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I have considered the case communicated to me
by Mr. Fotheringham with the utmost attention. I
have no difficulty in judging of the nature of the case
but I am sorry to observe that it may be of difficult
cure. It is a constitutional ailment that has subsisted
for the whole of his life, and must therefore now
be difficult to mend. It is however a local ailment
that does not affect his general health, and I hope
it may be prevented from ever doing so.

This regimen of late has been very properly
ordered, but he must consider himself as particularly
delicate with respect to exercise, and that on this
head he must always be extremely cautious. His
walking ought always to be very gentle, never fast
never up hill, nor never long at one time. He
may go on horseback, if he goes at a foots pace
but trotting will always be hazardous. Going in
a Carriage at a slow pace or smooth road maybe

His diet seems to be properly ordered, but I must
observe that he should be very moderate with respect
to Animal food even at dinner, and ↑he↑ ought to take
none at all at Supper. Broth Pudding and
Vegetables ought always to make a great part
of his dinner, and he ought steadily to persist in
avoiding every thing salted, or seasoned with any
kind of Spicery. I have no objection to Spruce beer
taken moderately, but water is still better.
The wine he takes is very allowable, especially
as it is diluted with water.

He has been very properly advised to the
Uva Ursi, but if he has taken it for any length
of time, he should lay it aside for a fortnight, and
then enter upon it again at two tea spoonfuls
for a dose, but never continue it for more than
a fortnight at one time ––

Gum water may be a very proper remedy
but I don't know of what {illeg} to {illeg}