My dear Darwin

The above address will account for my delay in not answering your letter sooner, which I received this morning.—² I am very sorry to hear that you are suffering so much. The particular form of complaint you describe, is what the doctors term ‘Waterbrash”.³ It is obviously a diseased secretion of the stomach, but of its true nature I am not aware that anything very certain is known, as it accompanies various kinds of general derangement. The treatment usually recommended is light bitters with subnitrate of bismuth & hydrocyanic acid & I think it not improbable unless, as is most probable, you have already tried it that some such combination might do you good. But I think a useful adjunct under any circumstances would be to give the stomach something to do, very early in the morning, & before the vomiting usually occurs. Perhaps a cup of milk & water with a few grains of calcined Magnesia, say 10 or 15 taken early in the morning with a little biscuit or dry toast, might persuade the stomach to limit itself to its proper function. I have enclosed a prescription for the other medicine which you can try or not as you think proper.⁴

With respect to the flocculent matter you mention as contained in the ejecta I should not be at all surprized to hear that Goodsir detects his Sarcina in it.⁵ That organism however, whatever it may be is I believe extremely common, though under certain circumstances it becomes so much increased in quantity as to cause the idea that it is the cause of the disordered function.

I do not think that this is so, & in minute quantity I do not myself consider its presence a sign of any importance whatever. All that I have been led to conclude respecting it when more copious than usual, is that for some reason or another the contents of the stomach are delayed longer than usual in that organ, I imagine that your stomach is weak in its muscular power & perhaps in consequence very dilatable, & that it does not push on its contents as rapidly as it ought to do— whether there is any cause of obstruction besides this, I cannot say, but think, that reason is alone sufficient—

I think however that with this change of Symptoms as it would seem to be, you had better ask some advice,—   as regards the man to apply to—I think you would get a good opinion from D^r Brinton who has paid much attention more especially to diseases of the stomach & is a sensible & prudent man at any rate not likely to do you any harm—⁶

I have been down here with my family for about a week, but until today we have nothing but rain, though it seems now inclined to take up.—

Believe me | Yours very truly | Geo Busk