[Page 1]
To Mr Thomas Duncanson Surgeon at
Forres.

I have considered to all the attention I am capable
off the whole history of your friends complaints & shall be very happy
to give him relief & you satisfaction. I consider the cough
rheumatic pains & coldness of his stomach & bowels as gone & out
of the question & at present I attend only to his swellings & evening
fever. With respect to the 1st I regret a little that you have nt told
me whether there is any fluctuation to be felt in the abdomen but from

---

[Page 2]

the swelling you mention of late increasing towards
the pit of his stomach with scarcity of urine & emaciation of the [rest?]
of his body I conclude he is or will be very soon, evi¬
dently Ascitic & from the circumstances in the cause & conduct
of his disease I suspect there may be visceral obstructions
This opinion implies an unfavourable prognostic but
I hope matters are nt desperate & that the following measures
may be of service.

The dose of Crem. Tart. & Jalap you mention seems to
have been well judged & to have had good effects & I would
have it repeated every 2 or 3 day as his strength may bear.
In the intermediate days let him take a dose of crem. Tart.
in the morn but no more than to give him one stool. The
same day at noon & towards evening let him take a dose
of the Diuretic Infusion ordered below & he may also take a dose on
the evenings of the days he takes the Purgatives. In the dose
of Crem. Tart. & Jal. you employed I suppose the first was in
large & the 2d
in small proportion & so I would wish it
to be as, while his evening fever continues. I think he will
not bear any strong Hydragogue.

Every day that he takes not the Physic he should continue to
go on horseback & take what exercise in that way he can easily
bear.

His diet may be of any plain light meat his appetite leads
him but he must as much as possible avoid broth & all liquid food.
His drink may be Rhenish wine with a large proportion
of water but he should take as little of either as he can be satisfied
with.

If the swelling of his belly goes on increasing & gets any
[considerable?] let it be anointed all over with Olive oil.
Let the rubbing of it be gentle but long continued. If
that has no sensible effect in promoting urine in the course
of 8 or 10 days the trouble of it may be afterwards saved.
In the whole of the above you may perceive upon what
supposition I have proceeded but from some imperfection

---

[Page 3]

in the description of the case there may be some uncertainty
in my judgment of it & therefore if you suspect any thing
of this kind I desire you will write me & give me the facts
more exactly & in the meantime as circumstances may be
daily changing I leave matters to your discretion.

For Mr. A. C. ¹