DEP/DUA/1/18/05 (Transcript version)

George Karr

(1778-1779)

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George Karr.

Sympt with which this patient affectd not numer.

And may justly consider whole as constit merely one disease.

May however be some question with [regard] to nature of this disease.

But still more respecting name.

And that rather from differ. in definit of terms than from diff in sentim.

To disease of pres patient some would affix term of dysentery.

While with others would have appellat of Diarrhoea only.

If consider as Dysentery every disease in which bloody stools, compl of pres. pat. unquest well entit to that appellat.

But if on other hand by Dysentery mean a pecul. febrile affect. either deriv origin from contag. or capab of being commun by it, no reason for suppos. that patien has any such disease.

For my own part am disp to adopt term in latter sense

And to conf term Dysent. strictly to what calld putrid or contag Dysenter.

In this view hold pres patient to be affected with Diarrhoea.

And that notwith occurren of tenesm & bloody stools.

Which indeed am disp. to consider both in Diarrh & Dysent. rather as accid than as giving any charact of the affect.

But although not charact of genus, may yet often serve to elucid nature of affect.

For here to be observe that when under diarrhoea compreh every inst. of encreased disch by belly forms very extens. genus.

And accord will observe that Mr Sauv. in his syst has defind upwards of twenty species.

Although at same time considers as separ & distinct genera the [Celiaca] & Lienteria which Dr C. has with [perh.] greater prop ranked under genus of Diarrh

Of all species describd by Mr Sauv case of our patient corresp. most exactly with what he terms Diarrh. vulgaris.

And these disch which take place does not so much consist of matter that has been used in alim, as of matter separ from circul. mass of fluids.

When this this case more dispos. to bloody disch than in most other inst.

And from alterat in state of secret by which mucus [abraided], with this species also, tenesm more apt to occur.

For occurr of these circum then, here led not merely to name but to nature of affect.

And disp to view pres compl. as const princip in dispos of intest canal to augm secret. & encreased action.

On this idea of affect, cannot give a prognos so favour as would do in some other cases

For many circum such for ex as mere irrit to intest, or like, which in nature very [tran] yet capab of giving rise to this affect.

Is nothing also in favour of patient that compl. has already cont. for space of sever months.

And that took rise without any obvious accid as tending to induce it.

At same time nothing as yet at least in case before us which portends much danger.

Patient at that period of life when such vigour as to give good chance of natur recov

And has not hitherto at least resis. use of those med calcul. for remov.

Upon whole then inclind to hope that in no long time may have fav termin under such treatm as shall be direc.

With this view from opin given of nature of disease imag. that great obj to be aimd at is

To dimin dispos. in intest canal to augm secret or encreased action.

And this cheifly be be brought about by strength tone of secret vessels & [mov] fib.

This intent however more easily accompl. if due regard paid to some other circum.

Partic by diminut of impetus of circul at intest.

And by remov of irrit causes tending to support or encrease augm action.

On these gener. princip use of partic remed which have here employd will be readily understood.

On these gener. princip will readily understand diff pract. to which have here had recourse.

Began pract. here by ordering for our patient first an emet & afterwards a purg.

In these sole obj in view, was by evac alim canal to remove all irrit [there]

For notwith freq. disch. yet often hap. that no prop. or free evac.

And that either sordes in stomach or that indur scyb. lodged in [plica] of intest give const. irrit.

Hence then becomes very necess prelude to med either strength tone or dimin disp to action.

In case before us reason to presume that intent here in view fully answered

For both from emet & purgat free evac.

After evac then obt. had immed recour to an astring.

And with this view employd Suc Jap or as is still calld in Phar. although [with] improp. the Terra Japon.

For accord to accur. acct of this med by Mr [Kerr] pub in 5 Vol Lond Med Obser is a veg. extract from species of [illegible]

Hold it in cases of Diarh. to be one of best astring.

And although may be given in diff forms yet none pref to infus.

Here comb infus with Cort Cinnam as carmin & Syr Diacod as sedative

For consid operat in both ways if not absol. necess at least as prop in pr. case.

Since patient began this med comp consid allev.

And hope that by contin may be be entirely removed.

If this howevr not the case shall prob. have recourse to other astring unless prev by new occurr.

And should these happen imposs to foretell what meas. may adopt.