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an anxiety to consider the subject fully & an uncommon degree
of occupation has made me later in writing to you than I wish. I own
after much consideration your ailments are a little difficult to account for. It is
possible that the concussion from the fall you had [which?] hurt your kidneys but by the
[{illeg}alre?] of the problems which followed after. I believe the effects of the fall were chiefly
on the muscles & that your kidneys were only hurt by the immoderate quantity of [soap?]
you took in a very short space. I must doubt if you have set down
{illeg} numbers exactly. for I have known severals who toyed with
soap than could bear & I have never known one who could bear ℥iv in
one day without being very sick & being purged very briskly whereas ypur
account says you took above 1/2lb per day for a month. If it was so
I am not surprised that [yr?] going by urine overstretched the vessels
of the kidneys & [on ye least check?] of perspiration made you liable
to Diabetes & tho' it had ceased for some time I shall not
wonder if upon certain occasions you shall have some return of it.
When it does happen in any degree you may expect a suppression at least some
interruption of {illeg} secretions & in this way I account for not only your costiveness
{illeg} for a suppression of the secretion of Bile & in consequence of the colour of your stools
A Jaundice is only the consequence of an obstruction of the Bile se¬
creted & will not be produced by a suppression of the sectretion itself. You say
you have no doubt of the excretories of the Liver being obstructed but I think
you should have said the secretories which makes some difference. I have
not time to tell you how much Dr Mead is mistaken with respect to
the influence of the Liver in Diabetes. without disrupting the state of
either your Liver or kidneys I must give my view of the matter. I
think the tone of your abdominal viscera is much weakened & this will pro¬
duce relaxation in one part & obstruct in another & particularly in the alimentary
canal will produce indigestion & flatulency. To restore the tone
in general, Bark, Chalybeates, & cold bathing may be employed &
among the rest the alum whey which as a saline matter will be applied
to the kidneys more than to any [Other?] part among the strengtheners I
must not ommitt being much on horseback which not only strengthens
the system in general but also relieves the viscera by promoting perspiration
& if you must otherwise keep in view by [usn?] belt & flannel. It may ↓be↓

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very proper also to promote the secretion of Bile & the only means
I certainly know of for the purpose is vomiting butdo not push it too
far for frequent vomiting weakens the stomach. [when ye?] secretion of bile is
restored the intestines may (↑will↑) be sluggish & may require a free
stimulus but I think a warmer purgative than the soluable Tartar
would be proper & I believe the Pil stomatic London Pharmacopoeia would answer
I believe the flatulency of your Intestines will be relieved by the
Thebaic Tincture & you may not be able to disperse with it
but it will not strengthen & it may increase costiveness & I would
wish to avoid it as much as possible. & CC

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