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For Dr Saunders

As to your Nephritic complaints depending upon calculi in the kid¬
nies, can give you no new light. I believe in no Solvents but
various Alkaline substances relieve without dissolving & the caus¬
tic lye after Chitticks method, ¹ is the best.

Your strangury & the glutinous mucus of your urine I
understand very well. Lieutaud ² the first I found take
notice of it under Catarrhus vesicæ & I have now practised
often upon it. Has various causes; very common one is violence
done to the neck of the bladder by frequent passing of stones
& sand. Have found if difficult to cure, & left it generally
to a palliative course. To avoid all fermented liquors
& all acids is very necessary. The using of a light diet

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of the most mild & bland aliments. Avoiding bodily exercise
even riding, but going in an easy carriage commonly
relieves. Opiates are often necessary & for that & other
reasons the belly must be kept open, & best by the
oleum ricini. Besides these palliatives, the medicines
I have found of most service is the Uva ursi 2 or 3 drachms
every day. It generally agrees well with the Stomach
& does not bind the belly. I have sometimes found it
laxative so as to require Opiates, but whether lax¬
ative or not Opiates are often employed along with it
as a part of the Palliative course. You are to expect no
very remarkable effects from it till using it a week or two
& sometimes a longer time.