[Page 1]
For Mr MacKenzie

I dont think it possible to cure Mr Mackenzie['s]
disease entirely I believe it will be ready to return
upon occasion for a long time to come but I am
persuaded that by proper management he may
prevent the frequent returns of it and when it
does return that the violence of it may be much ale¬
viated. For preventing returns we must use
a light diet taking care never to fill his stomach
with any kind of animal food and to avoid
all things heavy of difficult digestion. His ordinary
drink should be plain water but when his

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[Page 2]

breathing is more than usual uneasy he may
put to his water as much as the cooling Mixture
prescribed on the paper apart as will render
the water slightly acid. He must avoid all kinds
of Malt liquor. He may take a glass or two
of wine at dinner but must of no account go
farther as being in the least heated by strong
drink will always [aggravat?] his complaints

He must avoid all sort of bodily exercises but of
the most gentle kind but going on horseback or
in a carriage at an easy pace may be of much
service to him. He must take great care to avoid
cold and in damp and cold weather he should keep
much at home. In very warm weather he must
keep himself as cool as possible & particularly
avoid being in the sun. He should always go to
bed betimes in the evening and get up pretty early
in the morning but several times a day he may
rest upon his bed for a little but without sleeping.
He should continue the Issue in his arm but it
may be shifted from the one arm into the other
To prevent the frequent returns of his disease
I hope the pectoral pills prescribed on the paper
apart will be of service he may take them
for two or three weeks together but he should
then lay them aside & only after a week or two

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[Page 3]

intermission take another course of them
upon returns of more severe asthma if it has
brought on by smoke dust or other such accident
causes it may be expected to go soon off again
& it will not be necessary to have recourse to
any medicine but if the fit either obstinate or if
it has come on withour evident cause I expect it
will be relieved by the use of the ethereal spirit
prescribed on the paper apart. The dose at first
may be a single tea spoonfull but it may be
increased to two or three & taken two or three
times a day but observe that it should be [reserved?]
as much as possible for severe fits as a frequent
repetition render it of less effect. It must
always be taken in a little water & the best
way of managing it is by pouring the dose into
a two ounce phial nearly filled with water and
stopping the phial with the thumb inverting
it and shaking it a little the whole is to be swa¬
llowed so soon as poured out the phial con
tin containing this spririt is always to be kept
inverted and standing upon the cork. As the
spirit is consumed a little water should be added
to the phial so as keep it always nearly full.

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[Page 4]
For Mr Mackenzie