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To Mr. Mack

yours of the 5th. I received only yester¬
day and that so late that I could not answer it in course.

The ailment you speak of seems to me to be a flatulent
swelling tho you leave me a little uncertain as you do not say
whether the child has than any evacuation of wind and
of (f) if this makes any change on the state of the swelling.
However that may be, nothing but its depending on flatulency
will account for the sudden rising & falling of the swelling.
I have many instances of children being more or less in a tym¬
panitic state and I cannot suspect any collection of water
while there is no scarcity of urine and while the child in respect
of sleep appetite and stools is seemingly in good health. I
tho give you my present opinion but shall allow what may
hereafter occurr to correct it if necessary. In the mean time
I think you have treated the ailment very [correct?] but

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chalybeate is what I chiefly depend on and you may gradu¬
ally increase the dose of the Rubigo to five grains twice a
day adding to each dose a little cinnamon and sugar. The
rhubarb I would reserve till costiveness may require it and
then it may be given with Magnesia. The exercise you
have advised is exceedingly proper and should be continued
as far as weather will allow. Tho it has ↑not↑ done all we
wished, the diet ordered is still very proper. As little liquid
food as possible and therefore little broth and no tea. A little
solid animal food seems necessary and a little port & water
is very allowable providing always that neither the meat nor
wine shall be found to give any heat. A little egg either in
pudding or by itself may be safely tried. I should think every
kind of malt liquor very improper. By these measures I
hope you shall have success and I earnestly wish it being
always Dear Thomas