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The history of his case communicated to me
is seemingly full exact and written with good judge¬
ment and allows me to be very confident in the
opinion I have formed of it.

Tho there are threatnings of Atony and some¬
thing Paralytic, the disease at bottom is certainly
the Gout, and there are none of his symptoms but
can be explained upon this supposition. The pains
he has had and in some measure still has in some
joints may have been usefull, and no application
should be made to put them away, but they have
been too vague, incompleat and transitory to give him
good health, and I am afraid that this will not be
established till a more compleat fit of the gout shall
come to his lower extremities. –

This however it is very difficult to procure by our
art, and we can only do it by a proper regimen to put th[e]
general system in such a good condition, as to allow
the operations of nature to have their proper course.

The fundamental article of this regimen is
proper exercise, and without this I know from much
experience that everything else will have little effect.
Walking moderately on dry ground and in dry weather
is allowable, but it requires discretion, for much walking
so as either to bruise the feet or fatigue the body, is more
ready to put off than to bring on the gout. Of all other
exercises going on horseback is the best, but in this
case the weakness of the head and hands and especially
the present state of the season hardly allows of riding,
for any chillness of the lower extremities might be very
hurtfull. At present therefore Mr Gordon must

It is of the utmost consequence for Mr Gordon

With respect to diet a full one would certainly be
hurtfull but a very low one would perhaps be more
so. Every day at dinner he should take a little solid
meat of any plain kind he likes best, but make up
his meal with plain soup and bread and with some
kind of pudding. A little bit of vegetables may be allowed
but he should not take them largely. He should take
no animal food at supper and some kind of milk meat
is the most proper. At breakfast both tea and coffee
are improper and he may take cocoa or weak
chocolate, or as at supper milk with pottage or
bread.

Malt liquor of all kinds and particularly small
beer I think improper, and for ordinary draught

Two or three glasses of wine at dinner or after it
every day is very proper, and it should not be of Claret
Hock, French white wine, or other small bodied
Wine, but should be red Port, Madeira, or very good
Sherry. I hope the quantity proposed will prove safe
but if he should find it either to heat him or touch
his head in the smallest degree, the quantity must
be lessened, or perhaps even then diluted with water.
if every kind of wine should be disagreeable he

Both in view of his gout and his natural con¬
stitution it is very necessary for him to keep his
belly regular, and if nature does not do this for him
he should never be ↑above↑ two days without taking a
medicine. For this purpose in a gouty case I pre¬
fer guaiacum to every other Laxative. Guaiacu[m]
in Rum has been usefull to some persons and it
seems in some to cure the gout entirely, that is to
prevent the inflammatory pains of it, but I have
known it do so by bringing on a worse that is a
fatal disease. I cannot therefore advise it in the
Rum Tincture but in the formula here subjoined
and taken only in the quantity necessary to keep

In this case Tonic remedies seem to be indicated,
and might be usefull, but cold bathing while pains
are frequently attacking the extremities, is in no
ways admissable. If the stomach was more con¬
siderably affected than it is now, Bark bitters and
Aromatics might be usefull, but while the appetite
and digestion are tolerable, I would rather let alone
these remedies. – While there are pains of any kind
I suspect some inflammatory disposition to be present
which hardly agrees with Tonics of any kind, and there¬
fore I would even delay the tonic which I think the
safest, that is the Chalybeate medicines.

Warm bathing has sometimes been usefull, but it
seems to have done no service to Mr Gordon, and with

If any symptoms should threaten his head I would
apply Blisters to the inside of the Calfs of both legs, but
I would not willingly do this while there are any pains
flying about or threatening the lower extremities. A pea
Issue a little below the knee may be usefull but I can
hardly think it yet necessary.

The use of the flesh brush very properly employed
at present should certainly be still continued and will
be still more usefull when the exercise I have proposed
above is joined with it.

These are the advices I can offer to Mr Gordon at present
but upon a report of the effects of these, or upon any new
occurrence, I shall be very ready and desirous to contri¬
bute every thing in my power to Mr Gordons relief.