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I have conversed with my very old aquain¬
tance Mr Fleming and find that he labours under a very
disagreeable ailment commonly of very difficult cure.
It is commonly owing to a schirrous angustation of the Oeso¬
phagus a little above the cardia and when that is confirmed
I take it to be incurable but the disease I have sometimes
found to depend entirely upon spasm and whether with some
degree of constant angustatio yet from its being occasionally
better and worse I judge that something spasmodic occurs.
Upon this Supposition before he is going to swallow let him
try half a tea spoonfull or a whole tea spoonfull of Æther
in an ounce of water. Let the æther and water be previous¬
ly mixed in a vial to be kept till the time of use inverted
upon the cork. If this answers you will use it occasionally
as you shall find proper observing that a frequent use is
ready to render it less effectual. If you shall distinctly
perceive it ↑to↑ be Spasmodic you may think of trying Camphire

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dissolved in a large proportion of Sweet oil, as 3 or 5 grains to
an ounce. It will even be worth while to try sometimes a spoon¬
full of Oil by itself for whatever opens the passage without
renewing the spasm will be of service and perhaps you may
find that the most powerfull of all Antispasmodics [Opium?]
may be of use. But to attempt a radical cure of the dis¬
ease the only very probable remedy I can think of is Mercury
and I would prefer the Mercurial Pill given to taint his
breath or give a little of the copper taste but no farther. On
this you may bestow more or less time as he bears it and
his business allows for at this season he must be confined.
If the Mercury cannot be admitted for any length of time
or at intervals only I would in the meantime give him Cicuta
with a valeat quantum valere potest ¹ and because I think he
should not be without a medicine. With respect to diet he
must take what he can swallow most easily for every new irri¬
tation will aggravate the disease which seems to have been
first brought on ↑by↑ a strain. In diet therefore Egg, Blanc mange
Jelly & every thing that can be brought into a gelatinous

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form as [Neatsfeet?] veal Head, an old Cock &c: His warm punch
at night may be very properly continued and the effect of it makes
me the above antispasmodics may be usefull. Mr Fleming is
old Comrad I have a regard for and therefore your writing as often
as you shall think there is any use for it will never be troublesome
to me. I am with very sincere regard