[Page 1]
For Lieut Gilchrist

As the history of Disease is very distinct & full
I have no difficulty in forming my judgement con¬
cerning it. I think it is evedently an apoplexy and
Palsy from a serous effusion upon the Brain It appears
that at least since the beginning of January last
there has been a disposition to such effusions and
I have no doubt but his asthmatic fits have been
owing to such on his lungs The event of the whole
is very doubtfull and likely to prove fatal but it
is not desperate as a sanguine effusion or congestion
would have been and there is room to hope that
as many others have in like cases been {illeg}

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[Page 2]

So Lieut Gilchrist may be recovered The blister
all already applied are extr↑e↑mly proper and it will
be desireable to keep some part of his head running
as long may be If the blister last applied is dryed
up before this comes to hand let a fresh one be applied
and some part of it afterwards turned into a perpet¬
ual Issue or if that is very troublesome let a seton
be put into his neck at any rate let a Pea Issue be
immediately cut into his right leg on the inside
a little below the knee His most ready ref relief
is I think to be obtained by purging and promoting
urine Let some Bolusses be made of five grains Jalap
and one grain of colomel one of these is to be taken
early in the morning and repeated every hour till
they begin to operate and then stopt This operation
may be repeated every third day for severall times
after the first trial it will be learned at what intervals
and how often the Bolusses are to be repeated

On the days that he does not take the Jalap let him
take the following Electuary

Of this let him take a tea spoonful early in the morn¬
ing and repeat it every half hour till he has taken
about the fourth part of the above If this gives several
stools it is enough but if it does not the dose next
day must be increased On the other hand if it in
does (↑is↑) found ↑that↑ the Electuary can be brought to purge

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very freely and at the same time as it commonly does
to promote urine it may be continued for several days
together and the Jalap posponed These are the
measures I would chiefly depend upon but if he
cannot be got to take medicines by the mouth he
must be tryed with injections which may give some
relief tho they cannot produce much evacuation
I should be fond of vomiting while continues
upon his brain other internal medicines can at
present do little the effect of any [medicins?] stimul¬
ant is very precarious so that Erutions employed
shou'd employed at long intervals only
If he admit of any diet that shou'd be light and
and cooling while his pulse is so frequent he may
require drink but that other ways the less {illeg} (↑liquid↑)
he takes the better