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For Mr Andrew Stewart

I have formerly and now with all the attention I am
capable of considered the whole of your Complaints, and shall be very
happy to contribute to your releif. To give you the theory of them would
puzzle me, and give you little satisfaction, it is enough to say that it
is a Disorder of your Nerves which the Circumstances of your Life
for some years past very well account for. How far any Disposition
to the Gout may have a share in it is not easy to Determine, but I
would admit of no measure that is inconsistent with such a Sup¬
position. The Disorder has chiefly affected your Stomach, and it
is from thence that I suppose the Complaints of your head chiefly
to arise, but these are encreased by any degree of fullness in your
Vessels. For releiving your present Complaints, & preventing their
return I shall offer you some Advices to be refferred to the following

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Heads.

1.st The avoiding those Causes which have brought on your Disorder.

2.dly The Management of your Stomach.

3.dly Avoiding the fullness of your Vessels.

4.thly The Management of your Belly.

In the first Head, as intense Application has had the chief share
in bringing on your Disorder it is necessary you should now avoid
everything of that Kind. As it might be difficult to do it, so it is
not absolutely necessary to avoid some attention to Business or Study
but the first should be such as gives no Anxiety, and the last should
be so conducted as never to give fatigue, and therefore never to be con¬
tinued long at one time. Your Scheme for removing from the
Temptations of Business and of forming Connexions that will
necessarily lead you into Amusement is certainly very proper.

2 d With Regard to the management of your stomach, you must
take care to obviate every Cause or Occasion of Indigestion.
You must use animal food, but should prefer the lighter kinds, &
with all take particular Care never to make a full meal of any kind.
When your Appitite issharp is sharp, you must take Soup & Pud¬
ding so as to avoid a full meal of meat. Those may seem sometimes to
give an uneasy Distension of the Stomach, but it is soon discussed
and always safer than a Load of Meat. You should take Fish seldom,
& sparingly, avoiding the heavier kinds, & high Dressing. Roots
Roots, Greens, & other such Vegetables you may not digest easily,
but in that Respect you will find you Stomach in different Condition
& when you find your Stomach tolerably firm you should always
take some Vegetables along with your meat, & particularly when you
are in much Exercise, you may take them pretty freely. They fre¬
quently disturb the Stomach, but they are very necessary to our
Health and I would have you to take them as far as you find you can
digest them. I would have all this understood as said also with respect

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to fruit, which are in several Respects proper for you. In taking
animal food I would earnestly recommend a plain Cookery &
that thereby you should on all Occasions avoid by the relish of food
to be tempted more than you are by appetite Spice & Pickles of al[l]
kinds you shoud take very moderately. The Directions I have
now given for your Diet chiefly respect your Dinner, for at
Supper I woud not have you take meat of any kind. Youu
may if you please avoid this meal altogether, but I would
much rather you should take a light one, & if you cant digest
any kind of milk meats these are the most proper. A
Breakfast you must take neither Tea or Coffee. A Weak
Chocolate is one of the most proper but if you do not digest thi[s]
easily you may take a weak Broth, or if you like something
in the shape of Tea you must make it of Baum, Sage Rosemary
or other such plant of Home Growth. For ordinary Drink, let it
be Toast Water alone or with a little Wine in it, & you must avoid
malt Liquors of all kinds, as also Cyder, or any other small wine
for your ordinary Draught. In strongD Drink you must be
very temperate, but it will be very proper to take a little of them
every Day & I would prefer Wine to any kind of spirituous Liqor.
I think you should go not go beyond half a pint at one time and if
you observe this rule you may take what kind you please if it is
sound & neat. On the management of your Stomach, I have only to
add that I expect by the Regimen now laid down joined to proper
Exercise you will avoid any Occasion for vomiting, but if by an[y?]
Accident you are put off your Guard and from that or other Causes
your Stomach becomes disordered with Loss of Appetite and Symp¬
toms of Indigestion it may be necessary to take a Vomit, but I wou[ld]
have you to consider that this remedy gives only a temporary relief,
that the frequent repetition of it weakens the Stomach, and therefore

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I would have you employ it very seldom. The 3d Article of your
management turns upon avoiding too much fullness of your Blood
Vessels. It would by no means be safe for you to enter upon any
meagre or extenuating Diet, and on the contrary a Diet of a nourris¬
shing Quality is very proper but it must be proportioned to your
Excercise, & other means of keeping up a full Perspiration A
warm Climate in Winter will be very favourable to this purpose,
but you must not depend on that alone, but should take some Ex¬
cercise every Day if possible on horseback, and at least in a Car¬
riage. This Excercise I consider as an essential part your con¬
duct, & I expect it will both keep your Stomach in good Plight,
and prevent any excess or fullness in your Vessels, but it may
[go?] further in the first than in the last that is that it may encrease
your appetite more than it discharges your Vessels, & there¬
fore you must still study great moderation either in the quan¬
tity or quantity of your food. As it is not possible for you to
judge that your Excercise & Perspiration are exactly adjusted
to the food you take in, you must constantly watch over the
Growth of your body; and whenever you find it encreasing
you must either diminish your food, or encrease your Excer¬
cise, or perhaps ↑do↑ both. These Measures will be more especially
necessary if you find the Complaints in your head at the same time
encreased and if it shall happen that you have not attended in due
Time either to the Disorder of your Stomach to affect that may
affect your Head; or to the fullness that may encrease the Disor¬
der it may then be necessary for you to let a little Blood more or
less as the fullness & Disorder of your Head is more or less consi¬
derable. Whenever the Disorder of your head is very much so I
believe taking a little Blood will be necessary but it is much
more desirable to prevent the occasion of it by ↑Diet &↑ Excercise, and I would

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even trust to these and avoid bleeding in all cases of slighter Disor¬
der. Frequent bleedings certainly render our vessels more liable to
fill faster, and in so far as you have been obliged to bleed several
times lately, you must be the more jealous of your filling up too
fast, but I do not think the matter has yet gone so far, that you need
to think of obviating it by repeating Bleeding. I could never advise this as a
remedy for a general fullness to any person that can take measures in
Diet & Excercise & I would never have you to employ it but when the
Disorder in your head is very considerable.

We are now come to the last article we are to speak of & that is the
keeping your belly regular. Almost every person liable to costive¬
ness is liable to disorders of the stomach & the head & you must there¬
fore have a very constant Attention to avoid it. It would be happy if
you could do this by Diet as medecines are always inconvenient
sometimes hurtfull & at best introduce a disagreeable habit
the diet that answers the purpose is different in different persons
& if you can by some attention find it out with respect to yourself
it will be lucky but in the mean time I shall what is the
most general case. A good deal of broth a large proportion of
Vegetables along with animal food & particularly a good
deal of fruit afford the most laxative Diet & if you can bear
these things without their disturbing you by their flatuency
you may possibly avoid the trouble of taking medecines
but if you cannot order the Diet answers your (↑the↑) purpose
you must necessarily have recourse to Medecines With re¬
gard to the choice of those you must observe that Rhubarb &
other such can hardly be so managed as to answer the end with¬
out their being liable at one time to do too much and at another
too little. Aloes or the medecines prepared with it are the only pur¬
gatives that can be employed to keep the belly regular without pur¬
ging. Sacred Elixir is of this kind & is very certain of its effects but it is

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heating & drying & I would have you try the pill below which I think
is less so. But indeed I think Aloetics of all kinds too heating & I would
wish to avoid them. At any rate the same medecine frequently repeated is
liable to lose its effect & it is proper for an you to be provided with some
variety of Laxative. I have therefore subjoined also a Sulphur Electu¬
ary which is not disagreable and I hope may answer your purpose.
if it does it is safer for your bowels than the Aloetics. When you first be¬
gin to take the Electuary you must observe that it does not always ope¬
rate in the first dose & sometimes several must be taken before it
operates but when once begun every repetition will have effect & even
a frequent repetition will be necessary have therefore patience to
d adjust both the dose & the repetition to your Constitution you will
find it a very convenient Medecine. Besides keeping your belly re¬
gular if the disorder of your head should be frequently troublesome.
I believe it may be of service for you to take sometimes a purga¬
tive that may open you two or three times & such a remedy may
sometimes save a bleeding but it must not be practised frequent¬
ly as much purging is liable to weaken the tone of the Stomach. For
such a gentle purgative is liable as I think may be proper I have set
down in prescription below.

I have now only to add that the more I consider your pro¬
posal of passing the winter in a southern Climate the more I ap¬
prove of it as I believe the summer heats of such a climate would
rather be hurtfull to you & I think against the end of March you
should set your head Northwards so as to get to Britain against the
middle of may

For MrStewart

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For MrStewart