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Patient found it difficult to be comfortable, unless his feet were elevated. He had not have any gravel or foulness in his water for over seven years.

For pain in the neck of his bladder, Sir William Boys prescribed him bathing, electuary of marshmallow. Sloane also prescribed an emulsion. (see Sloane MS 4075, f. 187.)

He was eating sparrow-grass. Patient had also bathed twice.

The bathing helped but he stopped doing it because of stone in his urine. He had also developed pain and heat in the bladder's neck. Years ago for stones he took a turpentine glister and wondered if he might do so again or if it would worsen his piles.

Lord Salisbury was bled according to Sloane's instructions to treat his cough, heaviness in sleep and fever. The redness of the measles had gone.

As his symptoms continue the author has administered a purge four times as well as a blister on the inside of the arms. He is sending a coach and begs Sloane to come quickly. Patient requested barley sugar in his remedies.

Crippled legs and gout. He also noted a white patch above his ankle which was present before he started treatment and so cannot be due to that. He also noted that his joints are swollen in his hands.

He took the waters at Bath, bathing in them daily, owing to the inability to fully extend his legs. He had no pain unless he forced his legs to uncurl, but suffered from gout. He read a dissertation on the various Bath waters by a Dr. Oliver and therefore eschewed the "intense heat" of the King's Bath in favour of the Cross Baths. This made his blood less thin, despite his diet which contained no red meat. He wondered if he should rub linseed oil into limbs. He complained that he cannot go abroad because he cannot sit in a [sedan] chair unless it was specially made to suit his condition.

He was still unable to fully extend his limbs and it still hurt to try. He still had pain from gout. He noted that he met an "old French clergyman" who told him of Sloane's electuary that had soothed his limbs.

Sloane prescribed cephalic and carminative remedies.

See ff. 286-297 for the complete case. This is the fourth letter.

She still had symptoms, especially flatulence, and vomited a dark phlegm. Two or three stools daily.

Kimberley called twelve days before: sizy blood, regular pulse, no thirst, clammy tongue, good urine. Complaints were wandering pains in shoulders, arms and legs, as well as sweating.

Irregularity in non-naturals, leading to foul and acidic blood.

Encouraged sweating until the 20th, but it only tired Isted.

On the 22nd, purged him with manna. Told patient to avoid malt liquor and seasoned meat. Drink: wine and Bristol water, wood decoction (prescribed by Sloane). Wanted to try tincture of lime if Sloane agreed.

Mercurial purges not an option since patient disliked them.

After recently coming home, at death's door. Had been unable to ride to a neighbour's. Has swimming and beating noise in head. Slept poorly the previous night. Imputed many of the problems to concern over death of a fine infant boy of Mrs Boyles and another accident. Voided some gravel. Very weak and stomach has failed. Hands and fingers often in cold sweat.

[Previously prescribed as hysteria. Sloane MS 4075, ff. 321-322.]

Will observe whatever Sloane orders, except issues. Has recently been bled. Took some mixture of Diacodium Sloane had prescribed in London. Asks if she should take other prescribed drink, too: "I am one of ye least drinkers in ye world & shall drink but little of yt unless yu wod have me." Takes usual drink and tries to get out once a day. Taking mostly barley water and milk, as well as electuary.

This is an update, with descriptions of a fast beating heart, shortness of breath, spots on arms, gas, a possible distemper, foot and ankle pain and hand weakness. Electuary fills her with wind and causes rumbling in stomach all day.