DEP/DUA/1/21/02 (Transcript version)

James Burton

(1779-1780)

---

James Burton.

Disease few sympt. Dist markd.

Yet as to name at least some doubt.

But princip more from diver of defin name to same affect. than any other circumst

Is affected with gripes tenesm & bloody stools

And although neithr quickness of pulse thirst, nor heat, yet can hardly assert that has been or is now without fever.

Though absent when hist taken may [occ] at other time

And in such compl. freq at partic time of day.

Besides might be pres at begin althoug now absent.

Cannot therefore from thence inferr that [not] dysentric

And with many wherever gripes tenesm & bloody stools, even although no fever name of Dysent employd.

Certainly however not with propriety.

At least very diff from febrile diseases where same sympt from pecul. contag.

+ Or at least have if has been prod of pecul fomes would consid infl. as now over.

And if origin contag Dysent now look on patient as subj to Seq. of that affect only.

At this state Diarrh & Dysenter not unfreq. the same.

That is leave simil topic affect of intest partic about rectum

To that alone would approp term Dys

And to pres. therefore would be inclind to give name of Diarrhoea.

>+

Must however allow that Diarr. often in diff state.

And not unfreq. rather salut. than morbid.

Not only cures self but even prev. other affect to which syst. would be subj.

This however can be no means consid as being case in pres. inst.

For has now subsisted for six months.

And during that period has induced great debility & exhaust.

May concl. therfore that whatever origin now supported even by local affec.

And such not unfreq. occurs both in Diarrh & Dysent.

Perhaps strictly to be consid as seqn of the Disea

And then influ of infect having ceased in Dysent. too affect may be viewd as same.

And in this condit now suppose disease of pres patient to be

With regard to cause Pat no conject

And nothing to be learnd from hist which can throw light upon it.

May however observ. that dysent affect. more disease of warm than cold clim.

And that both these & diarrh observ most freq in this country after warm & dry summer.

This observat [confirmd] by last sum

Need not observe that there has never been Never in my [remb.] a warmer or dryer.

And never met with more inst of these affect

How connected hard indeed to say.

For certain that free disch by surf. tend to bind belly.

Heat indeed by evap from marshes may give rise to pecul miasm.

And thus induce contag.

But this will prop Perhaps also may offer an expl. of induct of Diarr. where no contag supp.

Prob. from free disch to great extent greater dispos to be suddenly checked.

And when does occur attended with more consid conseq.

But whether this any share in induct of disease of our patient or not, now little doubt that at consid height.

And not without appreh as to term.

If as suspect intest at extrem not merely morbid laxit or sensib but top disease cure always diffic.

And in many inst notwith every remed. fatal termin

In pres inst from long contin syst already debilit.

And although no symp fever yet should not be surp. at occurr.

May observe also that some anom & distress sympt.

Partic pain about pubis affect disch of urine.

This do not consid as of itself threatn danger.

For consid look upon it as merly dep. on spasm. action prop. from rect. to neck of bladder.

Yet addit evid of local disease

And of morbid sensib in parts here princip seat of disease.

From all these partic then cannot look for sudden cure.

And even not without doubts as to termin

Yet still at least no app. threat immed danger.

And hope even that cure may be obtaind.

If not, opport at least for trial of dif remed.

And although may not be able to remove shall yet be much disap. if cannot give tempor. allev. of compl.

This however not case with meas already taken

And that too notwith use of med. from which freq. benef.

Although has faild yet on some gener prin benef. from others.

Here have already said that suspect actual topic affect.

That is that part of intest canal prob. near rectum actually in excor or ulcer state.

And that such freq. occurrs abund confirmd by dissection.

But healing of this as indeed in cases of superf & extern sores [must] in great meas. be work of nature.

And great obj. at which we are here to aim may be referrd to two heads.

1 The restrain inordin action aris from augm sensib.

2. The restor. tone to those parts of the intest canal in relaxed or irrit state.

As answ. former intent no artic with [whch] I am acq. sedativ powers of which to be comp with Opium.

Of late indeed cont. that Opium not to be rankd among class of Sed but Stim.

But he who den. that in gener. at least dim pain, prod sleep, & allays inordin actions must contr. facts.

And by sedat. every writer hithert at least has underst. med poss. [such] pow.

Was then with view to last of these effects that have had here recourse to it.

And if affect contin shall afterwards use it to greater extent.

For consid it at least as most cert. means of palliat.

Neither of these artic prod of this country

Nor do I know any we possess which can be consid as of equal effic

But hitherto used only to small extent.

And in treatment had prin in view not so much the immed palliat, as prod more perm relief from restor. tone.

This again as well as restr. disch. cheifly to be expectd from diff astring.

And as such have already had recourse to two artic of both of which entert high opin.

Viz. G. Kino & Succus Japon.

>+

First of these G. Kino a new art of Ph. Ed.

And has not I bel. place in any other.

Has now howevr for many sever years been in pract at London.

And for introd to pub. notice are indebted to Dr Fothergill.

On this subj paper in first Vol L Med Obs.

Descr. it as a subst. which had at diff times met with under title of [illegible] Sang. Dracon. or fine G. Senegal.

But is of opin that as has no connex with either would more prop be named G. Rub. Astring Gambiense

Recomm. it as a remed. in all diseas proceeding from laxit & acrim.

And partic in Diarrh.

Since Dr Foth public has been brought from Africa in consid quant

And not unfreq empl. at least by some practit. partic in this City.

Although name of G. so far of Res. nature that compl. diss by spt.

To this menst. imparts fully its [astr.]

And accord place given to Tinct e Kino.

Began with it in this form as thus most cert. freed from impur.

Here united with mint water in order to give prop. form.

And added prop. of Laud. that from confl as restr. inod action, effects of astring might be better obt.

In this way have often before employd it.

And in some cases with very remark success.

Cannot however say that in pres inst this was the case.

For during use for week sympt rather aggrav.

And looseness in partic in no degr. dim

Could not however look upon it as having had any tend to aggrav. affect.

Nor inclind at once to desert it as disp. of advant expected.

Hoped that by encr. quant might still obt. good effects.

But when wishd to augm dose [thoug] it prop also to change form.

As quantity of Spt in tinct object to introd to extent that wishd.

From this led to use in solid form.

And with view of correct flatul. [which] in some meas. expected from Spt add small prop of powder of Cinnam

That might better judge of effects also opium entirely omitted.

But thus given even to extent of scruple without desired effect.

In these circum then thought it advis to desist from farth trial.

And although want of success does not alter opin of med. yet consid as [unique] to circum of pres. case.

Now therefore have substi to it the Succ. Japon.

This also anoth astring on which in such cases great confid.

This artic with great improp. has [desc] in Ednr Pharm the name of Terra Jap.

Now univ allowed that entir Veget.

That extract of species of the Mimos.

And that all those earthy matters adher to it entirely impur.

Acct of tree, as well as meth of prepar., accur. describd in Lond. Med observ. by Dr Kerr of Beng.

And auth of Phar. [illegible] have accord changed name to that of Succ. Jap.

Have with prop. also introd prepar. under title of Succ Jap. [depuratus].

In [this] from solut in water [strain] & evap is freed from earthy mattr.

And wherever to be exhib in solid state unquest. prop.

Here howevr empl. it in state of watery solut.

And thus also get rid of impur

For while all activ parts readily diss in warm watery earthy matt fall to bottom

Have thus then one of most eleg. as well as most conven forms of exhib

For while menst. water will dissolv the suc japon to great extent not restr. as to dose by activ qual of menst.

And water also menst for veget aromat as well as for Suc. Japon.

Hence can readily give impregn by addit during infus.

For this purp. none perhaps bettr suited than Cinnam.

And accord. Infus. Japon which we empl. made with equal parts of each.

In gener. dram of each to ℥ VIII of water

But accord to circum may be varied

Of this strength directed to pres pat.

And with same intent as had form empl. Laud with Kino, used here also

This I hold to be less active astr. than former.

To this concl. should be led from sensib [qualit]

But still more incl to inferr it from what have seen in pract.

If however thus infer. from anoth qualit better suited in some inst of looseness.

Partic those where reason to susp. an [abraided] excor. or ulcerated state.

Has less of resin & more of mucil qualit than the Kino.

And from this circum better fittd for afford gentle [defin] to parts.

Is cheifly on this acct. that led to employ it after Kino used withou effect

And hope that by prop contin may overcome affect.

If this case may yet be prop to put patient for some time on use of Peruv. Bark.

And by this means reason to expect that tone of viscera may be compl. recov

If not thus successf. from Infus Japon in pres. state, shall yet push it farthr

And before desert. use will give both astring & opiate to greater ext.

From this pract, have I must own greater confid than from any other that can at pres. suggest.

Yet should it prove ineffect various other meas. which in such circum recomm

And is partic in such cases that Simaroub & Rad Indica advised.

Latter of these however though highly extolld not yet introd into Pharm & not to be met with in shops.

Is cheifly prod of Portug settlem in South Americ & prin used in Lisb.

And from circum of being diff obt rarely empl. here.

For my own part have used it only in one case

And there without any good effect for soon after begun dis proved fatal.

Not however in any degree to be ascribd to the med. but to sympt fever which occurd before begun.

And on dissect. intest & neighb. parts found in highly ulcer. state.

From this therefore could form no opin either for or against this med.

And have been prev. from future trials by not being able to proc. it.

As Radix Indica diffic to be had so also is the Simarouba.

At least of such qualit as to be dep. on.

In shops barks very manif diff from each other sold under this name.

Nor wonderful when consider that tree from whence obt unknown even to most able Botan.

Dr Wright however in ingen Phys from Jamaica has now ascert. beyond [dou]

And has given in papr on subj to Phil Soc

If therefore can proc it good & genuine shall be disp to give it trial here should Suc. Japon. fail.

And to this the rather from [reput] which has had not only abr. but in Europe also in circum nearly sim to those of our pat.

Accord to acct by [Mr] Jussius [Men] of R. Acad. in flux which in Fran. succeed very hot summer used with great advan

And repres. by [Degnerus] as having had equal success in epid of same nature in Germ.

How far this as well as former, acts on any other prin than as astring has with many been matter of doubt.

This however may at least obs. that what repres. as genuine not very remark for astring.

And when given in large doses effec very diff from what would exp from astrin

Would by no means however from this at once inferr specif power.

On contrary consid trial as rather necss both for determ effects & ascert. mode of Oper

These then trials which at pres. have princip in view for comb. affect of this [pa]

And which unless in as far as [coun] attend by future occur. mean to put in pract.

If reduced entirely to plan of [pallia] shall cheifly attempt this by opium.

And in place of Liq. Laud. will exhib it in solid state.

Unless perhaps when shall think it advis to have recourse to it in form of inject as well as taken by mouth.

Would fain however hope that case may soon put on more fav appear.

And that in place of being necss. to have recourse to any pract. sugg may yeild to meas. already begun.