DEP/DUA/1/13/03 (Transcript version)

Mary Lamb

(1777)

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Mary Lamb.

Disease of this patient with respect to name may be subj of some dispute.

Not howevr so much from any diffic respecting nature as from diff names sense in which same term has been adopted.

Some who consid gripes, tenesmus & bloody stools as constit dysentery.

And in this sense of term would necess bestow that appellat on pres. affect.

By term Dysentery howevr would wish to understand a pecul. febrile affect. dep. on a specif. contag.

Of such an affect in pres. case no room for entert. any suspicion.

Used in sense in which I would adopt term have little diff. in pronouncing dis of pres patient to be Diarrhoea.

And while affords example of this affec to high degree is at same time in simp & uncomplic state.

For besides morbid affect of fecul. disch all other sympt such as common attend of diarrhoea.

Thirst, parchd skin &e natural conseq. of serous disch. from the system.

While tenesm & bloody stools in as far as do occurr here merely affects of abraded state of intest.

Want of menst. disch although for six years to be consid as natural state of syst.

For to be observd that before this patient had arrivd at forty fourth year.

A period before which not unfreq. [leave] [women]

In history indeed one partic which would lead some to consid affect as diff somewhat complic.

That is state of vegetab. matters disch

Are told that when these employd in alim come off undigested

This has by itself been supposd to constit a partic genus of disease.

And in most nosol. system disting. by title of Lienteria.

Appreh. howevr that with improp consid as separ. genus.

And cannot help thinking that Dr C. has followd best plan in conj. with Diarrhea.

Pres. inst affords even argt for such [apn].

For here lienter affection holds only in partial [manner]

And while diarrhoea of long standing this sympt has never gone to any great height.

Respecting termin of this case am not entirely without appreh.

Cannot indeed say that has as yet had any very great influence on syst.

Patient neither greatly weakened nor of appar. exhausted habit.

Has already howevr subsisted for consid length of time.

And during that period has resisted [affec] of various med.

Of nature of these indeed have not been able to receive informat.

But may reasonable presume that are not the least powerful.

Since came under our care various artic used without effect of prod much change on affect.

And with regard to this disease may be observd that is one apt to become habit to syst.

When this the case both greater diffic in cure & greater caution requist.

As sudden means of checking often followed by very disagreeable conseq.

In such a case as pres. therfore object to bring about rather grad than sudden cure

And in attempting this endeav [taken] employd.

Here after disease of so long contin little reason to suspect any partic cause affording irrit to action.

Or at least if such existed could not imagine of that nature to be removed.

In pres. instance consid disease to be chiefl affect of encreasd dispos. to action & augm secret by intest.

At same time this augm secret not affect of encreased determin to intest.

For of this no evid from state of pulse of heat or any other circum.

Would then upon whole consider the affection before us as princip affect of relaxed & irritab state of bowels.

And consider cure to be depend on meas capab of restoring prop. tone.

Which will at same time have affect of dimin irritab.

This last however an end, at least more immed obt. by means of proper sedativ

Which in pres. affection may also be prod of good conseq.

To be observed howevr that although have already said do not suspect any partic irritat to subsist const. here yet such may be occas generated.

And from state of bowels now describd may naturally suppose that there will occurr remarkab. dispos. to acidit.

Of which accordingly at diff. times evid indicat have appeard.

Is on these gener. princip. that have already had recourse to the diff. med which have been used.

Partic to Lign. Campech. Ter. Japon & Rhubarb as astring & tonics

To Magnes. as an absorb.

And to Liq. Laud as a sedative.

From all these patient has obtained at least tempor. relief.

And probab. would have had more effect if had cont. to take them regul. without intermiss.

From inattent in this respect howevr after compl. somewhat abated, had again severe return.

But since that by use of Rhubarb conjoind with small proport of L. L. again consid abated.

And if under this cont to recovr [should] not think of changing it.

If howevr looseness still obstin. is intent to try with this patient a med which have used but little.

That is the G. Kino

An astring from vegetab. kingdom which has not yet made its way into greater part of Pharm

And what indeed think somewhat strange not even in Pharm Sueciae.

Upon authority howevr of trials by Dr Foth. vid Lond Med. Observ. has had a place in Ednr Pharm.

And as found to make very eleg. tinct have thought of employing it in that state

Should this also fail have next thoughts of trying Peruv. Bark

At same time conj. it with a small propor. of an opiate.

And from one or other of these meas. disp. to hope for good effect

Must howevr observe that in removal of pres. affect much must dep on avoid exciting causes.

And by cold prod determ to intent or by acrid matters supporting irrit there every other meas will be renderd abortive

Consider case therefore dep. more on attent & regul. on part of patient than on any meas. which we can employ