DEP/DUA/1/33/24 (Transcript version)

Nelly Grant

1783

---

Nelly Grant Janr 17. 1783.

In case of this patient nothing either pecul or alarm.

But exhib example of affect. very freq in this clim & at this season

viz Diarrhoea.

Of this suffic evid from freq of stools.

While at same time without either fever to give susp of Dysenteria

Or any uncomm app. in smaller disch as takes place in Coeliaca, Lient. &e

Besides freq of stools indeed when pat came under care affect also with other sym

Partic pains in belly breast & head.

These however to be consid merely as symptom

And indeed some of them partic gripes are almost constant attend of this affect.

While headach again well known to occurr as sympt of many diff. dis.

But partic of affect of alim canal.

Hence then to be viewd not only as ex of Diarrhoea, but that too in simple & uncompl. state

This disease often conseq of obv. accid.

Partic from improp articles empl in diet & from action of cold on [surf].

First operat as giving pecul. stim to intest. second as occas uncomm determ of blood there.

But still more freq as happ. with pres patient takes place without any obv. cause.

Then chiefly arising from pecul state of secret taking place into intest.

Whatever cause in most inst at least not a danger disease.

And unless when allowed to run to great length seldom obstin.

Then indeed disease has not only become habit but such local affect have taken place as with diffic removed.

But in case before us, sympt neither severe nor of long contin.

Had reason therfore to hope for that recov. which has now taken place

But of prognos after fav termin which has already occurrd now unnecss. to make any observ.

This termin howevr I am inclind to think prin to be attrib to pract here empl.

For before came under our care disease had contin encr. in viol for space of fourteen days.

But from time that began pract direct, sympt began also to decline.

In treatm of this case you will observe, first prescr. for pat. an Emet.

From this had in part at least in view the giving determ to surf of body.

And thus by restor equab. [balance] dimin flow to intest canal.

But still more intent to prod full evac of stomach.

By this means hoped to disch sordes which collected there from pass. downwards, would augm looseness.

While by emptying stomach, expected still farther advant as paving way for other remed directed at same time.

As an Emet here, had recourse to Ipecac.

Which where action of full vomiting required, is in my opin, most cert. means we can empl for obt it.

In this respect unquest prefer to emet. Tart, the operat of which as an Emet. at least at least with respect to degree of action, much more [uncert]

Some indeed inclind to consider this latter artic as possess. great diaph powers.

But as far as my own obs. goes, have never been able to see any thing confirm this opin.

Indeed diaphor. powers of either very much propor. to preceding sickness & to degree of action, which induced.

These however, even from triffling circum, very various.

When addit empl for determ [influ] to surface, no artic more powerful as a Diaph than Ipecac.

As every day exempl in combin with Opium when empl. under form of Dov. powder.

Here therefore, besides certain prospect of obt. thorough evac of stom, as far as diaph powers either prop or necess, had reason to hope that should obt. them.

For degree of operat when empl in subst. by no means prop to quant taken

As soon as operat begins, greater part of what lodged in stom, disch even in active state

Thus what may be consid even as overdose, has more the effect of securing & quicken operat, than of prod it to excess. degree.

Here neither disap in effects expected, nor did it do too much.

How far, to full & free operat of emet, good effects which followed were to be attrib, cannot pretend to say

Of this, from anoth med, being at same time employd had no cert opp. of judging.

But while reason to presume that had some influ in this way, little doubt that from stom being prev. emptied, artic afterwards used had more influ.

This artic you will obs. a simple water infus of the Succus or as has long been improp calld of Terr. Japon.

The active astring & mucil parts of this veget subst. admit of ready solut in warm water.

While at same time all earthy impurit derivd from kilns in which prep. fall to bottom.

Hence then such watery infus one of most eleg modes of exhib it.

To quant of ℥i with from four to ℥VIII of water gives active med.

Merely by itself however taste rather unpleas & sometimes does not sit easily on stom.

Hence though no adjuv empl in Rx. yet corrigens sometimes necess.

As such here you will observe empl. to equal extent with Succus Japon the Cort. Cassiae.

Unquest one of most grateful of vegetab. aromat.

Is prod of species of same genus of tree with that which furnish the Cinnamm.

And except in circum of price very little if any thing infer to it.

Our being able to purchase it however at much easier rate an addit [indu] to empl in Disp. pract.

And even in priv pract [where] Cinm ordered this freq subst by Apoth prob. without any matter injur to praescr.

With this corrig espe when sweetend with due prop of sugar of syrup forms a very agreeab. med.

Accord though pat at that period of life when more apt to consult taste than [interest] taken without inconven.

From this astring med had reason to hope that encr. disch into intest canal would be restrained.

While at same time from [encreased] tone of musc fibres, less liab to be affected by slight stim

In these expect, probab [were] not disapp.

For from time that began cure loosenss gradually dimin.

And in space of two weeks, state of disch from belly, entirely in nat state

While also, free from all other sympt.

In this situat, reckond farther attend unnecss.

And consid it as ex of cure of Diarrhoea by means of Infus Japon