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Your case appears of difficult cure. I have little doubt
about it, I take it to be entirely spasmodic & think there
is no appearance evidence of either polypus or aneurism in
the great vessels near the heart --- I hope there is no immediate
danger but a spasmodic affection probably hereditary, sup¬
porting the system so generally must be ↑of↑ very difficult manage¬
mt. Antispasmodics may give some relief & as long as
you find benefit from Camphire I have no objections, to it;
but any chief dependa↑e↑nce would be upon Opium taken
freely, when you do take it, but I would wish seldom
for it cannot give but a temporary relief; & the frequent
use does harm. If you can obtain any durable relief
it must be by tonicks; & I prefer Chalybeates to every
other. You say you have tried it, but I fancy but in
small quantity, & I find that we not only can give it in large
quantities doses, but they are commonly necessary to do
service. I begin with five grains of the rubig: Chalybs
prop. mixed with a little cinnamon & sugar, but gradually
increase the dose to ʒſs twice a day & even wash down
that either by a draught of some chalybeate water or by
plain water with some drops of Tinct. Mart. Ph. Edr ¹ ---
These are the only medicines I can recommend but much
depends on regimen. You judge well in livg always
in cool air & your drink should always be cold. Considering
the disposition of your Stomach to acidity I think you
should taste no kind of ferment liquor, plain water your only