DEP/DUA/1/39/10 (Transcript version)

James Goodall

1786

---

Jas Goodall Febr 18. 86.

When this patient came under our care was subj to complic of affect.

But these by no means of equal import.

In Cough Dysp & viscid expect to which then subj, have common sympt of catarrh.

And what here took place, seem to have been affect of accid cold.

Imag. that as had been, but of short stand, would soon even of [itself] cease.

And accord, this event has already taken place, without any med being directed for that purp.

But if this part of affect slight same obs. cannot be appl. to other

To the looseness which prin led him to apply for our assist. had been more or less subj for upw of 30 years.

And during that period a var. of remed empl. utmost affect of which to prod temp interm.

While disease thus obstin was also at time when came under our care very severe.

For had not only sever loose stools every day but these also with consid gripes.

At To same cause also are prob to referr sickness at stom, flatus & borborygm.

Seemd also to have had consid influ. on constit in gener.

For could have no doubt in referring to this both unhealthy app. & debilit.

Anoth circum also prob. conn with looseness here was interm of pulse.

This indeed a sympt which it must be allowed occurrs in other cases.

And some even with whom may be consid as it were natur. state.

That is interm obv. even in health

But where occurs in disease none with which more freq. conn. than Diar.

Nay as taking place in fevers has even been consid as forerunner of critic diarrh.

And with view to explan of it sever ridic theories have been offered.

But that for these, little found, abund app. from being often attend of Diarrh in other cases.

And has been very remark in case of pres patient

In general one beat lost in every 15 or 20.

But besides these circum still anoth to be pointed out perhaps more partic.

As being a circum disting one modif of Diarrh. from others.

State viz in which foecul. mattr disch.

In gener. came away with app. of being very little digest.

That is with almost no farther solut than obt. in mouth by mastic.

This circum disch of food in indig. state has been supp. to char. even partic genus of disease.

And disting by title of Lienteria.

For my own part however cannot see in what essent diff from Diarh.

Nay sometimes reason to believe that merely affect of quickness, with which matter hurried through alim canal.

Though at same time, am I own disp. to think that in genr. there takes place also, a morbid condit in menst. furnishd by stom for solut.

But at any rate, even thus, no essent. diff. from Diarrh.

For still prin part of affect, in freq. & watery disch.

And thus gener. exhaust. gener loss of strength & debil of intest canal in partic.

Consid disease however as Diarrh. prognos could not in pres inst be very fav.

For after contin for 30 years had become as it were habit.

During that time had resisted use of many powerf. remed.

And not to be expect. that would now be easily [chequed].

Nay to be doubted if that could with safety be done.

For from such change in balance of circul. reason to appreh bad cons.

Hence then great reason at least to concl. obstin of disease.

And when consid debilit cond. not even without danger.

For from very severe attack might even have sank under [illegible]

But at least somewhat in fav of pat, that no evid, of being supp. by any local affect in intest canal.

No fixd pain, or sense of heat at any partic part.

No marks in quickness of pulse of [illegible] [fit] of any hectic fever.

And when consider relief which patient had once before obt. reason to hope that might again obtain some allev.

This chiefly to be lookd for, by dimin depos of watery fluid into alim canal.

By dimin irrit. state in conseq of which peristal. moti. accel.

But above all, by restor due tone & vigour to musc. fibres by [which] consid affect in both ways.

This chiefly to be expected, by use of gentle astring & tonic.

For here as already obs. dang. of sudden checking disch such, that could not with safety employ very strong ones.

Began pract. by Emet.

In this had somew in view Catar.

Thought might be of serv as unload breast & determ to surface.

But used also with view to looseness as means of evac. stom.

And thus at least rend operat of othr remed more affect.

In obv. operat of vomit not disap.

But had no influ on looseness.

And with view to this now resolv. on use of an astring

As such made choice of the Tinct e Kino.

A formul. which has only of late had place in our Pharm.

And not yet introd into man others.

But unquest a remed of very consid activ

Basis a Gummi – resin subst. import from Africa.

And prod of a tree hitherto [illegible]

First recomm to attent of pract by late Dr Foth.

And in pass. of his in Lond. Med Obs. where treats of it under title of G. R. Astring Gamb. will find best acct of it yet pub.

In sensib qual. poss. consid degr of pleas astring.

And has been chiefly found useful in inst of obstin diarrh.

Espec. those of Lient kind.

With some such have formerly empl it with adv.

And indeed, with this very pat. had formerly affect of giving at leas consid remiss.

All more active parts of Kino readily solub in spirit menst.

And this hold to be one of best forms of empl exhib it.

For does not then require [solut] but introd as it were in act. state.

From fear howevr of sudden [check] to looseness unwill to use it to great extent.

Hence as [excep] here had recourse to Vin. Rhei, which while first operat that of gentle purgat, has [ultim] also an astring affect.

And accord even by itself often very useful in such cases.

First affect of this mixt. seemd to be that of augm looseness.

But from contin seemed to be somewhat abated.

And what still more fav. foecus matter disch a more digest app.

From this led to think of [purs] use somewhat farther.

And accord with mixt with mixt conj. [use] of Rhub. & G. Kino in [subs]. each grX indies.

During first week under these med consid benef.

But in following one very great aggrav of loosness.

From what cause proceeded not clear.

But he himself susp. the [powder]

And not imposs. that Rhub. may have had this affect though did not purge at first.

But at same time think it more probab. that from some other cause.

And indeed formerly often aggrav of loosness when could not tell to what to be ascribd.

Here however his own susp. suff. to induce to lay aside at leas pres formul.

But still willing to give farther trial to Kino.

In place however of Rhub. now directed it with equal parts of Tinct Absinth, one of strong of veget bitters.

And often useful in affect of alim canal.

To these added also small prop of Tinct. Theb. as means of [allang] tend to inord action.

Under this med has now [cont] for three weeks.

And upon whole compl. consid relievd.

Is [therefore] [intent] even although there should be accid return to [persis] in use.

But if in end fails, may have recourse to Suc. Jap. Cort. Peruv or such other remed as circum at time shall indic