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I have just received your letter
concerning Mr. Bell and do not delay a minute
in returning you an Answer.

The Case is certainly singular and if I had
an opportunity of conversing with you I should make
several observations upon it but it is not conve¬
nient to give them here.

You seem to have acted with great propriety
and have prevented me in several remedies that
I would have proposed.

With respect to the present state of the disease
you are not so clear and explicit as I could wish.
You do not tell me what extent or degree the
pain of the Shoulder or Arm still continues but I
suppose it is still considerable and if there is
no inflammation or swelling upon the forearm

I would have a Pea Issue put in by Caustic into the
ordinary place and I hope that both the Caustic
at first and the discharge afterwards may be of
service.

Let the top of the shoulder be annointed every
night and morning with equal parts of the Bal¬
samum Anodynum and Saponaceum.

The only internal remedy I would Propose
is the draught ord Prescribed below to be taken
every night at bed time and if you shall have
found that the Opium had no effect in increasing
his delirium and that he still continues to have
restless nights you may add to the draught
prescribed from thirty to forty drops of Tincture
Thebaica. If the delirium continues or in¬
creases I should think it proper to Blister
his head.

As your expression is the Jaundice continued
for some days and you say nothing of its continuing
now I offer no advice with regard to it but
if you have led me into any mistake on that
subject and advise me of it I shall supply
my defect hereafter. With best wishes for Mr.
Bells recovery I am with great regard