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Miss Furie

I had no more time on Saturday night than
just to acknowledge the honour of your letter but I have since
very attentively considered the whole of your accurate account
of Miss Furie's complaints. The general delicacy of her con¬
stitution and her former winter complaints with the present
circumstances of them must give us some suspicion of approaching
phthisis but I hope it is not yet far advanced and by no means con¬
firmed and I think she has the better chance that she has come
into hands who have employed the most proper remedies that
could have been proposed. But as the Lady's friends, for whom
I have a particular regard, do me the honour to ask my advice
I shall here give the best I can. The bleedings employed have
in my opinion ↑been↑ extremely proper and if pains of the breast or Sides
with any difficulty of breathing should recur, I still think the
taking away a few ounces of blood maybe of service. The blis¬
tering was also a proper measure and upon any return of pain
it should I think be repeated and even tho no pain were present

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I think a small perpetual blister on the might be of service
In such cases small bleedings, blistering, Diet and exercise are
the remedies I depend upon but at this Season and in such a recent
Case I cannot advise the latter and even within doors I think every
precaution against cold is necessary and therefore the flannel shirt
is extremely proper. However tho it be necessary to guard against
Cold I hold much external heat & therefore very warn chambers to
be very improper. With respect to diet I cannot order it more
properly than you have done it but I regret much that she does
not agree with milk which I should otherwise think extremely prop[er]
But as she bears Asses milk very well it is probable she would also
bear Cows Milk diluted with an equal quantity of thin Watergruel
or Barley water very well sweet↑e↑ned with sugar or honey, and wo[uld]
with to have ↑it↑ tried but not in large quantities at first. As I have
often found Nitre irritate a cough so I disswaded ↑it↑ in this case in
my last letter. The Rob Sambuci is certainly most proper but I be¬
lieve you may improve it by joining with it two parts of a thick
Mucilage of Gum Arabic. The use of Opiates I am not very fond
of in such a recent case but tho frequency of cough in the night pre¬
venting Sleep often renders the Anodyne necessary and now after you
have induced some habit of it, it is not easy to get quit of it but I leave

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the matter entirely to your good judgement. There is also another
particular and if I mistake not peculiar to this case that I must suggest
to your consideration. The sudden suppression of the Catamenia
and the disappearing of the fluor albus shews a constriction of the
Uterine vessels to have taken place and to the coming on ↑of↑ the spitting of
blood seems to shew that in consequence of that constriction there has
been an increased determination of blood to the breast. How much this
may aggravate the phthisical tendency you will readily perceive and
I think it is probable that ↑if↑ we could take off the uterine
constriction we me might be of service to Miss Furie. I know
of no probable ↑& safe↑ means of doing this but by warn bath¬
ing. May we not therefore towards the approach of the
next menstrual period employ a semicupidium for two
or three days taking care that the heat of the bath is very moderate
not exceeding 90 degrees Fahrenheit but continued from half an hour to
an hour as the patient bears it. Please consider this matter and
I shall be ready to correspond with you further on the subject. I am
with very great regard Sir your most obedient humble Servant