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There can be no doubt with regard to the disease nature of the
disease which this Gentleman has been afflicted with -- It is evidently
Rheumatism of the acute kind and probably might have been relieved sooner
than it was, by letting more Blood. Now however it seems to be quite gone
but it is an ailment very liable to linger in a chronic form and liable to
also from several causes to return in an acute form so that the Gentleman
is very prudent in desiring to take precautions against it -- and the
following measures seem to me the most probable for answering his purpose.

1. There is nothing more hurtfull to Rheumatic dispositions than
a Cold and damp climate and it might have been very proper for him to have
quitted Dantzig for the winter but it is now too late -- Nothing short of Italy
would put him in security and he would be in more hazard from such a length
than he can be from remaining at Dantzig.

2. Remaining where he is his first care must be to avoid cold and
nothing is more suitable to this than the flannel shirt that he employs and he
will do wisely if [it?] he continues it even during the summer & for certain during
next winter or perhaps for life -- Besides his this he should especially
during the winter be warmly cloathed & this implies more or less of cloathes according
to his former habits in this respect but let this be a constant rule that whatever
cloathing he once gets into he must on no occasion change it for lighter or thinner
till winter is quite over -- He should at all times carefully avoid being
heated by Exercise or by very warm chambers, for in propertion to his being heated
he will be the more liable to catch cold -- For the rest, let him avoid as well
as he can all damp & moist weather and more carefully still all damp places --

3. It is very proper to continue the use of the flesh brush not only
upon the pained parts but in some measures over the whole body -- It may
be used both at night and morning but the last does not most service --

4. All kinds of moderate Exercise will be usefull but bodily Exercise
as liable to heat him must be used with caution & riding on Horseback or going in
a Carriage will be safer for him -- The last will be at all times safest, but
when the season & weather allows going on horseback will be more effectual --

5 The measure most especially necessary to prevent Rheumatism
is to prevent fulness of blood -- but this is not to be done by blood letting -- When a
fullness has arisen Blood letting may be necessary to prevent its consequences but at
all other times - Blood letting disposes to fullness & the German Practice of [stated?] ¹
blood letting necessarily produces the fulness thye mean to avoid and it is always
attended with much hazard ² -- I must therefore advise this Gentleman not to return
to the practice of ↑stated periodical↑ blood lettings but to depend upon Diet & Exercise for preventing fullness

He should take animal food only at Dinner & then only moderately
& never making a full meal of it but filling up his meal with pudding or vegetables
At supper he should take no animal food but Milk & vegetables will be proper
At Breakfast, Tea Coffee or weak Chocolate --

For ordinary drink he may take small beer or Water with a little
wine in it -- At dinner every day he may take a few glasses but taking
care always that he never takes so much as may in the least heat him --

At supper he may also take a little wine but then with rather more
caution -- He should take spirits in no shape -- He may take a little well
brewed Malt liquor but the wine is safer -- I say nothing of the kind of
wine most proper for him if it is taken with ↑the↑ moderation I propose the kind is
of little conseequence Good Rhemish is as proper as any

6 -- There is nothing can be more hurtfull than sitting late
at night - He should go early to bed and full sleep is very proper --

7. These are the Particulars of Regimen & if carefully attended
to few medicines will be necessary - The only one I would recommend to him
is the Volatine Tincture of Guaiacum made according to the London
Dispensatory -- Of this he may take a tea spoonfull every night at
bedtime in a glass of wine & water ---

In the month of March next for two or three weeks he may
with advantage drink twice a day a quarter of an English Pint of
the antiscorbutic [Juices?] prepared according to the either the London
or Edinburgh dispensatories --

In case he is liable to Costiveness it should be carefully
obviated and the means taken I would choose is his taking in the
morning a teable spoonfull of whole & unbruised white mustard
seed, moistened with a little water and small beer --

There remains now only with regard respect to his
going to any baths & which he should choose

If against the end of spring or beginning of summer he finds
himself [very?] ³ from all pains and especially if he finds he can bear damp
weather without any return of pains I shall think it very improper
for him to go to ↑any↑ bath whatever -- Further tho he shall find some
return of his pains if these pains are with any feverishness or any
inflammatory symptoms in the joints I shall in this case also think
all kind of Baths improper But, if his pains continue {illeg} (↑to trouble↑) him
chiefly in damp weather & appear manifestly to be of the Chronic kind
without feverishness or Inflammatory symptoms I shall in this case think

I think it very probable that by the regimen proposed above he
may be so well as to bear the climate of Dantzig with safety but if I shall
be disappointed in this and his pains continue either in one shape or other
I shall think it very proper for him to quit Dantzig before next winter
in order to pass it at Naples or some other part of Italy nearly as warm --