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I had the letter of yours of the 22d past some
days ago but some {illeg} precautions prevented my having
so much time as I thought necessary to be employed in
such a difficult Case and therefore I am later in my
Answer than I wished and than I commonly am.

After frequent consideration I think his {illeg}
may be said to be a Dyspepsia but I dont think it
has proceeded from any original weakness of his [Stomach?]
or [System?] but probably has been produced ↑or it has often brought↑ by a
Gouty diathesis appearing only as Atonic. The account
which happened to him about Seven years ago is
both for and against this opinion. Its coming into
his right foot and afterwards into his knees must
have been Owing either to Gout or Rheumatism
but the Rheumatism has commonly [an evident?]
cause of Strain or Cold which is not here taken
notice while the whole circumstances of his Constitution

{illeg}
{illeg} I have had
{illeg}

I must advise him to try the Tincture of
Guaiac made by taking One Ounce of Gum Guaiac
and rubbing it {illeg} with an equal part
of double refined Sugar and pouring upon these
a quart of {illeg} Rum and after frequently
Shaking them to other during three days
digestion filtrating the tincture for use. It may
be filtrated or poured off clear as it is {illeg}
used. Of this tincture a table Spoonful is to be
taken every morning and repeated for weeks or
months afterwards. This is the favourite reme¬
dy at present but from what you tell me
of your Patients irritable Constitution and his
being easily hurt by Spirituous {illeg} I suspect
he may not bear this tincture of Guaiac even
though very well diluted and I think I have

This dose
commonly keeps the belly regular but if it
gives more I diminish the dose or give it only
once a day. If even the two doses of Guaiac
do not keep the belly regular I would allow
your patient to take his dose of fresh whey
though I am otherwise not fond of that [account?]
laxative.

I am to propose no other medicine to your

Moderate Application to business, frequent exer¬
cise on horseback, the utmost care taken to avoid
cold, a Diet of light Animal food with very
little of [account?] and flatulent {illeg} and

I cannot conclude without Saying that it is
highly agreeable to me to correspond with a Person
of so much accuracy and Judgement as you have
discovered on the present Case and I do not grudge
the trouble of receiving from, or in writing long
letters to such a Gentleman. It flatters me
very much that such a person {illeg}
Writings and puts any value upon them. Your
Expression upon this Subject gives me a strong
temptation to gratify your inclination for a fifth
Volume but my present time of life {illeg}
{illeg} in {illeg} and my many {illeg}
{illeg} allow me [carpere?] {illeg} I am [with]
very great regard