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After considering the full and accurate history of
this Case I give the following opinion.

It is so very unusual for Ascarides to give
great irritation to the System that I cannot easily
suppose that the Ascarides which appeared {illeg}
a few days before the attack of this disease had any
share in bringing it on but as this kind of worms
are almost always very much confined to the rectum
so if they had been there they should have again
appeared in the many Stools that have since
been voided, of which however there is no mention
made in the History of the Case. I say again
therefore I do not suspect them to be the cause
of this disease but if they are continuing to be
voided should give any such suspicion let the
following Glyster be employed.

Mr. Mc.Farquhar writes that for some
years before the attack of this disease Miss Baillie
had Symptoms of worms and had passed several
but he does not Say whither they were Ascarides
or Terites and therefore till I am further infor¬
med I cannot treat this disease as a Worm
Case and though it were the remedies that have
been employed and those that I am to advise
are the only proper that could be employed at
present.

There might have been suspected that
at first there was some slight Phlogosis of the

Stomach but {illeg} of the remedies as employed
and the state of the [pulse?] at best remove every sus¬
picion of this kind and I consider the disease to
have been purely Spasmodic.

In this view the remedies of Musk and Opium
were the most proper that could have been propo¬
sed and they seem to have been very successful
in removing the Spasmodic Symptoms of Vomi¬
ting and Hiccup and if the like Symptoms
should again return, the same remedies must
be again employed, giving them either by the
mouth or largely in glyster if Vomiting should
prevent their being given the other way. The
Symptom that seems now to remain most
obstinately is the Fainting but that I hope
shall also yield very soon as She Seems now
capable of taking both nourishment and
Medicine. The following I hope shall be of

Service to her whenever the Stomach will admit [of it?].

For obviating the returns of fainting the
medicine I would wish to employ is the Tinct.
Valer. Volat. a tea spoonful to be given in a
little water when the fainting threatens to come
on, or in the intervals of fits when they are
in danger of continuing ↑repeating↑. If the Tincture of Valerian

is not at hand as it is not always in the Country
the Compounded tincture of Castor may be employed
and with either of them ten or [fifteen?] drops of
Laudanum may be given if it shall be found
on trial to prove Cordial and especially when the
approach of a fit can be discerned sometime
before it actually comes on. I need hardly say that
when Laudanum is frequently employed it will
be necessary to obviate the Costiveness which it is
so ready to induce. I would do this especially by
glyster in which from half a dram to a dram
of good Asæfœtida is dissolved.

I say nothing about Diet in this Case because
it must be adjusted by the discretion of a person
on the Spot to what the Patient can take
and can bear.

I have given you on the preceeding pages for
your friend Miss Baillie the best Advice I can and if
hereafter I {illeg} to it I shall be ready
to do it upon your further information.

The accounts you give me of your Son Thomas
are extremely agreeable and wishing you and your
family every good thing I am with great
regard