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A very difficult case. From the symptoms affecting the
stomach which formerly attended the fits I would suspect some
systematic affection to be the foundation of the disease; but as
those symptoms have now gone off and others marking a ge¬
neral affection are much abated I am disposed to consider
the ailment as at present purely local or nearly so. and to
depend on a rupture or erosion of a blood vessel on some part
of the internal surface of the urinary passages. The ardor
urine may give suspicion of the urethra or neck of the
bladder but then I think the disease should be marked with
more uneasiness in these parts; and I imagine indeed that
the source of the blood is higher, possible in the kidney itself.
The copious discharge of pale urine which he formerly had
could proceed only from an affection of the kidney.

I wish I could speak with confidence as to the particular
remedies. I can hardly propose any measures but those sui¬
ted to hemorrhagy in general. Avoiding much exercise,
all external heat, & as much as possible any irritation
from meats or drinks As I do not consider it as an active
hemorrhagy I cannot propose evacuations, especially after
the disease has stood so long. As costiveness is a conside¬
rable iritation ↑to↑ the urinary passages, it is to be carefully
obviated but neither by glysters nor by alaetics nor by
saline matters which always directly irritate the urinary
passages. Flowers of sulphur Diacassia or Castor oil
seem the most proper. Tho I trust little to internal as¬
tringents being carried farther than the prima viæ I
think they are more likely to irritate the urinary passages
than any other part, so in this case I would try the Alum
either in substance or Serum aluminasum. The
quantity must be as the stomach easily bears. I had
lately a case very much the same with Mr Crompton's
There was a discharge of blood in the urine, which had
subsisted for several months without symptoms of any
nephritic or other is internal affection & without any

symptoms which could mark the source from whence
the blood proceeded. It had gone farther than I hope is
the case with Mr Crompton: in rendering the person
very pale and leucophlegmatic; but is now quite cured.
Various remedies had been employed with very little
immediate effect & the discharge ceased when he was
using hardly any medicine at all: but if we can im¬
pute his cure to any remedy it was probably the
alum which he had taken very largelye little
befoer. The last remedy he took was the uva ursi &
I should think, considering the state of Mr Crompton's
stomach, that a very proper remedy for him.

I wish you had given me an account of your
own or others practice upon this case. It might have
superseded much of what I have said. Chalybeate
astringents have perhaps been employed & I should
be glad to know with what effect. For I should ex¬
pect them to be rather hurtful.