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I was favoured with your letter concerning
Lady Stuart in course & now Dr Monro and I have had
three days to considered her case & we have examined the cir¬
cumstances of it every day. We have told herself and her
friends that we think there is water in the belly but that
{illeg} hitherto has been very much owing to wind. To
herself we have talked so as to obviate despair as well as we
can but to her friends we have acknowledged the event to be very
{illeg}full. With respect to the management of such a case
we shoud not think it necessary to say much to you but
it is required and expected that we should give a very full
advice. To give ↑y↑ them we are of opinion that as the only hopes
can be from the discharge of water either by stool or urine,
{illeg} ↑to be↑ attempted as far as her strength shall be found to
{illeg}. We don't think she can be able to bear the more drastic
{illeg} {illeg}ives at least so often as would be necessary to make them
usefull & therefore we would depend chiefly upon the Cream

If the cream of tartar does not go to the kidneys and you also
must have intervals of purging we would fill up the time with a
diuretic Infusion of Bacc. Juniper. Sem. dauc. Silvestr. &c with a
large proportion of Sal tartari. We have given her doses of ten
grains & believe that she will bear fifteen at a time & this repeated
three or rather four times a day.

It is possible that these remedies must be varied & if you find
that dried Squills & Calomel can be admitted & found to answer we
should allow it to be a very proper remedy.

If the tension of the belly at present very moderate should come
to be considerable we would advise the long continued friction of
the belly with an oiled finger in the manner you are certainly very
well acquainted.

We have not said but that a paracentesis may in time be necessary
but we have said that at present there is no occasion to think of it.-

Lady Stuart bore the journey hither very well and we have ad¬
vised her taking exercise in the coach every day if possible.

We have advised her taking what light solid meat she easily can
and in general as dry a diet as possible

For ordinary drink we have advised her taking some wine & spirits
in a moderate quantity of water. Perhaps a good Dutch Gin is the
most eligible spirit & Rhenish the preferable wine

If thirst should be urgent we have advised the cheating
{illeg}it with a bit of lemon or tamarind

We have advised also the continuance of the flannel shirt.
And we hope we have said enough & need hardly add that we are en¬
tirely