DEP/DUA/1/20/14 (Transcript version)

John Lyon

(1779)

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John Lyon.

Sympt of this patient but few in number.

And of such nature that can have no diffic at least respecting name of the disease.

Yet cannot be said to be altogeth so plain that no room for doubt as to nature.

Disease consist in freq. loose stools to extent even of 10 or 12 in space of 24 hours.

A period during which in ordin [health] at a med not more than one.

Matter disch. however no farther altered from natur appear. than might expect from such freq.

Is indeed we are told, of thin [consis] & frothy appear.

And When consid that disch so often takes place as to allow no time for absorp first of these necess. conseq.

While again with thin fecul. matter air bubles natur. [illegible] which cannot happen or at least cannot be obv. [when] more hard & firm.

That with such freq. should at times be affected with tensesmus cannot seem strange.

This a conseq. natur result. [from] [every] cause by which mucus from return abraded.

With these diff sympt however fecul. matter at least in as far as is compatib with change of consist retain natur colour.

And may safely venture to say that in this respect has undergone no morbid change.

Nor again on other hand is any morb condit indicat by change of smell.

From commen. even till pres period has been entirely free from fever.

No suspicion that disease either origin from contag. or that has had any tenden to affect others in simil manner.

On contrary ascribd & probab. with justice to a manif cause, action viz of cold to surface.

From all these circum taken [togth] can have no doubt in pron. disease to be diarrhoea

An affect. in this clim by no means infreq. & in some cases very obstin.

But although thus little doubt with regard to name must [observe] that is by no means on this ground that [ration] plan of cure can be founded.

And that all pract. by no means agreed with respect to nature evid from consult. either nosol or pract. writers

Though all nosol. very much agreed as to defin., yet have assignd very diff [places] to this affect.

And must own cannot see [with] what propriety this genus, as well indeed as Diabetes, refrrd by Dr C. to gener. class of neuros. & to order of spasm.

Do not mean to deny [affirm] that inordin muscul. action not [concerned] in induct of them, or that may not be comp under gener affect, where lesion of [motion].

But if on these princip to referr two diseases now mentiond to head of spasmi hard to say appears to me a very diff matter to say what affect may not include under that term.

While at same time inordin action in as far as does take place occurrs only as second conseq of other morbid states.

To all this may be added, that [certain] no natural analogy, between this & other affect referrd to same order, as Tetan. [Tris] Convuls. Epilep. &e

Would then upon whole conclude that while this an artif arrang. contrad to nature & founded entirly on theory is at same time an improp. one.

And Must think therefore that these nosol. have done much better who have class it under head of encreased disch. to which stricking & natural affin.

And indeed is by the evac. that debilit & all other danger conseq of this disease are induced.

Here however to be observd that freq. evac may result from very various causes.

And accord. find that Sauv. & other nosol. have formd of these a very numer. tribe of species.

But without entering into consid of these may take more simple view of matter & more applic to pract.

Whatever remote cause may consid it as ultim refer. to one of these sources.

1 The state of stim [illegible] applied to muscul. fibres of intest tend to induce action.

2. The state of matter to be dischargd as having a praeternal fluid [consist.]

When And 3d. State of muscul. fibres acted upon as having greater dispos. to have action induced from any stimul.

When merely from first circum perhap always to be consid as to certain degree salut.

And is unquest. most ready [means] by which irrit cause to be expelld.

This also freq. the case with second.

Or at least when changes in distribution take place in fluids, in conseq. of encreased disch by intest, other evils avoided.

In [last] case howevr disch to be consid as always morbid.

And to this affect has natural tendency to degen. when occurs as prod of two formr.

From consid of these causes however [either] as simple or combind, both progn. & pract must much depend

In case before us great reason to presume that at first arose from matter depos in intest canal of uncommon fluid.

And that this proceeded from augm watery separ. in conseq of determ from surface to intern parts.

Now howevr has contin for long time after reason to believe that natur ballan of circulat restored.

And has proceeded to such length as to induce with patient no increased debilit.

May presume therefore that while [eva] not now [salut] is supported also by morbid debilit of intest canal.

Hence then although still no threat sympt. reason to appreh. that will be both troub. & ted.

And this the rather as before he came under our care remed judic employd insuff. for radic cure.

While again during attend at this place after had in great [meas] [subsidd.] had again return even without manif cause

Yet although tedious hope that may at length be overcome

And that shall be able to dismiss patient free from affect.

On suppos that affect here the conseq of determ from surface to intest canal, pract before patient came under our care with great prop begun by use of sudorif.

And from these tempor. recov at least obt.

But either from accid neglect or from circum. to which patient from situat naturally exposed, soon afterwards subj to relapse.

When on this acct therfore became our patient might have been expected that should again have had recourse to same meas.

But as admin of proper sweating ment with us be left entirely to patient themselves, & as often exposed to cold during the pract., wish to avoid it.

Was cheifly however with intent of giving determ to surface that directd the emetic.

And in this way few meas [illegible] more powerful.

For while from impress on stom excit [illegible] tenden to dimin of resist at surface from [attack] of vomiting have [increase] of force prop. blood [illegible].

Besides this evac of stomach often also of service as remov. matters which otherwise from passing into alim intestinal canal would operate as stim encreas action

And accord find that from emet. good effects seem manif to have [arise]

After operat stools both less freq & of more natur consist.

Having obt. this relief then consid it as most import obj to restore vigor to intest canal.

And thus hoped both to carry off remain affect & to prev. return.

For this purp. use of astring seemd most naturally indicated.

And here resolvd upon trial of astring from veget kingdom which with this intent at least but rarely I believ in use.

That was the Uv. Ursi.

Of purpose to which this vegetab. princip. employd in med would here be foreign to our purp to speak

May only observe that powder of leaves manif a strong & pleas astring.

And was solely with view of obt that effect that had recourse to it in pres. case.

Here comb it with equal proport of powder of root of [Heler.] which as conj aromat & bitter hoped would act both as corrig & [illegible].

Undr this med contin for space of forthnight.

And appar. with good effect.

For during almost whole of that time state of disch. by belly may be said to have been in natural condit.

Had but one stool a day & that too of natural consist.

But two days before last report looseness returnd & with consid viol.

Then also observd that powder gave some sickness at stomach.

Although consid both as affect of accid, probab. of improp food creating disorder of stomach, yet led me to interm med.

And have now put him [nearly] with same intent on mixt with Tinct [e] Kino.

From this, or use of former astring, either by itself or as comb. with some other aromat hope that may soon be in condit to be dismissd.

If not, may have again recourse to Emet or to Opiates.

And from these shall in all prob obt. tempor. cure.

But [inclind] to think that radic recov. cheifly to be expected from giving strength to intest.

And if these already suggested fail, may try [other] from vegetat king as Lign Camph or from Miner as Alum

But would fain hope that none of these meas. will be necess.

And that from pres. course patien may soon in no long time be in condit to be dismssd