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For Miss Middleton.

I have carefully considered the account which Miss M. has been
pleased to give me of her ailments & can percieve that they have
now had so long a se↑a↑t in her constitution that they may require
a great deal of time & pain to be removed but I hope that at length
they may be greatly perhaps entirely relieved. After the swellings
which Miss M. was troubled with last year, I am very doubtful if she can
safely meddle with any mineral waters whatever, if she does it must be
by a very cautious trial & that of Bath will be the safest. But I am
clear that nothing promises to be of more service to her than a
long Journey and I think she should try this as soon as the weather

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& her own strength will admit of it. It is very possible that a sea voy¬
age might be of service & I should not be much afraid of the sea sick¬
ness, but as it would be undertaken with diffidence & perhaps attended
with anxiety & otherwise exposed to uncertain circumstances I cannot
advise it, but in the case of a land Journey's being impracticable which
I hope shall not be the case. Till this can be attempted Miss M. must
palliate her ailments as well as she can. The Laudanum must be
continued both to promote rest and remove pain ↑and↑ if Miss M. can find
it has the effect of preventing pain & retching, she should take it
other times as well as at bedtime, but I cannot speak positively a¬
bout this without being upon the spot and knowing the course of the
ailments more exactly. The chief inconvenience of the too frequent
and free use of Laudanum is costiveness & this must be carefully ob¬
viated. The best means in this case will be ↑by↑ water Glysters which
I think may be otherwise useful and should be given frequently &
in large quantities Besides the use of the Laudanum I hope Miss Ms com¬
plaints may be relieved by the infusion ordered below. As she finds
her stomach bear it she may take 2 or 3 tablespoonfuls at a time
& she should take such doses 2 or 3 times a day. It will best to take
them at some distance from her little meals, but I would have her
try them particularly when she feels that oppression at her sto¬
mach which is the forerunner of her retchings. As the stomach
is so often a nice & whimsical organ if the infusion should not
answer I would have her try also the steel drops ordered below.
They are to be taken by 20 or 30 at a time in half a gill of water.
This must always be pretty warm, and the times of taking are the same
as for the infusion.

For a stomach ready to reject every thing, it is difficult
to prescribe a diet and in such cases for the most part, the rule is to
give what the stomach can bear tho' perhaps otherwise not very eli¬
gible.

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At present the Chocolate the Sago or Panada do seem to me very
proper, & I believe some other things prepared from a grain might
also be tried but I suspect that no kind of wine added to any of these
will answer well & if something to give a relish to these otherwise
insipid things is necessary I would prefer a little Cinnamon Tea
with a teaspoonful of brandy to any kind of Wine. Miss M. has
not told me if any kind of feverishness hangs about her or at
times disturbs her & therefore I dare not say how far she may try ani¬
mal food but I imagine that a little broth or Calves feet jelly will
be usefull to her. I wish too that her own inclination might be
gratified with a little milk, but while this is so much disposed to
curdle it cannot be proper. I have however frequently found that
new milk mixed with an equal part of warm water gruel & well
sweetened with sugar was more easily digested than plain milk &
Miss M. may at least make a trial of this. I must conclude that
with observing that all the circumstances of Miss Ms constitution &
ailments, are not fully told & therefore my directions may not
be exactly suited to them but if Miss M. shall be pleased & co cc