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Dr Dobson Liverpool

I wrote you some posts agp, & promised to write you
again by the next post but I am liable to so many interruptions,
that what is not immediately urgent is readily postponed. I dont
know how you may like my solution of your case, but the
more I consider it the more confident I am in my opinion, but I
shall be glad to hear from you on the subject. However you may
think of my theory I doubt if your patient can be pleased with
my practice, when I refer him to the general cure of the gout,
which I think is practica. -- He will think that this pro¬
mises little but you may tell him that this is only because
he will not admit of the cure of the gout, which I think is more
practicable than most people imagine. - I must not how¬
ever insist on this, but must say what I can about guarding

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the neck of the bladder from attacks, suposing the gouty diathesis
to remain. For this purpose the first thing to be attended to,
is the avoiding every thing that might irritate the neck of the
bladder, & therefore keeping the urine as mild as possible, by
plentifull dilution, but chiefly by water for every addition
to it is either useless or hurtfull. All fermented liquors, are
of the last kind, & especially the weaker & more acessent ¹ kinds.
In like manner all acids & [acrids?], whether in food or
drink are to be avoided. Diureticks of all kinds &
therefore ↑many of↑ the remedies employed for gleets are pernicious.
Diseased parts aquire a sensibility which people in health
have no notion of. Tho not necessary in this case, I must
observe to you, that nothing hurts this desease more
than costiveness, & the pains & gleet which your patient feels in the
morning, & the relief procured by his stool are fine illus¬
trations of my general doctrine, for his pains are
spasmodic efforts of the bladder, Among the irritations that
may be aplied to the neck of the bladder I reckon bougies,
for, tho the disease is sometimes attended with strictures &
relieved by bougies, I have found the frequent application
hurtfull. Topical cold bathing has been usefull, but
rarely [is?] universal bathing I hold to be very ambiguous
in gouty constitutions. -- Buxton is certainly one of the
safest. Besides the recommending to avoid irritation you
& your Patient, will expect a medicine to take off the spasmodic
disposition, & I have one to propose which you do not expect.
That is the Uva ursi. In many calculous, & what is more

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venereal & arthritic cases I have found it of great benefit.
It is to be given in powder three times a day, begining with
half a dram & increasing to one dram for a dose. It is safer
than bark, or any other bitter in arthritic cases, but still
I do not continue it longer than three weeks at one time and
indeed if it does not show effects in that time I do not expect
afterwards. The apthæ you mention I am quite unaquain¬
ted with and therefore can offer you no advice. -- I am with
great regard and affection Dr Dobson