[Page 1]
For in Shetland

Having considered the case laid before me by Mr. Nicolson, I am
of opinion that the disease is entirely seated in the gullet or what
we call the Oesophagus, and has very little connection with the sto¬
mach or the rest of the body. I imagine the ailment consists in a
stricture of the gullet which will be difficult to cure, but I do not
think it absolutely incurable, and I am persuaded it can be very
much relieved. But for this purpose he must in the first
place make a great change in his manner of life. He must
not continue to expose himself to much fatigue or to the vicis¬
situdes of heat and cold as he has hitherto done, and particularly
he must avoid being cold and wet. At the same time he must
avoid strong drink and particularly spirits, for his ailments

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[Page 2]

must be encreused with his being in the least heated with strong
drink of any kind. Under this regimen I hope our remedies may have
a chance to do service. His first care must be to keep his throat warm,
and for this purpose let him wear two slips of plaister spread pretty
thick on linnen laid on each side of his windpipe from theLarynx
down to the Sternum. The most proper plaister is the Antihy¬
stericum, and it should be fresh spread from time to time. The
upper part of his throat should also constantly be kept warm by a
piece of flannel laid from ear to ear so as to cover the corner
of his jaws. Let him farther make use of the Electuary ordered
on the other page. He should take so much of it every morning
as to make his belly regular. With all this let him avoid swallowing
any thing, which by its dryness, firmness, or bulk give an irritation
to his gullet. When he desires to take any food let him always
begin with some moderately warm liquid, and after some mouth¬
fuls of this let him try bread soaked in the liquor, and having
thus by degrees dilated his gullet he may proceed to some¬
thing more solid. Till he can bear these, warm milk ↑will↑ both
be most easily swallowed and give proper nourishment.