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I have no doubt in considering his complaints as a
Spasmodic Asthma tho not exactly in the most common
form; but I have known great variety in this disease
& the peculiarities in Mr Browns case dont hinder
one from thinking the Asthma the fundamental
disease. This conclusion however is not very comfor¬
table for of a hundred Cases of this kind I have hardly
known one that admitted of a radical cure. In most
cases we can only endeavour to moderate the fits and
to prevent their frequent return- For these purposes I
believe that most of the remedies commonly known here
have been in this Case proposed & tried & I have nothing
very new to offer; but I shall give a few remarks upon
several remedies that have already or may be tried -

The siziness of blood gives some encouragement to-
bleeding & it commonly gives some relief, but frequently
the relief obtained in little & even when more considerable
it is commonly, but of short continuance & I have constantly
found that frequent bleeding disposed to a more frequent
return of fits. I would therefore advise Mr Brown to abstain
from bleeding but upon the most urgent occasions-

Vomiting in the time of fits is commonly a severe
operation; but if it is easy to Mr Brown & can be excited
without any strong remedy & especially if it is found to
favour expectoration I have no objection to Mr Browns
trying it employing it. It is common enough for Asthmatic
fits to be proceeded by indigestion and an inflation

of Stomach and in such circumstances I have known-
a Vomit prevent a fit or at least render it more moderate.

I have so often known Opiates give relief that I
am a little surprised at the effects of the Elixir Asthma¬
tiam ¹ on MrB. & am ready to suspect that it is owing
to some other of the Ingredients than the Opium
& unless he has already tried simple Opiates and
found them hurtfull I would still advise them
with this observation that if they are taken
immediately upon the coming on of the fit, they
may disagree with him as the smoaking does
but if the Opiates are not taken till the beginning
fit is beginning to yield they may be of great service.
however let him try what he can bear; but I
am disposed to think that the sooner he can take
the Opiate the better as I think it is the only remedy
to be depended upon for checking the frequency of
Stools he has been liable to.

Of the various things which in the time of Parox¬
yams may be employed to alleviate them, I leave
him to chuse what he has found to answer best; but
there is one remedy wc I believe he had not tried & which
I believe I find more effectual than any one I ever
tried- this is the Vitriolic AEther or Liquor ↑AEthereus↑ Vitrialicus
of our Disp- ² If this can be got good he will

find benefit from it. It is to be taken at first in doses
of 20 or 30 Drops; but may be taken afterwards to
a Teaspoonfull of two; It is always to be taken in a
little water & it would be right to learn of somebody
who has used it the proper management of it, as
a great deal depends upon this. Tho the Aether
should give him relief, he should use it as seldom
as possible as frequent repetition destroys its
effects. - ; Coffee and Indian tea both bad for
him. the frequent [sipping?] of mild tepid liquors may
be often necessary; but I wish he he could reconcile
himself to some other than the common Tea -
If he was in this country I should recommend
Ground Ivy to him; it may not be found in
the West Indies; but I some very light Aroma¬
tic plant or flower may be found that will
not affect his Nerves like Common Tea --