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For Mr Addison -- Bo:ness

I think the case now pure nephritic & from

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the pulse being so little affected I am as clear that
the affection is spasmodic rather than inflammatory
& therefore that you have done very properly in
first making sure of an open belly then in
giving opiates & employing fomentation. I really
hope that before this time the Semicupium
has given relief. If it has not the affair must be
more difficult. I doubt not but you have attended
to the state of the bladder and if any sense of
weight fullness & tension above the pubis has
shewn that a quantity of urine is collected in
the bladder; that you either have or will endea¬
vour to pass a catheter. I suspect it indeed to
be an ischuria renalis but even then it is proper
to give satisfaction by passing a catheter into
the bladder. Whether the case depend on an
affection of the bladder or of the kidnies while
no feverish or inflammatory symptoms arise our
only measures are the employment of Opiates &
fomentation & one way of fomentation is by large
water glysters or at least of common decoction only
thrown into the rectum two or three times a day.
The only alternative I can suppose is that fever & inflam¬
matory symptoms may arise when bleeding will be
necessary and opiates must be used with reserve.