DEP/DUA/1/38/25 (Normalised version)

John Farquharson

1786

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January 21^st 1786

N^o26. John Farquharson a man in 22^d year subjected to severe & long continuing Diarrhoea.

But notwithstanding these circumstances is still in what may be called simple & uncomplicated state.

For no symptom in case which does not very frequently occur in that affection.

And no symptoms which can consider as indicating any other disease.

For flatus, borborygmi & acidity may as well as gripes be considered as almost constant attendants of Diarrhoea.

Although of long standing yet would fain hope that without any local affection of intestinal canal.

For has not at least any fixed pain or sense of heat.

Nay would seem even that gripes & tenesmus less considerable than formerly.

Must however be admitted, that when diarrhoea long continues in generality of cases is consequence of some local affection.

And that also by continuation such not unfrequently induced.

Hence then cannot be entirely without suspicion in present instance.

And this must necessarily very much affect prognosis.

For when that the case is often incurable nay frequently fatal.

Here however at present at least no symptoms which can give much alarm

And hope that by proper remedy may be able to overcome affection.

Here notwithstanding long continual discharge have begun you will observe by directing a cathartic.

For often where appears very considerable looseness, yet faecal matter particularly under form of hard [illegible] [relieved].

Hence then from full & free evacuation great advantage often derived.

But particularly useful as paving way to employment of opiates.

According to pill Thebaic have here had recourse.

And from these may at least [expect] that temporary suspension of looseness will be obtained.

For at least very few cases in which as allaying motion & diminishing sensibility will not be product of this effect.

But though thus discharge for the time restrained can hardly expect that will be overcome.

For little perhaps rather no tendency to restore intestinal canal to sound state

And in this affect every reason to conclude that not only irritable but also debilitated state takes place.

Indeed among other particulars is in present instance indicated by distension from wind, flatus & borborygmi.

To use of opiates therefore shall probably think of superadding, the use of such articles as will tend to brace & strengthen intestinal canal.

And with this view is my intention to make trial of a course of Rhubarb.

And have thoughts of employing it in substance as conjoined with aromatic & absorbent.

Either magnesium or crabs eyes or even the Pulveris Cretacea according to circumstance.

Particularly according to state of discharge by belly which may then take place.