DEP/DUA/1/33/19 (Normalised version)

James Marshall

1783

---

N^o10^th November 27^th 1783.

James Marshall at 36. complains of great pain extending over his whole abdomen & stomach attended with borborygmi & flatus & sour eructations. The pain is not constant but recurs frequently after having had intervals of ease for some minutes. When the pain is violent, it is attended with retractions of the Umbilicus. He is much relieved, when he discharges wind either upwards or downwards but particularly in the latter way

He has no looseness & his belly is in general preternaturally bound unless when he uses Rhubarb.

He is not so violently affected when he confines himself to the house; but his complaint is always aggravated by accidental exposure to cold.

Tongue white, Appetite bad Urine natural. Pulse regular, Sleeps ill.

This affection commenced three months ago & has increased in violence within these three weeks

He was similarly affected three years ago, but not to so great a degree. He knows no cause for his complaints & has used [no] medicines.

Rx Pulv. Rhei ℥i. Magn. Alb. ℥ii M cap coch parv. bis indies ex Ag. Menth. Pip. cyatho.

29 Cont Med & cap. Pil. Foetid cum Aloe grV om. m.

December 6 Has continued his medicines regularly & since the use of his pills, he has a more free discharge of flatus. The returns of the pain of his belly are less frequent, but still very severe. Appetite somewhat mended

Other symptoms easier. Cont Med. u. a.

13. Has continued his medicine regularly & all his symptoms are much relieved, but within these few days, he has discharged several ascarides by stool.

Interm. Magn. cum Rheo Cont. Pil. Foetid & Hab. Aq. Calc lb. injic ℥IV pro. Enem. altern. quag. nocte.

20 The injections of lime water were used as directed. But since he began to use them he has seen none of the worms. The pain in his stomach & abdomen has been considerably increased since he gave up the use of his powder.

Interm Aq. Calc. Cont. Magn. cum Rheo & Pil Foetid. u. a.

January 3^d. He has seen no more of the Ascarides & he is now much less affected with the pain of his belly

But he has in general five or six loose stools every day.

Interm. Pil. Foetid cum Aloe. Cont. Magnes. cum Rheo u. a.