Dear Sir,

A patient of mine some time since passed into the care of a physician down town whose name was given me as a Dr. Layman. I knew of no such physician. From the address given I judge however from an examination of the Medical register that Mr. [Burus/Burns??], he is an Irishman, I must have mispronounced your name. I can't claim ignorance of you as I have [sent/met??] you once in consultationn in (152nd St) have heard you hightly spoken of, and was on the point of having you in consultation in an [obscure/abuse??] being difficulty.

I have no doubt there has been an equally erroneous statement of your opinions in the case of the patient referred to. I saw her on the 19th Oct at Mr Burnes' at [Lewood/Irwood??], pronounced her to have intermittent fever, for which I prescribed. I called again on the 22nd (if I made a call in the interval it is not charged and I don't remember it).All febrilesymptoms had disappeared and the patient felt much better but was not strong and had occasional nausea which she said had troubled her for some time previous. Finding no cause for this I took some of her urine home found it albuminous and under the microscope presenting several fragments of [tube casts??]. I told them she had symptoms of incipient Brights disease.

I said moreover that it is not the fatal disease that people think it to be and that under treatment she had a good chance to recover. They said they were unable to keep her there and that her relation in the city were not[vile/nil/wil] enough, nor had she any means. I advised her to [winter??] St. Lukes. That was all I saw of them or her until I heard that (apparently with ill nature) they were[pleading??] the report that she had no symptoms of renal disease, that you said she had had Intermittent fever which had been improperly treated and had ['that her' crossed out] as a consequence become Thyphoid fever. Now Dr I am not an ignorant country doctor. I studied with Walts Parker & Prof Lorey: was House Physician in Bellaree from 1854 to 55: House Surgeon from, 1855 to 56 and studied microscopy under J.C. Dalton and Rolins of Paris. Will you do me the favour of telling me in what condition you found the patient and whether she ever has no symptoms of renal disease.

I am sure you cannot hold that Intermittent and Typhoid fever are convertible diseases. Of course I ask this as a favour but your position in the profession assures me that you will not allow your opinions to be misrepresented to a dishonourable end.

My friend Dr Sands remarked that he knew too well your reputation to believe that you would pursuit such a use of your means.

Very sincerely

Wm Forthingham