DEP/DUA/1/18/14 (Transcript version)

George Karr

(1778-1779)

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George Karr another of patients now dismissed cont about month under care

Although affect cheifly charact by freq loose stools consist prin of bloody matter & accomp with tenesm consid as inst of Diar

Or at least as being in no degree that pecul febrile affect to which term Dysent in strict sense of word, alone applic.

Consid disease to depend on dispos of intest canal to augm secret & encreasd action had some doubts with respect to termin.

Was however in hopes that might at length be able to restore him to perf health & to dism free from complaint.

This end sooner accompl. than expectd when last spoke of his case.

Had then put patient on use of succus japonic.

An astringent from which in such cases have often seen best effect.

Although therefore have appreh that should be obliged to have recour to employm also of some others yet resolved first to give this fair trial.

When formerly spoke of case had employd succus japon only in way of watery infus.

And this reckon one of most [plain] & eleg form of exhib it.

For by this means entirely freed from earthy matter often adher to it in great abund.

And indeed to such extent as to have long given foundat to suppos that was really an earth. Hence name of Terra Japon.

Now however know that whole adher earth merely impur from kilnes in which prep.

And cannot help thinking that a succus japon [illegible] should be introd into Pharmacop.

In this state when to be exhib in subst whether in form of [bolus], powder or like, should have it most pure

Although under use of Infus, symp mitig, yet on seeming tendency to relapse, thought it advis to push it to greatr extent.

And accord with infus comb empl. of it in subst.

Here directed use in form of powder

A state in which at least as readily acted upon by stomach as any other.

Here however directed it to be comb. with pulv. Cretac.

In this intent was to correct any acid which might exist in stom.

And which if existing would necess. tend to support & aggrav. compl.

Often however occas looseness where no evid of superab. either from vomiting or even from acid eruct.

When pres in stom may be destroyd by all tribe of absorb & even of bitters.

Of these however few more affect or conven answer the purpose than common chalk.

Especially propr where with destruc of acid want rather to comb the opening binding than the binding opening of belly.

Under formula of Pulv. Cretac have opport of exhib it not only in most pure state, but as comb. with diff arom.

Nutmeg viz & Cloves.

These however which strong & acrid [illegible] enter compos only in small propor.

Imag. therefore that pres combin would sit more easily & lightly on stom, from still farther add of [illegible]

And was with this intent that orderd with these powders same prop of [Cinam]

In this state patient sensib of no inconven from med as affect stomach

And can not doubt that exerted [here] as well as through tract of intest, [effects] as an astring.

To its operat am inclind to ascribe fav change which soon afterwards took place in state of pat. compl.

For in no long time dismissd free from affect to which subj sever. months before