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For Mrs Keir of Wester Rhynd

After considering Dr Robertsons account, I think
Mrs Keirs ailments cheifly of the nervous kind & which I
suppose for a good part of her life she has been liable to.
She now seems to have a cough added to these complaints probab¬
ly from cold contracted at two different time in December last.
The medicines employed by Dr R–– for both ailments
seem very proper particularly the blister & Issue &
if the Cough continues frequent with any increase in the shortness
of breathing, would have the blister repeated applied as be¬
fore between the shoulders if the place of the issue is
at the same time covered with a thick plaster. –– Proper
to continue the Decoction of Althea with Gum Arabic & if
the Cough is troublesome by a frequent tickling proper to employ
something thicker of the mucilaginous kind, such as the
Mucilage of Gum Arabic made according with a 3d or a 4th part of
the Elder & which may be taken by teaspoonfuls
frequently when the cough is troublesome. The Squill Pills may be continued & [wish?] they could be given in such
quantity as to obviate costiveness & more Diuretic. These are
the remedies I can propose for her cough & these are some
others which might be thought of particularly vomiting &
bleeding but from some consideration I am going to mention
I cannot think either of them admissible. The swelling of the

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feet, the state of the urine which I take to be scanty, the Pal¬
pitation which she has been liable to for some time & the short¬
ness of breathing which she has of late complained of, all [con
an?] to give me a suspicion of water gathering in her breast
& tho this suspicion may not at present lead to any measures
there is no harm in Dr R–– attention being directed
that way & he must soon discern whether there is any foundation
for it or not, & when he can determine either positively or ne¬
gatively measures must be pursued accordingly. In the mean
time have only one advice to offer & it is that if the sto¬
mach does not bear squills in such quantity as to move
her belly & promote urine, let the [Cream of Tartar?] be employd
for both purposes. When Mrs K– gets tolerable sleep
I would [avoid?] Opiates, but if the cough becomes so fre¬
quent as almost entirely to prevent sleep I think a Dose
of Paregoric Elixir both necessary & safe. the Diet
at present properly ordered, but if possible let it not be
too much of the liquid. If women or Asses milk can
neither of them be admitted let her take cows milk mix¬
ed with an equal part of water gruel well sweetened with
sugar.