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It was so late on Wednesday before your
letter came to my hand that I could not possibly answer
it in course.

I have Since carefully considered Mr. Forbes
full and exact Journal and there can be now no doubt
that his Conclusion about the nature of the disease
is quite just. It is purely Hysteric and though
that has ↑is↑ often obstinate I have no doubt of her
getting the better of it on this occasion very soon.
The plan proposed in my former letter for
relieving the Case by Tonic and Antispasmodic reme¬
dies I am persuaded is still the most proper that
can be proposed and I perceive that Mr. Forbes
has entered upon it very properly and I have only
to offer a few remarks on some particulars. I
proposed a formula for the Bark which I have

found to be the most [convenient?] for prescribing young
Persons to the use of that medicine but I must
own that I have ordered too small a dose for such
a disease as the present and if the Young Lady
will admitt of it and her Stomach will bear it
I am clear that the quantity of Bark should
be increased. If it should happen that the bark
should be very disagreeable and cannot be admitted
in sufficient quantity you may try with or
without the bark to give from ten to twenty
grains of the Limatura Martis præparata two
or three times a day. These doses may be taken
in a little Currant Jelly and in that shape will
hardly be found to be disagreeable and they may
be made sufficiently pleasant by the Limatura
being previously rubbed with an equal weight
of refined Sugar. These are the tonics I would

employ and for the Antispasmodic I would trust
entirely to Musk and Opium and especially to the
latter but I must remark that it is probable
that large doses may be required. If the dose of
fifteen drops that has been employed was suffi¬
cient to put off a fit I shall not desire it to
be increased but it appears to me to be rather
a Small dose and accordingly if it
has failed in its effect I should have
no hesitation in increasing it a good
deal if either the recurrence or violence of fits
should require. I find some circumstances judiciously
marked which point at her Menstruation which
is probably to be the Crisis of this Ailment and
I think a Pediluvium perhaps a Semicupium
may be frequently tried and frictions of the lower
extremities will certainly be proper. Wishing you
heartily Success and with Compliments to Mr. Forbes
I am with great regard