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Some indisposition which I have been
under for some days past, and other accidents
prevented me from answering you in course, tho
I shall be extremely desirous to shew my inclination
to serve you as far as it is in my power. ---

I think I know your disease, & it is not a stone
in the bladder but a catarrhus viscid depending
upon gout determined to the neck of the bladder
by some previous ailments in that part. This may
possibly be new to you but I have had many
instances of it & have some at present. When ye
disease gives considerable obstruction & threatens suppression of
urine bougies may be necessary but when the disease
is fairly gouty they give no durable relief & very
often do harm. I would therefore have you more
sparing of them than you have been. The only
certain relief you can expect is from the gout
coming into your feet, but how to determine it there
I cannot tell you. If you had no feelings of it at all
I should advise you to bathing and blistering, but
as you have frequent darting pains I cannot
advise you to either remedy as I know they can
turn away pains that have a tendency to the feet.
All I can advise with a view to bring on gout is
to avoid accesent meats. & drinks weak wines &
every thing that can weaken the tone of the