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For Andrew Ross Esqr ---------

I am heartily concerned to find Mr Ross’s complaints. have gai¬
ned so much ground upon us & particularly to find that his own
fears & apprehensionsare so strong. They certainly do him much harm
& I am persuaded that they are ill founded & that he shall find him¬
self mistaken. I give no attention to the feverish fit which hap¬
pened on the 19 ultimo Because I consider it as entirely over & I now
consider the case as I did before as a case of Hypochondriasis
depending upon flatulent constrictions in the Stomach & Intestine.. My
intention [ye f.?] in the first place would be to keep the determination down¬
wdswards always free. If the Soluble Tartar has been employed &
answered it should be continued but if there has occurred any reason for laying
this aside I propose the preparation ordered below & as a warmer & more
carminative medicine. I think it may answer better It may be given every day
& at least every second day in such a dose as to give one stool. When
he had the fresh attack a bleeding was very proper but I dont like
the the use of it upon any other occasion. If it shall appear that his
watchings frights dreams & perturbation of mind are attend'd with
flushing of the face, beating of his temples or other marks of any

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unusual determination the blood to the head a bleeding may certainly be proper
but I should rather take it from his temples by leeches than from his arm
by the lancet. I think the blistering was very proper & the Issue might be
kept open or the blistering may be renewd whenever it shall seem
necessary it might be frequently tried to give him rest by fomenting his
Feet & legs which answers best than any bathing. It is to be done so he
lies along in bed in his ordinary sleeping post. A piece of Blanket
is be laid under his legs on the bed to defend it from any
wet. The flannels to be employed must be large not less
than a yard & a half so as to wrap about both feet & both
legs at once. Such a piece of flannel is to be put in boiling water
taken from thence & thrown into a strong long towel & a
person at each end of it is to twist till the flannel is wrung
till very dry this is to be done in the kitchen or other
chamber separate from his. When the flannel is rung it is to be
carried in the towel to his bedside & there applied as warm
as he can easily bear it round his two feet & legs. A piece
of blanket is to be put over them to defend the upper bedcloath
from wet & these are to be laid down as usual. The flannel
will keep its heat for 10 minutes or more or but against that time another
flannel wrung out of boiling water in the same manner should be
ready to change with the former & in this way the fomenting
should be continued at least for an hour & when all is executed
properly it will be with very little trouble to him & I hope
with a very good effect. Persons very often fall asleep under
this operations. & when they do the cloaths must remain [appal??] but if he
happens to continue awake & impatient with the application the wet flan¬
nel may be taken away. his feet & legs well dried & a warm
dry flannel put about them. I have been so particular because the
practice is now with us & much depends exact neat & easy
execution & I heartily wish Mr Ross relief. It gives me
great concert that both his location & ↑the↑ season deprive him of the
valuable remedy of exercise but I hope the opportunity shall

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come in the meanttime, we must palliate as well as I can. I
have no great expectations of the bark & have warned against it
being continued too long. If the Valerian & Snake root prove any
ways carminative they must be continued at pleasure. At the same time other
measures must be tried & carry varied for dispelling wind,
sometimes aromatics, sometimes fœtids & whether you use
aromatic tincture or [compound?] tincture of Castor you must join
with either of them a tea spoonful of Ipecacuahna S.p. Corn.
Cerv. The friction of the Epigastrium will, still be useful. I
have nothing to add to my former on the subject of diet & not¬
withstanding the confusion of head I think you need not be afraid
of a little wine.