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For many years past Mrs Lockhart has been liable
to a copious and at times to an excessive monthly evacuation
This his has weakened her considerably and rendered her liable
to some nervous complaints and particularly to various ailmen↑ts↑
in her stomach and bowels - Of late years the evacuation,
tho still copious, has not been to excess and the management has
been by strengtheners and moderate astringents to obviate any
excess. The medecine most commonly employed is The Strengthening
Infusion A. and to obviate complaints of the stomach the powders
B. With these Liquid Laudanum has been employed but always
sparingly - When the evacuation was a little threatning the
Tinctura antiphithistica was tried but it did not agree with her
and was not pushed. The Elixir Vitrioli was also prescribed
but this also she thought hurt her bowels and it was soon laid
aside. Of late the Spiritus Vitrioli tenuis as ordered at C. has
been tried with no bad effect.

With these medicines her diet has been advised to be as
light as possible as her stomach could bear, but her stomach
does not truly bear stops & some solid food [seems?] seems
truly necessary and is not most agreable to her former habits
Hardly Hardly any wine agrees with Mrs Ls. stomach and
therfore her her usual drink is Water with a little wine
brandy in it. -- Gentle exercise in a carriage and being much
in the fresh Air has always been of service & has been
advised except at the end of the month when absolute rest
has been enjoined

Of late the tone of the stomach seems to be very much
hurt. She has had very little appetite is uneasy after taking
food and frequently throws it up. This has especially
happened at a monthly period which with some remissi[on]
has contineud longer than usual but in no excess of quan[tity]
In this situation she has twice taken a vomit of ten gra[ins]
of Ipecacuana. She has vomited easily & thrown up [a]
good deal of slime, but the operation has been attend[ed]
with no durable relief & I would not recommend the re[pe¬]
tition of it. Hitherto it has been suspected that all kin[ds]
of bitters it might be heating and stimuating and therf[ore]
little employed but in the present situation it was tho[ught]
necessary to try such a bitter as ordered at D, and it has b[een]
used with no bad effect. It is advised to be still continued t[ho]
the effects of the journey she is now to enter upon may se[em]
to supersede it - The state of Mrs Lockharts bowels ha[s]
been irregular frequently costive sometimes loose. For t[he]
first she has sometimes employed sulphur & Cream of Ta[rtar]
but what seems seems best to answer with her is a sm[all]
dose of the bitter Tincture of Rhubarb according to the
Edinburgh Dispensatory -

The above is the history of Mrs Lockharts ailmen[ts]
remedies to be communicated to any Physician she may [have?]
occasion to consult & I have now only to add my direction[ns]
for her conduct during the Journey she is now to enter upo[n]

For the first part of it she should move slowly {illeg}
take short stages & short days journey's, -- Between stages
should always take some rest upon a bed & it will be ri[ght]

If Mrs L shall find that her Journey occasions any return of
[h]er evacuation, she must go on the more slowly or perhaps
[re]st a day or two.

Let her take twice a day a spoonfull or two of her bitters as
[s]he has done of late.

When she is troubled with thirst, she may two or three times
[a] day take from five to ten of the Vitriolic Drops in a glass of wat[er]

When she happens to be sick & squeamish these drops may
[so]metimes relieve it

If she is sick & faintish ↑immediately↑ before meals she may be relieved
[by] a tea spoonfull of sal volatile in Water.

While she continues to be liable to sick & squeamish
[f]its at night it will be proper to take frequently a dose of
Laudanum at bedtime and along with it some Sal Volatile
This will be the best security for good nights and therefore for
[su]pporting her under the Journey but at the same I would
[h]ave it taken no oftener that seems necessary. While her belly
[k]eeps regular it will be more allowable, but costiveness will
[p]rescribe some reserve. If the costiveness should happen, some
[T]incture of Rhubarb should be taken frequently. If the Laudanum
[is?] frequently repeated the dose must be increased to twenty five
[or] thirty drops. When the journey is over it will be very proper
[to] drop the Laudanum altogether except upon occasions of necessity

It is to be hoped that this Journey will be over before any
[m]onthly period shall return and before that approaches I
[w]ould have the bitters laid aside & would then advise Mrs L.
[to] have recourse to her strengthening tincture & Stomachic
[Po]wders the first to be taken two or three times & the last once or
[tw]ice a day.

In case it should happen that the evacuation either continues