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Your distress gives me real concern and I
shall be very happy to contribute every thing in my power
to relieve you but Mr. Polls letter came here too late
on Tuesday night to be answered in course and there was
no Post went out yesternight.

After considering all you tell me I have no
doubt in concluding your disease to be Gout & in that
case I cannot secure you against & I would not wish
to free you entirely from pains of your joints and I
shall be well satisfed if I can confine it to these.
When it comes into your Stomach with reaching I have
no doubt of Driving it out there by Brandy & espe¬
cially by Laudanum in large doses. I dare say you have
already tried these measures & I wish you had told
me upon what occasions you had done so, what doses
you had taken & with what effects till you tell me
this I cannot advise you very positively. I am sorry
to find that you have so bad an opinion of my good will

as to make so much Apology for Consulting me upon this
occasion. I assure you you may write me as often as
you please & may depend upon an Answer as soon as
I can possibly give it. I speak now only of relieving
your stomach amp; say further that if you have found the
Laudanum fail or are doubtful in taking it as freely
as the pains of your stomach may seem to require you
may try a Bolus of Salt of Hartshorn & Camphire a gr. v.
& let me further observe that when you are to take Lau¬
danum, you should take it if possible before the pain has
brought on any reaching for after that has come on you
are in danger of loosing your labour in giving anything
by the mouth & therefore when a reaching comes on before
you are aware of it or perhaps that your Laudanum
has been repeated you must thengive it by Glyster
in a dose that is double what you would have given
by the mouth. I need hardly observe to you that if
the use of Laudanum brings on costiveness this must be
{illeg}sued and the best means seems to me to be the
Aleotics especially in a spiritus or tincture such as sure

Elixer sacrum. As long as your pains keep tolerably fixed
in either your knees or feet I would let them remain
there except in so far as a moderate dose of Laudanum
taken at bed time may give you some rest in the
night but if they are very unsteady & frequently threaten
your stomach I may possibly advise you to a dose of Dovers
Powder but I must first know what experience you
have had of the use of Opiates in your own constitution.

When you have got the better of your
present distress I have much to say to you about
preventing returns of the like but I shall have
time enough for that hereafter if you shall be
pleased to give me the opportunity by a further
and fuller information. As I was not certain of the proper
Address for Mr. Polls I have addressed this letter to
yourself but please make my Compliments to him and
believe me to be