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W. Home Concerning Miss

I have considered the case you have been pleased
to communicate to me. It is of a kind I am very well
acquainted with and your account of the present case
is so accurate and full that I cannot think it any
ways necessary for the Lady to take the trouble of
coming here herself.

The disease depending upon the debility of the
Uterine System is commonly difficult to mend and it
appears to be particularly so in this case as it has
resisted some of the most judicious and powerful
remedies so (↑though↑) it is probable that the disease might
have yielded to these had it not been for the acciden¬
tal affection of mind and I am sorry to observe that
a relapse from such a cause is likely to be very
violent. We must however do the best we can and
hope for success.

I am sorry to find the Lady rejected the use

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of the limatura Martis one of the most safe and
powerful tonics we can employ. But I will not now
throw her back upon medicines which she has pro¬
bably taken an aversion to and I suspect she is
not very steady in the continuance of any medicine
whatever for a due length of time and which conti¬
nued however is very necessary in all cases of this
kind. I have prescribed below a medicine with
which I have had great success and if it agrees
with her stomach and she will take it in due
quantity for some time I don't doubt of its being
of service. I have prepared a small dose only to
begin with but if it agrees with her as I expect
it may be increased to double or treble the quan¬
tity. The best way of managing this is not to in¬
crease the bulk of the dose but by making a
small quantity of the mixture at once but by
renewing it from time to time to increase the

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quantity of the balsam. With this medicine I de¬
pend much upon her a regimen without which no
medicine will be of avail. She should give up
entirely the use of Tea and Coffee, avoid lying long a¬
bed in the morning and except at the very time of
Menstruation to go on horseback as of or in a Carriage
as often as the weather will permit taking care
however always to avoid cold particularly its coming
at her feet or legs. I have no objection to your ad¬
vice of injecting cold water but I suspect she has
and I would not insist upon it because I hope
you may obtain the same benefit by pouring some
cold water upon the small of her back every
morning. You may begin reconcile her to this by
beginning with a tempered water, that is, of one
part boiling water to four of Spring or well water
for Brook or river water is too variable to be
employed. When she has bore this for some days
you may gradually withdraw a part of the

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boiling water and at length almost the whole of it
and this Practice may be continued every day to the
very day of menstruation. When this is expected if
any pains of the stomach or back come on I think
it may be very proper to relieve them by opiates
which I find will often moderate the following
evacuation.

Her diet may be of ordinary fare but should
be moderate with respect to Animal food and pa¬
rticularly of fish. She is however also to avoid
much acescent or flatulent food. Her Suppers
should be always light and if she digests milk
easily she may take it either in the morning
or at night. It is hardly necessary to say to a
Lady that she should be very sparing of wine
or any kind of strong drink

I forgot to say above that during the time
of Menstruation she should avoid either walking

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or standing much upon her feet and should very
often ly along upon a bed or Couch. Till her ailments
are much mended Dancing is very improper.
Wishing you heartily success I am

For Miss