[Page 1]
Mr Spittal continued

I believe he may be the better for cold bathing but it
cannot be employed at present for several reasons.
The season is unfavourable & it cannot be tried untill
his present cough is quite gone & even then some re¬
gard must be had to the eruption which might happen to be
upon him in the mean time I think he can go no
farther than keeping his head close shaven & washing it
with cold water every morning.

The putting his feet & legs in warm water for
1/2 an hour or more before bedtime [might?] certainly be of
service but it should not be too constantly practised.
Twice a week must be enough & take care that his feet
& legs be always well dried & wrapt in a piece of dry
warm flannel till he is warm in bed.

I think it necessary to open some Issue &
you must either make a perpetual Issue in his back
or put a pea Issue in his arm.

I would still keep his diet low by giving him
chiefly milk & farinacea & abstaining from animal food.

He would certainly be the better for being much in the fresh
air & having some exercise both in walking & going
in a carriage & it might be tried when the weather allows
but if you find that the motion & variety of objects
confuse his head too much you must let it alone.

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[Page 2]

I expect that the Soluble Tartar must be so managed
as to keep his Belly regular without purging & if it
does no more than keep him regular you must give
him once a week a dose of your pills of aloes
Asa fœtid. & Calomel. If the Soluble Tart. be dis¬
posed to purge him he may let the pills
alone.

If you find him at some times liable to
have restless nights you [must?] try him with the anodyne
pill ordered on the other page. You [must?] begin with 2. but
must go to 3 or 4 for a dose according to the effects. You
[must?] repeat them for 3 or 4 nights following at one time
but hardly more as a frequent repetition of
them will render them useless.

In such cases the Patients being more or less
pliable is very uncertain & it is of great use to have
some who have authority over them If at any
time they are disposed to be outrageous it is necessary
to restrain them & nothing is so easy & convenient as the
waistcoat with long sleeves.

When he is at liberty he should hardly be left
alone, the windows of his chamber should be
screwed down & care should be taken that there
is nothing within his reach by which he can hurt himself.