DEP/DUA/1/42/14 (Normalised version)

Janet Frazer

(1787-1788)

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N^o 14

Janet Frazer. at 44

Principle part of disease consists in frequent loose stools.

And to this can have no doubt in attributing all other symptoms.

Or at least may conclude these to arise, from that state of intestines [giving] the looseness.

Here may perhaps be questioned whether to be considered as example of diarrhoea or dysentery

Some inclined to apply latter term to every case in which there occurs gripes, tenesmus or bloody stools.

Latter circumstance indeed not mentioned in history of our patients case.

But may observe that is one of those particulars readily escaping observation.

For often little attention paid to matter discharged by stool.

Hence from mere silence with respect to it cannot infer absence.

And with this patient gripes & tenesmus at least, described as taking place to high degree.

While with pulse at 90, great thirst, loss of appetite & diminishment of strength, cannot be said, that free from fever.

But though these give different disease from ordinary diarrhoea yet still more different from Dysentery.

For this term should I think be entirely appropriate to a disease, universally depending on peculiar contagion.

And in present instance no evidence that either received from contagion or capable of communicating contagion to others.

While as far as fever here occurs evidently appears that not primary disease as in case of Dysentery but symptom only.

And in short no symptom which will not often be met with in advanced or chronic state of Diarrhoea.

This then my opinion with respect to disease of this patient.

With regard to prognosis am I own inclined to look for favourable termination.

For upon whole can by no means be considered as a fatal affection.

In general this only happens, when allowed to run on so far that there occurs local affection of intestinal canal.

Of these however may at least venture to say that no evidence in present instance.

Disease indeed may be considered as having passed period of natural cure

For looseness would often appear to be operation of system for removal of some offending cause.

And this may infer to have happened in present instance from pain & uneasiness in alimentary canal preceding looseness for some length of time.

But when runs on for any length of time intestines acquire irritated & weak state.

And have at same time a disposition to increased secretion.

But by use of proper tonics & astringents may in general be successfully countered.

By these hope that affection in present instance may be combated.

And as such have here had recourse to succus japonica.

But of that shall afterwards speak