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For Mr M. Nasmyth.

Mr N.’s ailments depend upon & have begun in his mind &
affections of the mind in acting on the body affect especially the stomach
& heart. Accordingly in Mr N. disorders have appeared in
both organs, much confirmed & aggravated by repetitions. They
may be renewed by causes affecting either the mind or body but
I still think they are only temporary & transitory ailments & do
not imply any fixed local affection. In this view they do
not threaten any dangerous consequences. But they may be
easily renewed & it will require much attentions & time to secure
him against returns.

I hope that by fortifying the mind & body a great deal may
be done & for this

Let him guard his mind against surprise by preparing
himself for every new situation he may be thrown into. In
most cases we estimate the objects of our hopes or fears especially
the latter, too high & a man of reflection may I think moderate
the excess & its consequences. People plead constitution & feeling
to some reason but I am persuaded they appear unavoidable
because they were never attempted to be checked or overruled.
As far as Mr N.’s reflection can go in this, it will be of infinite & cc

When Mr N. is attacked with an uneasy palpitation, if he can
be persuaded that it is not dangerous, I believe it would not pro¬
ceed, to the degree of violence which it has often done, & might
either soon of itself subside or be easily relieved by some medicines which
we shall propose & if in either way a bleeding can be avoided it
will be much for his benefit. If in spite of these precautions
the palpitation proceed to a great degree & threaten a considerable

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interruption of the circulation I allow that bleeding may be necessary[y]
but even when it is tried employ, I would have them to try to
moderate the quantity, & that no more be taken than is abso¬
lutely necessary. I have known a violent spasmodic affection
taken off by drawing 2 ounces when it had been supposed before that
a pound would have been necessary.

Let Mr N. avoid the fatigue of business & particularly
sitting long at any business which engages him with much anxiety. Even
in sitting long variety gives some relief.

A little bodily motion may be useful of filling up the inter¬
vals of business & Mr N. should use exercise & fresh air but
he must observe that all bodily motion that is either quick violent
or fatiguing will do much harm

In Diet he must keep to a middle kind. On one hand he
must avoid much or heavy animal food, on the other, much & espe¬
cially flatulent vegetables.

For ordinary drink he must take water with or without toast &
with or without a little spirits as he pleases. All malt liquors
are improper. Strong liquors to the degree of heating may
be very hurtfull but a little strong drink may be very proper
& at dinner every day he may take 2 or 3 glasses of Madeira
or red Port & more safely if diluted with water or in place of
both a few glasses of Punch without souring.

No Indian tea or at least very weak. Cocoa tea or tea
from plants of home growth will be a better breakfast.
If he digest milk, some milk meat will be the best supper.

Mr N. must be kept regular in his belly & if not naturally
must uses medicines.

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These are the articles of regimen, which if carefully executed will be &c.
& render few medicines necessary but there are a few not to be dis¬
pensed with.

Whn his ailments threaten & he has some warning of the
palpitations coming on, let him take one or other of the anti¬
spasmodic medicines ordered below. I have ordered several that they may
be changed as repetition renders any one ineffectual.

At the same time when the palpitation is frequently threatening
he should take an Anodyne draught at bed time & this may be
for several nights repeated, but whenever circumstances will
allow it should be ommitted least it lead into a Habit.
For strengthening the whole of his system I have ordered 2 medicines
the one a Powder to be taken 2ce a day that is an hour or 2 befor
dinner & the same before supper. It must not be taken in a
liquid, but may be taken either dry or in a little Currant
Jelly or water berry. The other is a Tincture of which he is
to take half a gill after every powder. These medicines may
be continued for a week or two at a time but no longer. For
strenthening Mr N.'s nerves, nothing more useful than cold ba¬
thing. The season now is too cold & even afterwards it must
be with a particular management of which he shall be informed.