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I have considered the case very attentively &
am sorry to find it very unpromising. I cannot
be positive whether there is any ulcer of the ear or not
but whether there is or not I am clear that that the
topical affection of the ears is not alone the cause
of his deafness but there is also some internal
affection of the brain - Upon this plan in concert
whith Mr Hay I offer the following advice

1. Let two leeches be applied upon each temple
& let them bleed freely

2. Let his head be kept shaven & perpetual
of issue of the size of a crown piece ¹ be made
in the crown of his head

3 Let him be purged twice a week with
two grains of Calomel & with Jalap from five to
ten grains as may be necessary

This course must be pursued for some
weeks before you can judge of its effects but if
in that time it has no effect upon his deafness

I see no use for continuing the bark and think
it should be laid aside

I would also lay aside the Lime water
for washing his ear and instead of it employ
the following once a day.

I have nothing farther to advise with regard to diet
but the boy should be kept altogehter without animal food