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stomach we may hope that their effect may extend to
the [Brain?] upon this place I would advise to give gentle
vomit from time to time as want of appetite
symptoms of Indigestion shall direct. At the same time
the Belly must be kept open by such medecines as
your Experience has already found most convenient
in this case I should expect that the Elixir sacri
Edinburgh Pharmacopœia would be very proper. When Issues are
still open I would certainly continue so. I would wish
that these Issues were in the Neck arm & lower
Extremities & not on the head as I would have this
kept [for?] Blisters when occasion may require. This
occasion is such when convulsions are already come on
be which weigh pain &giddiness of thethe head or or some degree
of stupor gives you reason to suspect the approach. Tho the
former Rheumatic constitution & the late appearance of the
Blood may give you suspicion & some Phlogistic [Liath?]
I do not think the case is to be treat by Blood letting
as I doubt much if either before the fits or after them
that Bleeding can be of service, & the only time I
can find for it is when the convulsions are [present?] & if it can be
executed then I believe it the most likely means
of shortening the fits at least I have several times
found a few ounces of Blood answers the purpose When
I am thus speaking of shortening the fit I must add
that the one means of obtaining the same end that
I can support is to throw in the fœtid Enema

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our our Phamacopœia Pauperum if it can be done but I do not
mean to prevent you trying other measures by volatiles
or fœtids held to the nose &c. For preventing the return
of fits & obviating the whole symptoms I am much disposed
to trust to a low Diet for there is nothing in the Lady's constitution
strongly contraindicating. Very probably as a woman of
her condition & as liable to Nervous complaints her her manner of life
has been rather full & it must be changed only by
degrees. But I am persuaded that if she can be brought
to a diet entirely without animal food or wine she
would be much better. Till this can be done you must
employ medicine to correct the fault of the system the Bark
& Valerian are certainly the most proper remedies that can
be thought of but if are in some measure failing it must
now are become familiar & less effectual, I would
therefore change it at least for some time & give 3
times a day a dose of Colomba Root with Magnesia.
the dose of Colomba at first be 5 gr to be increased by degrees to 20 & the dose of Magnesia may
be a scruple or half a drachm according to the effect on her Belly.
If she cannot take the Colomba in [subig?] it may be
infused in water or a little spirit & water & given in
double quantity. In stomach complaints it has answered when
the Bark had failed & other medicine I expect litle from
either [Musk?] or Camphor after they have been often tryed
The Medicine I should think most likely to be of service
in preventing fits immediately approaching is the volatile alkali.
As the fits come on with fainting & coldness I think that 10 grains
of Salts of Hartshorn given then is the most likely to prevent them.
However I leave you still to try a puke or warm wine
as you have access but please to observe that the wine
alkali will do well together.