The date of his complaint uncertain, but tho it might originate
from Venereal complaints no connection with them now.

A local affection of the neck of the bladder, and as there seems
to be no purulency in his urine probably no ulcer and therefore no advice
with regard to that.

The Hæmorrhagy the only circumstance of consequence and as he
has no pain of his back nor ever has had nephritic complaints we cannot
suppose the blood comes from the kidney – and as he complains of some pain
in the neck of the bladder it is probably from thence – but the state of the
parts difficult to know.

Probably depends on a turgescence of the blood vessels which may called
as some Authors have done Hæmorrhoides Vesicæ

Of very difficult cure – I treat it as an Active Hæmorrhagy and
therefore use the Antiphlogistic regimen and when the Hæmorrhagy is urgent even
bleeding and when a return is threatened, it is often prevented by
Leeches applied to the Perineum near to the Anus, but that will
not be of service now when the Hæmorrhagy is present & has subsisted
for some days. I have below advised the use of nitre because you had
done it, but I have often found it irritate the neck of the bladder
& therefore here to be used sparingly

2.d letter ¹

While the Hæmorrhagy continues he ought to observe a cool regimen –
He ought to lie constantly on his bed but at the same time keep
his belly (↑body↑) cool –

He may drink freely but of the mildest liquors. The Arab.
Emulsion is one of the most proper & he may have it with double the usua
usual proportion of gum – & likewise some cooling nitrous powders
& if the Hæmorrhagy is not declining – when this comes to hand he may use
the powders precribed below which I hope will soon put an end to it

His belly must be kept soluble - by glysters or gentle Laxatives, for
acrid purgatives dangerous. – If he feels any strangurious pains or ↑frequent↑ irrita¬
tions to make water two ounces of the freshest florence oil thrown into the
rectum 2 or 3 times a day will be of great service