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I have considered the Case with great attention and
though I think there is much reason to suspect a
Phthisical disposition I hope that no disease of that
kind is yet formed and that the case may be
considered as that of a general debility only.

The means of mending this may I hope be
such as may at the same time obviate any disposi¬
tion to Phthisis. The Ladys first care must be
to avoid cold by a flannel Shirt next the skin, by
warm Cloathing in general and by every other
precaution against cold and moisture. With these
precautions her chief remedy must be her being
much in the open air and in gentle exercise
on horseback or in a Carriage. Her walking should
be very little and {illeg}. If she can have
a {illeg}
Sea Voyage {illeg}

While there is no symptom of hectic come on I would
not forbid her to take moderately of light Animal
food at Dinner but for the most part I would
have her live on milk and farinacea as a diet
sufficiently nourishing in her present state
of weakness and perhaps more so than any
Animal food would be. In the present weak
state of her stomach I think she should avoid
or take very sparingly of Roots, greens or
other garden things. Her ordinary drink should
be plain water or toast water alone avoiding
all sorts of fermented liquors, Malt liquor
because it is flatulent and wine because it
is heating.

If the pain of her breast continues [fixed?]
and troublesome let a blister be applied upon
it but the [place?] not turned into a perpetual
blister but [healed?] up that it may admitt
of another {illeg} necessary.

I cannot suppose that bleeding can be proper
for her unless circumstances occurr that I have
not yet heard of.

If it be certain that no Hectic symptoms
are yet come on I have no objection to her taking
moderately of the Peruvian bark and in substance
rather than in any other form.

I think the Gums are not necessary and
may be heating.