DEP/DUA/1/21/08 (Transcript version)

Euphan Preston

(1779-1780)

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Euphan Preston.

Sympt. in many respects simil to those of a pat. already treated of G. Burton

Hence less necess. to be said with regard to it

Here also compl. consist of freq. bloody & slimy stools with tenesm.

And to these may referr all other sympt. palpit. dysp. & pain in back

Can have no doubt then in consid it as one of numer. inst of looseness which have succeeded very warm summer.

Consid however dysent. as a name [which] ought to be approp to a disease dep. on pecul contag, would give this appel of Diarrh.

And that notwith tenesm with disch of slime or blood to consid extent.

For these hold to be merely accid circum which may occurr in both disea.

And to be totally unconnected with cause from which the affect may arise.

Whether then diarrh. or Dysent to be determ by other circum.

And here to be observd that pat has ment. no circum which can lead to susp. that derived disease from cont.

That no reason to think this affect in her has prod it in any other.

And lastly that has neither now nor form. been attended with any fever.

All these circum however commonly to be remarkd with reg to Dysent.

And concom fever in partic during earlier stages very consid.

While then name of Diarrh, must also remark that far from same sever. as in last case, that of Burton

Not only of shorter durat. but without those viol & fixd pains from under part of alim canal.

Here then less reason I think to susp local affect.

Or at least in way of ulcerat, schirr. contract or like.

Here only morbid condit probab is pecul. morbid laxity of parts.

And in conseq of this an [abraided] & irrit state

While again from mere exhaust all other sympt to be expl.

While however thus expl. sympt not perhaps so easy to acct for anoth. circ.

Relief viz which pat. has obt from a diff disease since this comm.

Was before we are told subj to affect of Dyspep. kind.

And these at least since commen of pres. disease not so severe.

Perhaps princip to be ascribd to their being less obj of attent during more serious compl.

For cert. that no affect more than stomach compl. aggrav. by thought.

But prob also in some meas [reliev] from open state of belly.

For from this very gener some allev. of stomach compl.

At same time however must be obs. that from viol purg. always aggrav.

And therefore at least doubtful in pres. case whether relief from this circ.

But here though freq. not consid disch.

Gives therefore greater presumpt that may have arisen from this circum.

And not improb. that on being freed from pres. affect will again be subj. to it

Thus far then prognos. unfav.

For in any situat but espec. with such a pat as pres. these compl. very diffic to be overcome.

But if thus appreh of return of former compl. proceeds on hopes that pres. affect unquest more danger. may be overcome.

This am still in expect. may be soon accompl.

Although must at same time observe that has already cont. with greater obt. than at first imag.

Or rather has again returnd after once in great meas. gone.

Remiss once obt for this patient am inclind in good meas to ascribe to remed empl.

Here imag that cure to be effected by restor vig to intest canal as simp sol.

By restr. tend to encr. disch from giving constric of vessels.

And by dimin dispos. to action.

Was with these views that had here recourse to an astring comb. with an [Seda].

And here as in former case empl. succus Japon in form of [simpl.] infus comb. with a small prop. of Laud.

My opin of this med already stated & some length when spoke of case of Burt.

And if these expect. from it disap. has here I think supp. char. which [gave]

From time that patient began use some of most urg. sympt consid dimin.

Looseness in partic became less freq.

And disch of blood almost entir disapp.

Was not surp. that should still compl. of pain of loins.

For this consid as prin effect of debilit

And remov. of that in every case work of time.

Nor did I think it strange that tenes. also should cont.

For this consid as only affect of rect. being still in abrad. state & without [illegible] [cover.]

And when once thus laid bare restorat can never be sudd. effected.

Hoped however that by short cont. these sympt also might be overcom

And with view of more readily obt this affect directed dose to be encr.

After cont. in this manner for week longer progr to recov still went [on]

And consid her as entirely rid of dis.

For now no more in gener. than one stool in space of day.

And that too of natur consist & without tenesm.

Hoped therfore that now both strength of intest & state of dispos to action in natur state.

Consid it therfore as more advis to omit astring than to persist in use.

For appreh. that might now be prod of inconv. as [indu.] oppos. state.

And from retent of indur. faeces [reasn] even to imag that form disease might be renewed.

Should have wishd therefore that pat. had contin for week without any med.

But as still compl. of pain in back was desir of app. not altog inact.

With this intent therefore ordered [illegible] of Bark with Camph. oil.

And besides [illegible] patient imag. that if pain in any degree a musc. aff might be of some serv.

But was in hopes that with regard to looseness nothing farther necess.

In this however now app. that was mistaken.

For almost as soon as med omittd patient subj to return of all former compl.

But whether this affect of any accid to which exposed, or of state of alim canal being still such as to req. astring is perhaps matter of doubt.

On either suppos. however same reas. which form led to use of Suc. Jap. ind. me to repetit.

Now howev. have somewhat varied form.

And with same prop of other artic have introd double prop of Suc. Japon.

As now inclind to think that [intent] require greater astring than once imag.

Am in hopes that by repetit of med disease soon again overcome

But should tempor. allev. be obt. will not again be disp to give up use so soon as formerly.

To secure effect will cont. it for some time although perhaps in smallr doses.

And if again prod of desired effect shall persist till prod of some inconv. or till consid disease as cured.

And this hope may in no long time be affected.

If however should be disapp consider pres also as case in which may make tillrial of Simaroub.

Nor do I consider want of success in inst in which have seen me lately [des] it as any obj.

For besides that case very bad one, Simaro employd although gen Bark, not of good qualit.

Trial therfore, if necess, must dep. on obt. it in more recent state.

Should I not be able to procure it may here have recourse to other med of Tonic or astring tribe.

Partic Peruv. Bark or Cort. Salic Alb.

But in hopes that none of these will be requist.

And that by med on which patient already put disease may be compl. cured.