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Mr. Leggat

I am favoured with yours concerning Mr.
Leggat and in course give you the best advice I can

The Case is very puzling. There is no doubt
of their being an Inflammatory state and Dr. Campbell
and you could not avoid seeing it in that light and
treating it as you have done and if the Case had been
purely and simply an inflammatory state your blee¬
dings and other measures would certainly have Cured
it before now. But there must be as you judge
some peculiar irritation that so often and so sud¬
denly gives occasion to a return of the symptoms
that this may be ↑and↑ whether without or within
the intestines it is very difficult to say. Your reasons
for concluding it not to be within is very probable
but still it may be nothing external to the intes¬
tines and what appears to me most probable

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is that it depends upon an irritability of a portion
of the intestines disposing it to fall into a Spasm
and which may be renewed by slight and impercep¬
tible causes. The suddeness of the late attacks and
the nervous symptoms with which they come on
favour this opinion and I embrace it because
it is the only opinion that admitts of practice.
The supposition of any irritation external to the
intestines is a very random one and could not
lead me to any practice at all. The insisting
on the view of the Case as purely inflammatory [when¬?]
ever proper it was before must now by excessive
bleeding destroy the Patient as certainly as his
disease could do. I am just now for trusting
the Cure to Opiates given pretty frequently and
pretty freely. At the same time I would {illeg}
the Antiphlogistic regimen {illeg}

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his belly open by glysters or gentle laxatives and
particularly the Oleum Ricini, to practice fomen¬
tations and fresh blisters as often as he can find
place for them. This is the best advice my judge¬
ment can offer to you but at the same time leave
much to your and Dr.. Campbells discretion and
particularly allow that sharp pain, much fever
with a hard pulse may require a bleeding,
particularly when there has been
a tolerably long interval between and
a former. With my very best Compliments
to Dr. Campbell I am