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I have considered with all possible attention the
full and judicious account of Col. Greys complaints which you are pleased to
send me and I shall be very happy if I can any ways contribute to the
Colonels relief. I have no doubt of the diesease being rheumatic and
tho the state of the blood seems to be much mended . I am perswaded
the diathesis in some measure still remains and has been at bottom
of the several relapses which have happened. During so cold a season as
at present, it is almost impossible to eradicate an inflammatory diathesis
but it may be kept within bounds and when the weather mends removed
entirely. Upon this plan I would recommend the utmost care in avoiding
cold, but at the same time not to keep very warm. I would advise also
a spare diet especially with respect to animal food, but I dare not
forbid this altogether as the Colonel may possibly be much exhausted
by the length of his disease and may absolutely require some sustenance of
that kind. I must therefore leave this to your discretion but with this
observation that a diet of milk and grain if he can bear it, would certainly
mend his diesease. With the same view I would have him abstain from
wine altog↑t↑ether but your being upon the spot may shew that it is in
some measure necessary and if you do I submit to it. With regard to medicine
I am ready to believe he will not now bear evacuations easily, but in case of
any relapse with a full pulse any topical pain and especially with any attack
upon the head I think the letting a little blood will be unavoidable
I hardly think in any case that purging will be proper but certainly the
keeping the belly regular and rather open will be very necessary. I agree
with you entirely that the remedies especially indicated are such as may keep
up the perspiration or even dispose the skin to be moist and for these purposes
the antimonials are certainly the best. You may if you please employ
small doses of James powder or the antimonial mixture wine but I depend
most upon the Tart Emet: given at Bedtime in very small doses but repeated
frequently till a slight nausea is excited. I am clearly of opinion that th
while the diesease was recent or when any fresh attack has been made
that opiates are a hazardous remedy but the want of sleep is a great distress and
contributes to increase or continue the disease and now the force of inflammation is

much abated I think you may safely venture upon an opiate. It will be
particularly safer along with the Antimonial and I illegible advise you to give it
in a pretty full dose for that is often safer and more effectual than a small one
I am pretty certain that one trial can do little harm and by the effects ↑of↑ that illegible
I leave you to be guided afterwards, only however well it may seem to answer I
would not desire advise the repetition to be more frequent than seems very necessary
Neither by the Antimonials wine nor by the opiate would I propose to do
more than excite a gentle diaphoresis as I think a free sweat may be
hazardous in this weather, but if the weather was milder I believe the
whole complaints might be suddenly relieved by a free sweat or two procured
by Dovers powder. The very remarkably effects of that which I have
experienced in rheumatic cases shows me that even large doeses doeses
doses of Opium may be sometimes employed with safety and advantage
To conclude this subject I must say. that to contribute to the Cols.
relief and to render every degree of sweating safe I think it necessary
that he should have flannel next his skin both day & night. Uppon the
whole at this distance I can only give a general plan & much must
be left to your discretion & c happy am I that I can put my advice
into such hands. when the weather becomes milder . I would propose
in case the disease continues either Dovers powder or a Course of
Calomile and Camphor. but neither can be thought of at present