in
his constitution to require any large eva¬
cuation this way & therefore tho I would
take no measures to stop it when nature
seems to point this way but neither would
I solicit or encourage it & therefore would I
avoid if possible Aloetic Purges. Tho I say I
would not encourage this evacuation yet I must
own that when the Piles are much swelled &
strangled it may be necessary to relieve ym by
leeches.