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Mr. Deale

Two days ago in conjunction with my
friend Doctor Stewart I had a consultation about a
patient of yours Mr. Deale of your City.

After considering fully his constitution and se¬
ries of complaints we have no doubt that his disease
is an affection of the head and that the complaints
of his stomach however considerable at times are sym
symptoms of that. I suspect there may have been
an orriginal torpor in his constitution but whither
as a cause or an effect we think his danger at
present is from a conjestion in the vessels of the
head and this is what our regimen and remedies
are to be employed to obviate. One means, will
be the continuance of the light diet he has been long
accustomed to, and that both because it is suited
to his ailments and because he has been accus¬
tomed to it, and we should be sorry if the kind

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solicitations of his female friends should at any time
make him deviate from it. For avoiding the congestion
we fear nothing is more proper than an open belly
but nature has taken care of his constitution in this
respect and probably his vegetable diet contribute
to it and therefore we do not advice any laxative
medicine but if at any time nature should fail
we leave it to your discretion to supply the {illeg}

You know well that all internal congestions are
obviated by supporting the perspiration and which
exercise only can secure We therefore approve
much of Mr. Deales continuing to take as much
exercise as he conveniently can. That which he
takes in a Carriage is certainly very proper but
we wish that his bodily exercise was a little more
than at present. We are sensible indeed that
his corpulency and want of habit makes him inca¬
pable of taking much in this way without
sweating which is by no means safe, but if he

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would begin with the little that he easily bears and in¬
crease this by very slow degrees every day he would
soon come to be as a great deal & we think with ad¬
vantage when we are mentioning exercise we must
not omit to say that the contrary that is siting
much at business would do much harm. We can¬
not indeed suppose that business is to be omitted
but we recommend it to his discretion to avoid siting
long at one time. Cold would certainly do much
harm but warm Chambers or being long in such
would be equally pernicious. Blood letting is
certainly the most effectual means of taking of the
Plethoric state of the whole system or any particu¬
lar part, but we think at the same time that
bleeding with a view to obviate is very often a cer¬
tain means of bringing on a Plethora and therefore
we can hardly advice any preventive blood letting
but we recommend it to your attention and we con¬
fidently trust to your discretion that you will look
after his constitution and that upon the appear¬
ance of either general or occasional turgescence

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of the system you will obviate the effects of it by a
proper blood letting general or topical as your dis¬
cretion shall direct. For obviating a Plethoric
state besides the means above mentioned we know
nothing more effectual than an issue and we
think that Mr. Deale might be much the better for a
pretty large pea issue put in behind the shoulders
and if after some time it does not discharge well or
is troublesome in one place it may be moved into the
other shoulder for we are of opinion that he should
have such a drain for life. We are of opinion that
few medicines can be of service to Mr. Deale but we
recommend the following

a Dose of this kind we would have him
take every morning for a month together and that for
several times in the years. This is all that occurs to
us now, but if at any time you think we can be
farther usefull to Mr. Deale we beg hear from you
Believe me to be