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The theory of Mr N.s ailments may be difficult, but of little con¬
sequence when the nature of them is so evident. ––

I consider them as Rheumatic & Inflammatory, coming by fits and
shewing a mobility, both which have been very little taken notice
of by Practitioners and still less by practical Writers.

My idea of the disease arose from the relief obtained by V.S. &
is strongly confirmed by the benefit of his present Diet, which
is always less acescent & flatulent, when no Animal matter what¬
ever is joined with it. I am clear that the same Diet should be
continued strictly for a long time to come, and at this season I know
no other preservative that can be employed. When the Season mends
I expect he will go frequently on horseback & in Summer take a long
Journey. With respect to the question you put concerning the preserva¬
tive means of bleeding and purging – the later I do not consider as very
powerfull & would push it no farther than to obviate Costiveness. ––

V.S. is more powerfull, but I would not wish to practise it often
because I am uncertain it contributes to induce a Plethoric State. –
I would employ it only when thes (↑r↑)e are pretty evidently marks of a
threatening Plethora or when actually some pains with a frequent
& full Pulse shewed the Plethora operating – &c. to your discretion
The pains affecting the right Kidney with an increased secretion of Urine
may give some suspicion of Nephritis; but as the Symptom may be
explained another way, I wait for something more decisive to mark it as
Nephritic ––––

I am sorry the Tartar has had no good effect on her arm; but
the season is unfavourable & the Spring may answer better &
therefore let her lay it aside till then & let her try it for a week
or two in the beginning of March against wc time I expect to hear
from you of her situation &c. –