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Unless great care be taken I have every reason to
expect a Phthisis coming on - I will enumerate a few
of the unfavourable symptoms, in order that the Patient may
enabled the better to describe his Case, shoud it be found
necessary hereafter to take advice of the Faculty at a distance

Among other circumstances - the Cheif cause of complaint
Is the pain in the side & breast - the Cough - and thick phlegm
& mucous spit up in the Morning - nor can the flushing in
the hands & face - the head ache & the bleedings at the Nose
be called favourable symptoms.

In taking the Pulse before dinner I observed it to
beat 68 soft & even - an hour after 84 full &
quick - at Night generally between 80 & 90

As I am convinced that the cure must very much
depend upon a proper Regimen - I recommend the following
to be strictly attended to - I hold a milk diet preferable
to any other to be persisted in for 4 Months at least -
Vegetables of almost every kind are good / those only
excepted which are apt to engender flatulence, such as the
farinacious pulse peas et cetera Ripe fruits may be used
with safety - Meats easy of digestion are to be pre¬
ferr'd - but avoid all salted dried & seasoned meat &
sauces - Drink no spirits, as Liquors, nor beer which
is apt to ferment - the less Wine the better - if taken
at all it shoud be mixed with water - Toast & Water
- & Lemonade are good drinks - Neither Tea nor any
thing else shoud be drank hot - the cooler the better

suppers are an useless meal in general & in the
present Case very unnecessary. Avoid night air

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& wetting the feet - Never ever heat the body by immo¬
derate execise - be careful not to go from a warm
room / especially after having drank any thing / without
a great Coat - Let your linnen be always well
aired - and & flannen shirt to be worn next the skin
is absolutely necessary --

As to Medecines - It were not amiss once in 10 or
12 days to take X grains of Radix Ipecacuanha in the
Morning fasting - & to assist the operation of this Emetic
by large drafts of Chamomile tea - Shoud the pain
in the side continue / Mercury if it ever becomes violent
bleed instantly / It will be well to apply a Blister im¬
mediately on the Part - sometimes relief is procured
by cupping - or let a seton be placed there - If the
Breathing shoud be affected, either put a Blister on
the back or ap cut an Issue under Scapula - which
I prefer thereby freeing the Bronchial & Intercostal
Nerves from that spasmodic irritation. In this Case
30 drops ofAntimonial Essence Huxham's Tincture together with 20
drops of Sweet Spirit of Nitre may be taken every Morning
The body shoud be kept moderately open - If the Cough is
very troublesome & the breast sore - drink largely of fresh
drawn Linseed Tea sweetened with Liquorice root

The common Pectoral decoction & barley water are
also good - If after a due observance of what I have
here laid down - the Complaint shoud continue or
increase It is my advice that the Patient be

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sent a Voyage to sea without delay - and if he
finds himself easier at Sea - the Voyages shoud be
frequent or lengthened - let the direction be South¬
ward - A short Residence also in Portugal - The
farther parts of Spain or in the Canary Islands
might also prove very beneficial

Extract of a Letter dated 10 December 1775

"Although I cannot refrain to express my concern at
"the account I have just received - yet I must own that
"it is no more than I expected - especially as you delayed
"to follow the advice I gave you - You complain "of a
"more violent return of the pain in your side," also "that
"your appetite fails you - Your Cough & spitting likewise
"continuing" - Then My advice is that you let your first
journey a Voyage be hither directed - where I coud wish
you to consult with our Modern Esculapius - or if
you chuse to authorize me I will consult Doctor Cullen
& inform you of his opinion. In the mean time I have
only to reiterate the advice I before gave you - added
to which is my desire that you shoud begin as soon as
possible to drink asses Milk every Morning- nor can I
omit to remind you that a more than ordinary case
is necessary at this juncture - when the very Air is
fraught with Contagion - The same epidemic disorder
having already infected most of the Northern Provinces ¹ ,
Germany Holland & England, and Edinburgh is now at

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this instant in one universal fit of Coughing

Extract of a Letter dated 20 Jan 1776

The Journal of your Case wants no technical terms and
you describe it tolerable well - beside, I begin to draw a
secret satisfaction from it - for I flatter myself able to
discover that you begin to take care of yourself - And
if it is really so - Why then My friend shall soon have his
health again - and I will lay him under fewer restrictions
- As to Physick - I mean drugs - since they are so difficult
to be had in Campbel town - we will endeavour to do
without them - save now & then a gentle Vomit / fasting /
of Ipecacuanha or Oxymel of Squils - when the Head
breath and breast shall be affected. Tho these are old Womens
remedies - they are not the worse for that & may be
joined to the Prescriptions of your House Physicians - I
suppose you mean Father & Mother - provided they have
Spirits, wine & fermented Liquors out of their Compositions
- there will be no danger in following their directions.

The Pain in your Breath & bleeding at the Nose you
say has left you - you Cough & spit very little - Why
then will have nothing to do with Blisters & Issues
for the Present -- Whever bid you "dabble your feet
in warm water - take Spirit of Hartshorn, Gruel, -
Isinglass & Madeira - at Night - but not to sweat" must
have studied & practised - where I never yet have been
or heard of.

I have no objection to the warm Milk upon

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Honey in the Morning provided you take especial care
not to get cold - which this mixture will more or less
subject you to - A cup of Chamomile tea now & then
is very proper - but, as to your mixture of Acid Spirits
Candy et cetera et cetera they had better be given to the Surgeon
who recommended them to you - You may take gentle
exercise on horseback if you like it - but whenever an
opportunity offers that you can sail out to Sea - though
it be for a few hours only, days, indeed woud be better
embrace the occasion without delay. I like your
Breakfast & dinner exceeding well - but as for your supper
- it were better bestowed on the first poor object that
pass by the door - and you woud be sure of a reward, by
a good nights rest. et cetera et cetera

Extract of a Letter dated Edinburgh 6 February 1776

Your last Letter only served to confirm what I before expected
- from the Account I received of you from Colonel Campbell-
that your Complaints have returned - Nor do I see what
it can prevail my prescribing for you while some one
or other is allowed to object - and I must own to you that
Mr C woud have shewn more delicacy to me & candour
to you - if he had made his objections to my advice while
I was present - but my opinion of your Campbel town
officiators in Medicine - is no better than that I have of
your Laboratories - which are not the best supplied with
drugs - wanting indeed, some of the most useful & at the

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same time most common articles in the Materia Medica
so, I have all along endeavoured to order as few as
possible - Those who bid you {illeg} apply the Blister
to the belly instead of the back as I directed - where I suppose
tical ² the same learned persons - who advised you to the Heterodi¬
composition of Hartshorn, IsingGlas, gruel Wine
Spirits et cetera -

Indeed Archy I always feared a return
of your disorder - and so it will again & again unless you
pay a rigid attention to proper advice - whether the
Rules I have laid down deserve that appellation -
beither you - nor your Ignorant advisers can say - because
you have not followed them - This I can say - and I have
this instant read them all over again - that to the
best of my Judgement I coud do no more - Not but I woud
heartily thank any Man that shoud point out a more
proper or efficacious mode of treating your disorder
founding his Knowledge upon Theoretical facts & prac¬
tical experience.

There is always a great inconvenience
in prescribing for Patients at a distance - Therefore I
again recommend it to you to embrace the first conve¬
nient opportunity of coming to Edinburgh - that I may
take you to Doctor Cullen - whose judgement & opinion
in disorders of the breast especially - I woud rely upon, more
than ↑any↑other Physician I know - If this cannot be, you
must learn to distinguish the difference between a
continued sensation of pain in your breast - and an

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acute sudden pain in your side - when you can do
this, I refer you to my opinion dated Campbeltown 19 November ↓1775↓
- where I have made the distinctions x in what places the
Blisters are to be applied - and also when bleeding is neces¬
sary - which I now farther recommend may be as
seldom as possible - never but in case of immediate
necessity such as a sudden violent haemorrage at the
Nose - acute pleurisy, difficulty of breathing & inflam¬
mation. - My Letters of 10 December and 20 January I also contain some
rules & advice which I see no reason to prohibit - Except
the Article of Exercise - and I do enjoin you now to take
no other exercise than riding in a Carriage - or gentle
walking. No more dancing I beseech you et cetera