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Mr Gibson

as [s?] of the 17th. current
and shall be very happy to make you a better return than
you expect. I must own that an ailment that has subsisted
for four years and has resisted so many remedies must be
difficult to cure; but I hope there is nothing either in these
circumstances mentioned nor in your time of life to give des¬
pair. It is possible that the disease cannot be absolutely &
entirely removed but I am persuaded that it can be relieved
and rendered very tolerable. This however is to be done as
much or more by regimen than by Medicines. From the obser¬
vation you make on the effects of the church or of a cold room I am
certain that you may be much hurt by cold and may be relieved
by your studying to avoid sit. If you have not a flannel shirt --
next your skin I think you should have it and be otherwise always
well cloathed and particularly in your feet and legs. If you have
not also been otherwise attentive in avoiding cold I shall not be sur¬

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prized at the continuance of your ailment. At this season you
Should be little abroad, never in the evening and hardly ever after
dinner, and at the same time you should never be in very ↑warm↑ chambers
and abroad or at home you should avoid all draughts of Air.

I am of opinion that you will never bear walking to any de¬
gree and that walking fast, walking up hill or any how long at
one time will hurt always hurt you and make you more liable
to cough; but much exercise in a carriage or on horeseback the
former in cold and wet and the latter in fair and mild weather
will always be of service in keeping your breast free from phlegm.

When Dr Fothergill advised an abstinence from animal
food he either found you in a feverish state or judged you dis¬
posed to it but I hope the fear of that is now quite over and
I would not now think such abstinence necessary. However a
full diet of animal foot would certainly do harm and a very
low diet would do as much and therefore a middling kind is the
most proper for you. Some animal food ↑is↑ to be taken every day
at dinner but none at all at supper and even at dinner the
whole meal should not be of solid meat but a great part of it

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always of broth pudding or vegetables. A few glasses of wine after
dinner are very allowable but the temperance you have commonly
observed should be strictly continued. A steady attention these
things must I think be of service and neglects in respect of cold
exercise and diet may have done you harm and may have defeated
the effects of remedies. The guaiacum advised by Dr Gilchrist was
a promising remedy but I cannot advise the continuance of it
without knowing better in what manner it was formerly employed
The Issues put into the arms were also promising and I think they
should have been continued as it was only after some length of time
that their good effects could appear. There is a remedy which
in such a case as this of yours I have found of great service
and that is vomiting from time to time. If it has not been tried
before I advise it now but without knowing something of your
constitution with respect to vomiting I cannot positively direct the
manner of it. If vomiting Strains you very much I would employ
Ipecacuanha only but if you vomit easily the tartar emetic may
be more effectual in dislodging phlegm. Besides this I have
but one other medicine to propose and I have given ↑a↑ prescription

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for it at the bottom of this page but I would not have you enter
upon it immediately nor till the season is advanced and much
milder for at present we might lose our labour. When you do
try it I would not have you use it constantly but only for a
few nights together when you find the phlegm on your breast
more copious or more tough than usual. I have thus given you
the best answer to your letter I can but must say that the informa¬
tion is not so full as I could wish and therefore if you ever come
this way I should desire to put some questions to you & should be
ready without further fee or reward to mend my advice as well as
I am able. In the meantime I am with great regard

For Mr Gibson