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For Mr. Grant of Montrose

We have very attentively considered the account
given by Mr. Bate & we are sorry to observe that there
is no doubt to be had about the nature of his disease
He has now got water in his Belly & tho' there were
no previous marks of any particular affection of the
viscera it is highly probable that there is some such,
& we consider the previous disorders in his Stomach to
have proceeded from the same.

In such circumstances our prognostic must
be unfavourable but at the same time we hope the Case
is not absolutely desperate but that there is still room
for attempting his relief. The purgative employed by
Mr. Bate was very proper & we think it might have
been repeated with advantage but we doubt if it could
be repeated frequently on account of the Calomel in it
We advise a trial of the Cream of Tartar alone by giving
a dram of it every ten hours from the morning onwards
till it purges him & we would have this repeated every
two days unless it purges him more largely than
his strength seems to bear but to expect that by

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giving it thus par reprise it may operate by
Urine with moderate purging only If this proves to
be the Case the medicine may be given every day
for several days together but it must be left to
the direction of somebody upon the spot to judge
whether it may be given every day; every other
or third day and if it can be brought to a proper
Operation & such an Operation as he can bear it
is what we think most likely to give him relief But
on the other hand it is possible that the Cream of
Tartar alone may not operate properly either in
the one way or other & in that Case we shall think
it adviseable to join some jalap to the Cream of Tartar
& two scruples of the later to an ounce of the former but
let the jalap be always well & long rubbed with double
its weight of the Cream of Tartar & then the rest of
the Cream of Tartar to be added. This mixture either
in Powder or made with Syrup into an Electuary may
be employed in the manner proposed above for the Cream
of Tartar alone only with some Caution against its
purging too much While these medicines are tried at
intervals only we shall think it very proper at these
intervals to employ Diuretics & we have no objection
to employing the Crocus Syrup but we have learned
from experience that this medicine is seldom useful
but when employed in much larger doses than Dr.
Stork first proposed ¹ If the Doses therefore already
employed have not appeared to be manifestly Diuretic

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let the Doses be freely but gradually increased to what
his stomach and Guts will bear We must observe that
we have frequently found it an uncertain medicine & that it
often does not prove Diuretic in any dose & if that shall
happen to be the Case with Mr. Grant some other Diuretics
must be employed & for one which we have often found
effectual we have given a formula below.

While attempts are thus made for Mr. Grants relief
we advise him to avoid as well as he can all liquid food
& as well as he can to take to the dry & solid. It is well
that at present he has little thirst to lead him to drink
much but even if thirst should come on he should take
as little drink as possible. One of the most proper drinks
will be a weak punch made of good Dutch Gin & with a good
deal of Lemon so that he may quench his thirst without
much drinking. If he can bear going abroad in a Carriage
some exercise in that way daily may be of service to him
It is possible also that a gentle and long Continued friction
of the fingers dipped in oil may have very good effects.
If his swelling can be taken down to any degree some tonic
medicines may be useful but it will be time enough to
employ them hereafter when laxity & uneasiness is the
only disease.