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This gentlemans disease puts on no regular
form, but from considering attentively the whole sym¬
ptoms and circumstances of it, I am of opinion that
the foundation of it is a disposition to Gout, which
shows it self by many efforts to attack the extremities,
though unhappily they are never permanent.

When such a state has taken place for some length
of time as in this case I know from much experience
that it is very difficult to correct ↑it↑ and it is seldom that
any regular gout or permanent inflammation of the
extremities can be brought on and therefore all we can
do is to advise such remedies and regimen as may
favour the tendency to the extremities & in the mean
time to obviate & remove the disorders which may arise
in other parts of the body.

For these purposes I must observe that though
Cold bathing seems formerly to have been of service
to Mr Leckie and while ↑the↑ same vigour of his system

On the contrary I am of opinion that moderate warm
bathing may be ↑of↑ great service to him. Buxton affords
such a bath and just now is the season for employing
it. I must therefore advise him to go immediately thither
and to employ the warm bath for some weeks, more or
less as he shall find it agree with him but observing
that less than two or three weeks cannot be a proper
trial. He may at first be in the bath for a quarter
of an hour only but by degrees he should prolong
the time to half an hour or more. He may at
the Same time drink the Buxton water every day
but always in very moderate quantity. While he
is at Buxton he should continue his usual exercise
as constantly as the weather will allow. When the
weather at Buxton sets in rainy there is commonly
a great deal of rain and a very moist atmosphere.

At Buxton Mr Leckies diet may be such as it
has been commonly before. I have only this general
observation to make that a full diet of animal food
or a great deal of cold vegetable food are extremes
equally dangerous for him. I say the same of
strong drink, any approach to excess would be very
hurtfull but a little wine seems to me very necessary
and certainly a littl total abstinence would not be safe.

These are the directions I think necessary with
respect to Buxton & for his conduct else where or
even there I find nothing more necessary than to say
that Mr Leckie Should ↑be↑ extremely carefull and studious
in avoiding any coldness of his feet, by thick shoes
and warm stockings to avoid all wet and if any
Spontaneous

Along with these directions I have inclosed some
prescriptions which however I would not wish to employ
till towards the approach of winter or during that
season.

One of these prescriptions is of powders & Infusion
for strengthening the stomach and enabling it to throw
of the Gout and if possible upon the extremities.

A second prescription is a solution of Guaiacum
to be employed upon occasional uneasiness of the stomach
and particularly when there is occasional for a laxative

The third prescription is for a draught which upon
occasion of headachs more severe than usual may be
employed for more certainly procuring sleep and Sweating