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For Dr Ravenscrofts freind

In a constitution much broken by West India diseases we
may expect appearances of an anomalous & irregular kind & such
I think they are in this Case. His Evening fit of coughing & expecto¬
ration threatens some Phthisical complaints & I would not under¬
take for its not ending in this way. But in the meantime the
abundance of any topical affection of the breast or of any profuse
sweatings and the total remission which happens in the mornings
makes me think that the disease is not yet Phthisical
but that it is of the Intermittent kind and such as
I have known long to continue long in persons come from
the West Indies. Such ailments are generally got
the better of in this climate but not in the winter
Season & this gentleman cannot expect any conside¬
rable relief till the approach of summer

In the mean time I think he has taken two
many medicines & everything heating may do him harm
I am not told of the quantity of Bark he has been
taken nor of the effects of but unless of the
effects have been remarkably good I cannot
advise the continuance of it - Large quantities can only
do service & they may do a great deal of harm
I approve of giving Emet Vomits at the beginning
of the fits & if his dose has been found I would repeat
them now & then. On the days on which he does

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not take a Vomit let him try a dose of L Lad.
from 20 to 30 drops about an hour before his
Evening comes on. If this keep his cough much
easier & does not increase his fever or produce sweat¬
ing the practice may be frequently repeated with
advantage- but if the Opiate increase his fever
and occasion much sweating -

Little to be expected from Medicine till the
Weather grows warmer &c. must keep close at
home &c. Live much on a milk Diet or very
little either Animal food or wine. Continue his
milk in the morning with the honey & rum. & when
he is to take milk at any other time let him
take it always with an equal part of water gruel
& sweeten the whole very mild with honey & this
he may take with broad rice Sago &c. in place of
plain milk & of such milk & grain he should
make most part of his Diet. This will probably
keep his belly regular but if not it must be
kept so by a Spoonfull of Castor Oil in the morning

For his legs friction & warm bathing - frequently in
the Evening use a Semicipium for 15 minutes rubbing
his hams all the while ---