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I have with great attention considered
your full & pointed account of Mrs Burrows complaints
& from most of the circumstances I must conclude that
her disease is seated in the kidneys & that more or
less of calculous matter sticking there produces all
the symptoms. At the same time I must own that the
chilly fits towards the Evening & the pains on motion
tho' not altogether incompatible with Nephritis are not
however incompatible usual attendants of it, & may
give some suspicion of some suppuration going on
in the Psoas & incumbent Muscles. It is a case I
have met with several times but there is no Author
has mentioned it expressly except one French author
as you may learn from sauvages under the title of
Lumbego Psoadica & more explicitely Dr George
Fordyce in his Elements. ¹ A peculiar Symptom
is a Difficulty & pain in extending the thigh of
that side so that it is always drawn up to the
groin.

Under the uncertainty of our Art I choose
to be circumspect in my Judgement & therefore have
mentioned {illeg} [things?] but at same time own it is
to little {illeg} for the last mentioned Disease is
almost entirely out of reach of our Art & we
must take to suppositions that admit of practice
& upon this plan I am very confident in saying
that the only medicines which can give Mrs Burrows
relief are these which you have hitherto chiefly pursued.

You are right in laying aside the Bark
when She is squeamish with much sickness at
stomach a draught or two of Camomile Tea may

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may give relief but I would give no stronger Emetics when
She complains of Sourness of her Stomach, Magnesias
may be usefull & more so if it keeps her belly easy
for if it does not, some cooling laxatives or frequent
injections must be employed. They must be employed
because I think Paregorics & Anodynes are [moderate?]
and I think you have hitherto been rather sparing in the
dose of these. I think the Saline mixture especially
made with Sol. C. Cervi should be continued & you
may add to every six ounces a {illeg} & a half of
Spir. Nitri. dulcis . An constant drink or In the
most part should be Arabic Emulsion or Marsh
Mallow Tea but at sometimes in the forenoons or
before the Chilly fits come on She may have a little
Hock with barley water. The formenting with a
bladder filled with warm water may give relief [here?]
I would expect more from flannel Cloths wrung out
of very warm water & wrung out between two hands
to be very dry & by which means they may be sup¬
plied very warm. Her diet must be light & cooling
& much of it liquid. Light Broths should be a great
part of it & is almost the only animal food I would
allow of. I have no objection to her taking a little
lime water but I doubt if she can take so much of it
as to be of [any?] service & there is [another?] medicine I
would recommend which has a wonderful [power?] on the
urinary passages & is not [improper?] on [any?] supposition
[about?] Mrs Burrows complaints. This is [the?] Uva Ursi
[let her take half a dram of the powder in Draught or?]
Bolus as She like best twice a day & if the Stomach
bears it well the dose may be increased by degrees to
a Dram. This is all that occurs to me at present
but it is possible the case will last for some time & I
shall appeal you further information. I am always
with great regard