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For Miss of Dumfries

Complaints of a mixed nature; rheumatic partly nervous no immediate dan¬
ger unless go on longer------ hitherto very obstinate as such complaints generally
are. --

1. Must not lye long abed, as soaking in it must be extremely hurtfull,
& prevent her ever getting the use of her limbs. Before rising, rub her
feet & legs with a flesh brush & after she is up, the same to her
arms & hands. Not only must she be more out of bed than hitherto
but even abroad in a carriage. While out of bed, must admit
easy company, & kept from thinking of herself or her own affairs.

For her feverish state, her Diet must be of the lightest &
coolest kind a little broth & a bit of chicken or such light animal food
at dinner, but no more, & chiefly take milk, grain & garden things.
Drink water or watery liquor no fermented or spirit. --- When

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low spirited, a little wine & water the first very sparingly & all
plain wine or strong drink might be entirely avoided.

As to meds. the two employed are most proper & therefore con¬
tinue them. The Elixir of Vitriol is well suited to preserve the
tone of her stomach & ye Elixir of guaiacum, to her nervous & rheumatic complaints

Open an issue in one arm & in the opposite leg & the best is
the perpetual, because of the frequent fresh irritation of the Issue
ointment. The issue of the arm may be a little above the bending
of the elbow & issue of the leg on the inside a little below the
knee.