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For Mrs Willoughby
Phthisis

I have now visited Mrs W. both night &
morning for 2 days & I know as much of the nature of
of her case as if she was to stay here for a month.
&c on this account I have advised to go home immediately
lest she soon be not able &c.

I am sorry &c but I must tell you what I
think & I have a worse opinion of it than when I
wrote you first. Her spitting is purulent her hectic
considerable & her emaciation & weakness great, &
I think I never knew one in such &c recover.

Having this opinion you will not expect that I
will prescribe much for all we can do is to make
her mind & body as easy as possible. Let her
milk in the morning be continued. Let her diet also be
continued without animal except it may be a little broth
a little hartshorn or even calves head jelly & perhaps
a little bit of white meat when she is on the road.
Her anodyne draughts will become more necessary &
[yres?] must be continued & even the dose increased
As they were to be renewed here & I did not know exac¬
tly your receipt I have given her a new one as
below which you may continue or change at pleasure. I have
put her on the use of an oily mixture which while her stomach bears
it easily [idem.?] continue. For the sake of some variety

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have ordered below an Electuary & Decoction which may be
employed at your discretion. They are not of much conse¬
quence & may be of some service. There is no little
hope of benefit from any Issue that in her present
state of weakness I cannot advise any thing of that
kind. While she can conveniently go out in a
carriage it may give her some relief but at this time
of the season it requires a great deal of caution to avoid
cold. This all at present but if any amend¬
ment or new circumstances &ccc Dr Thomas

For Mrs W.

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