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I have very attentively considered
your brothers complaint and am quite determined with
respect to the nature of it. I have no doubt that it is
a violent spasm in the left great flexure of the colon and
that the kidney is no otherwise affected than by its vici¬
nity which occasions the colon & kidney mutually to
affect one another. From this opinion of the disease
I must maintain that there is no other means of care
but by Opium which must be given in large quantity,
If there is no vomiting the opium may be given by the
mouth but if there is, it will be as effectually given by
injection. While the Opium is employed it will be as¬
sisted by a warm bath or by fomentation externally
and internally. A chopin of warm ↑or more↑ thrown in at
once will answer the latter purpose and this without
the addition of any purgative may be repeated as often

as can be convenient. But upon the first coming on
of the disease it may be proper to add some purgative
and I hold common salt or Turpentine to be the best
but either of them ought to be employ↑ed↑ment to the quan¬
tity of an ounce. If the turpentine is employed let
great pains be taken in rubbing it with the yolk of egg
to mix it very well with the water. When the disease
first comes on I would have one of these glysters first
employed and only when these are rendered I would give
the large dose of opiate. If it is to be given by in¬
jection let it immediately after the laxative is ren¬
dered and let it be given in a small bulk as of three oun¬
ces of a Solution of G. Arabic. By the immediate and
alternate use of Laxatives, Fomentations & Opiates I expect
that the fits of this Cholic may be always relieved and sooner
too than they have hitherto been. When the stomach will
bear it Laxatives given by the mouth may be very proper

the one I would prefer is the Ol. Ricini with a fourth part
of Tinct. senn. comp. Mix at once Ol. Ricini ℥iij
Tinct. senn. comp. ℥j and let them be always well shaken
together ↑before giving↑ which renders the oil less disagreeable and also makes
it sit better. A spoonfull to be given at once and if neces¬
sary repeated at an interval of th two or three hours rep twice
or thrice. Tho I have no doubt of curing the fits
I have great difficulty in preventing them. It is only to
be done by a regimen which can only be directed by his
own observation of ↑the↑ Juvantia & lædentia. Any view to Ne¬
phritic affection and therefore lime water can be of no service
tho I believe every corrector of Acidity may be of some.

I regret that I did not get a conversation with you on
this subject but when you have perused the above if you
have any remarks questions or doubts to give I beg to have
them being