DEP/DUA/1/39/18 (Normalised version)

John Farquharson

(1785-1786)

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John Farquharson. March 4^th

In case of this patient distinctly marked instance of Diarrhoea.

And that [appears] without complexity of any other affection.

For flatus borborygmi gripes & tenesmus, other symptoms mentioned in case besides severe looseness, well known to be if not constant at least common attendants of Diarrhoea.

Before came under our care affection had been of three months standing.

And during that time had subsisted with considerable degree of severity.

Would not therefore been wonderful if although at first simple diarrhoea had now given rise to some local affection of intestines.

And in this way from ulceration & other local affections induced sometimes even fatal.

In this case however as observed when formerly spoke of it, no symptoms that any such affect has taken place.

Though affected with gripes, yet these pains of flying & transitory nature

And here no symptoms of any hectic fever

For pulse while full & regular rather slow than otherwise.

If however local affection of intestinal canal had taken place might expect both fixed pain & some hectic symptoms.

Hence then formerly expressed hope that disease might soon be brought to favourable termination

And in this expectation have not been disappointed.

For some time since have been able to dismiss him free from affection.

An event which am I own inclined to attribute to practice here employed.

This however will more fully appear from particular view of remedy employed here & effects resulting from them.

Began practice by directing use of purgative.

In cases of Diarrhoea this may seem an unnecessary practice.

As may be supposed every intention it could serve fully answered by [spontaneous] looseness.

But to be remarked, that in many instances notwithstanding this, there does not take place full & free evacuation of intestinal canal.

Accordingly when a purgative employed hard [indurate] [illegible] often discharged.

Hence before use of medicine restoring looseness thorough evacuation in most instances proper.

As such had here recourse to Glauber salt.

An article, which, as free evacuant of alimentary canal, without occasioning discharge from system has very generally best affect.

To this however immediate subject use of Pill Thebaic.

This directed solely with view to opium it contains.

Which unquestionably one of most powerful remedies with which yet acquainted both as allaying inordinate action in moving fibres, & restoring those discharges dependent on increased action of vessels.

But in an [especial] manner when these occur in intestinal canal.

Thus no remedy more certainly effective in giving immediate check to looseness.

And in present instance were not disappointed in effect expected from it

For while salts operated well soon after began use of pills looseness very considerably diminished.

In place however of producing obstipation a consequence not infrequent on cure of Diarrhoea, belly still continued more loose than natural.

From this then led to continuation of pills.

While at same time with view to strengthening tone of intestines directed use of Peruvian bark combined with small proportion of Cassia with view to Carminative effect.

By this imagined that should secure benefit derived from pills.

And more effectively prevent tendency to return of affection.

While this powder employed however by accident pills omitted.

And on this occasion, whether from want of these or from some other circumstance aggravation of looseness took place.

Not improbable that might even in part be affect of powder.

For though Bark, most frequently binds belly yet in some instances from particular state of alimentary canal has contrary effect.

But whether this the case in present instance or not seemed in other respects to be serviceable to him

For observed that appears considerably mended

Hence then while ordered repetition of pills directed also continuation of powder.

But notwithstanding opiate in beginning of ensuing week severe return of looseness

And this he himself disposed to ascribe to powder.

A circumstance which led him to intermit use.

And at least somewhat in favour of his conjecture that under continuation with pills alone soon much mitigated

In this situation seemed inadvisable to do anything farther than directing him to persist in employment.

And at succeeding report so far free from affection, that farther continuation of medicine seemed unnecessary.

Was accordingly dismissed from attendance with request to return if subjected to any recurrence of complaint.

But as have since heard nothing of him disposed to conclude that continues well