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For Sir Thomas Haggerston Baronet

In a case of this kind difficult to give peremptory advice at a distance
for as the Gout is moving it is not easy to foresee its motions & there¬
fore &cc.

When his Stomach was affected here with squeamishness & vomiting I
have found at the same time he had much fever, therefore warm
medicines were not safe, but I relieved him by the Stomach Mixture ordered below.
which I hope may answer now. --- If the vomiting be more urgent
& the fever less, a warmer maybe employed as the [Cord.?] Mixture ordered
below.

He is disposed to an open belly, & if costiveness take place, use
glysters, emollient, laxative & purgative as occasion require.

If the Gout with inflammation come into the Extremities I hope
it may relieve the Stomach, so that nothing but a dose of the
Stomach Mixture now & then may be necessary, but if no pains or inflammation come on while the disorder of the Stomach is urgent
it may be proper to apply blisters, a little below the [Pince?], as
they are inconvenient if lower, in œdematous persons ----------

If as usual his Gout shift about into several places, blistering
is our uncertain remedy, & I've recommend rest, warmth, patience.

He may drink Madera & water, proportioning according to his Sto¬
mach & fever --- His food must be liquid as Chocolate not
strong. [Panaza?] with a little wine in it. Beef tea strong or weak as
as circumstances direct, & when nothing else will go down, a bit
of spunge biscuit dipped in Madera & water - -

His constitution he assured ↑me↑ did not bear Opiates, & I avoided them
tho want of sleep was sometimes urgent, but I will not be
positive that circumstances may not cast up in which they
might be necessary.

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