[Page 1]

[Page 2]

[Page 3]

[Page 4]

I was favoured with yours last week but by
particular accidents it has not been in my power to write
an answer before now.

Mr Mylred's case is certainly a very bad one & I
cannot give any favourable prognostic with regard to it
but I do not either absolutely despair as he has recovered
the use of his limbs & that the fits tho' still recurring are
much slighter than before there is some reason to hope
for some benefit from proper remedies & at least very
good reason for attempting these.

It appears to me that the remedies you have hither¬
to employed have been extremely proper & have had
success to a certain length but we must still try some
other remedies (↑what further↑) as the changes which have happened
in the disease may suggest.

I am ↑or↑ persuaded that there at the first attack there
was a considerable congestion in the vessels of the head
that they are not yet unloaded & that their plethoric
state may again readily occur. I would therefore advise
a few ounces of blood to be taken from each temple
once every ten or twelve days. It will be best taken
by cupping & scarifying but if that cannot be easily
done it may be by leeches.

At the same It will be proper also to keep his

The Issues in his ↑thighs↑ must be kept open but that
between his shoulders I would remove to the crown
of his head.

I expect little from internal medicines but if your
Valerian root is very good & you can get him to take
it to the quantity of a drachm twice a day it may be
of service especially if it is perceived to keep his body
open as in that quantity it sometimes does.

I would not now expect any benefit from warm
bathing & doubt if it would be safe but I expect he
may receive benefit from the flesh brush applied to
his whole body but especially to the lower extremities
The friction should be gentle but long continued.

If you can have Electricity applied it may pos¬
sibly be of service but this is not certain & the use
of it requires caution & then the trial may be safely
made. Let the shocks be very gentle especially at
first & according to the effects let them be increased
in force & number but ↑in such a case↑ it is never safe the making (↑to make↑)
them very strong & in this case it will be much safer
to apply the shocks rather to the limbs than to the
head.

His diet should be of a middling kind. He
should have some meat & may take a bit of any plain
meat to dinner every day, but should take no meat
at Supper. Even at dinner he should ↑not↑ make a full
meal of meat but should make it up with broth or
pudding. he should hardly take any roots or greens
any that is any cold or flatulent food. [Oi?]

For ordinary drink he may take Toast water
sometimes with a little wine in it & in that shape
or any other he may take to the quantity of half
a pint of good sherry every day. If it can be

If it can be any ways conveniently done he
should have exercise in a carriage for two or three
hours every forenoon.

It is necessary to defend him well against cold
& he will be the better for wearing flannel every
where next his skin.

The above is all I think necessary to say at
present if you have any remarks to make or
questions to put or if any new circumstances
have cast up I shall be very willing to write
again & you may expect it more punctually than
has happened now.

You put a question to me about my fee
which I am never willing to answer for the
most part submitting my own opinion to that
of others in this matter but if I must speak to
you I shall tell you that my fee is according
to the circumstances of the season & the trouble
I have from.

Nothing can give me more pleasure than
to hear of the Governors recovery & please make
my compts to his Excellency in ye most respectful
manner. Please tell Mr Betham that I shall
always rejoice to hear of the welfare of him & his
family. I am Sir with very great regard