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Revd Mr Patrick Duff -

I have considered Dr Skenes, & Dr Chalmers's letters. I too
hope Dr S--s opinion is right, but Dr C--- fears are
not without foundation, but upon the whole, I now conclude
that the Disease was originally Rheumatism, & that there
still remains a great deal of that affection in her body, &
as it is very ↑un↑common for the most obstinate Sciatic to end
in suppuration, so hope it has not taken place in this
case; however the Hectic Fever & Sweatings are very suspi¬
cious. but the report of the Infirmary man is favourable

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And Dr S--- reasoning from the pain of the Hip joint, not
being permanent while it appears often in the Shoulder & arm
is probable. To conclude all with what I should have thought
of before, the Case of suppuration is absolutely desperate. The
suppuration of Rheumatism still admits of measures for re¬
lief. I am therefore of opinion she should still try a Dose of
the Dovers Powder, which at first should be of 20 grains &
let the other directions of my first letter be observed, especi¬
ally that of raising the heat as little as possible. For the
repetition of this Medicine I must leace it to the discretion
of the Gentlement on the spot, taking notice of what I said
in my first letter on this subject. It would be of advan¬
tage if Mrs Duff would give up her Evening Opiate, but it
must be done by degrees, & it must not be ad↑o↑mitted on the
night preceeding the Dovers Powder. If Bark is proper
as I believe it may, it must be given pretty freely, but I
would not choose to speak pointedly on the subject, till
I have a report of the Dovers Powder. At the same time
I beg to know the state of the urine, both for the present
& for some time past if you can