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For Miss Dempster

Case not a common one. I formerly held it as
a general rule that all pains of the joints alternating with the
affections of the Stomach were to be considered as gouty but
have found exceptions & I think this among the rest..
Her age sex circumstances &c. lead me to think them
of the Rheumatic kind & upon this I proceed in what
I am to advise & that is to try her with a dose or 2 of
Dov. Powd. While her symptoms are so easy as at
present, you may let it alone &{illeg} if she has only
some slight attacks may palliate with the Elixir
Guaiacin. volat. given from 50 to a 100 drops in a

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little brandy & water, but in case of any violent attack
in either the Stomach or joints you may try the Dov.
Powd. but with the following attentions. Must take it in the
morning after her usual time of sleeping is over. Your
first trial may be in a dose of twenty grains.. Let her be
laid in flannel shirt & in blankets. Let her avoid
drinking for an hour or two or till there is no hazard
of her throwing up the powder or till some symptoms of
a sweat appear, after that she should take frequently
some warm liquor as thin watery gruel, weak
sage tea, or other such watery liquor. At any time
a small cupfull of weak beef tea with a bit of brread
should be her nourishment for the day. After taking
the dose she should have an additional blanket,
but if the sweat come freely that addition may be
removed & may be left with her ordinary bed cloaths
but during the whole course of it feet & legsshould have
some additional covering & when some sweat breaks out
if it is only about her head & upper parts you must
put hot bricks or bottles of warm watter to her
feet, to bring. the sweat to her lower ext{illeg}remities. The
desirable [measure?] is that the sweat should be over whole body
but moderate & with as little heat or [anxiety?] as possible
which will allow her to bear it easily & to have it
continued for a due length of time which is of chief
consequence. I would have it continued if possible
in a moderate way for 12 hours. & then shifted into
dry flannels & blankets but with out being taken out

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of bed for that night. Even next morning greatest care
must be taken to avoid cold & if can keep bed the
whole of that day, will be of advantage. According
to the trial & circumstances after it &c. you will be
determined to repeat the dose in 2 3 or 4 [days?] greater
or less as occasion &c & I must have a report
of this before &c further. &c