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For Mr. Johnston of Addergold

I have considered this Case with the
utmost attention, and find it difficult to be
accounted for, but hope it may be in time
relieved. It seems to have been originally
an Enteritis or inflammatory Colic, but I
hope the repetitions of it, are not attended
with so much inflammation, and consist
only and at least chiefly in a spasmodic
constriction, and that by obviating this
we hope the violence of the disease may
be avoided, and at length entirely removed.
Whether it depended at first upon a
redundancy of bile, or of acidity seems to be
doubtful, but I am of opinion that both
of these may depend upon such a loss of tone
as gives occasion to spasmodic constriction.

To obviate this loss of tone would be
with me a principal measure for preventing

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the [recurrence?] of the disease and which may I
hope more easily be done as these recurrences
are now more confined to one season. Durin[g]
the Summer he should continue to bathe [in]
the Sea every second day. At the same tim[e]
or at least from May till August let him
take the strengthening Electuary prescribed
below, taking it on the days he does not bathe.
In the month of September and after it durin[g]
the Winter, he should take great care to av[oid]
every part of diet that shows any tendency
to become sour or windy on his stomach, and
how for milk meals are of this kind
should be particularly attended to, and if
acidity at any time discovers itself, it
should be immediately corrected by [Absorbents?]
and Aromatics, by testacea or Magnesia
as the state of his bowels may indicate.
When the coming on of the disorder is
apprehended from his change of colour

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and loss of appetite, care should then be taken
that there is ↑at the same time↑ no approach to costiveness
which should be immediately obviated by
laxatives which may at first be gentle, but
should be rendered stronger as occasion may
seem to require. When both pains and
costiveness are considerable, the medicine
I would particularly recommend is the Oleum
Ricini, but always mixed with a fourth
part of the Tinctura sennae composita of the
Edinburgh Dispensatory, or as much of the Tinctura Jalappæ of the London. By mixing three
Ounces of the Oleum Ricini with an
ounce of any of these tinctures, you will
find that by shaking the Phial very well
that a ↑lately↑ spoonful more or less may be
taken more agreeably and {illeg} (↑sit↑) better with (↑on↑)
the stomach. If it does not Dr Clark must
find out some other laxative that will
for by the repetition of proper laxatives, the

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[fit?] for the time is to be get the better of, and
after it is over the Nervous weakness will
be best remedied by Bark and Columba. At
all times Mr. Johnston should be much
in the open air, and as much in gentle
exercise on horseback as his strength and
the weather will allow.

In point of Drinking he should take
neither Wine nor Malt liquor of any
kind. A little spirits and water may
be allowed, but always in very moderate
quantity.

For Mr. Johnston

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