DEP/DUA/1/41/40 (Transcript version)

Alision Denham

(1786-1787)

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Alision Denham.

When this patient came under our care was in situat truly distress.

And although affect of compl. nature yet no doubt that at time most import part of it the tenesm to which subj.

This in all prob. effect of state of encr. sensib at extrem of rectum

And that prob. arising from natur covering being abraided.

A conseq. often result from prev constip.

And to this in pres inst disp to referr it.

Though at same time may have been in some degree conn with cond of menst disch.

Of this however less presumpt from not being a comm occur in such inst.

For with freq. ex. of Menorrh. have not at least for my own part before met with any inst of tenesm.

Where at least had any reason to susp. that connected as cause & effect.

But whatever might be circum induc it, could have little doubt that immed dep. on state of sensib at rectum.

And that therfore most readily rem by counteract effects of that sensib.

In accompl. this howevr no artic in point of effic to be compar. with Opium.

Influ of which, as dimin [effects] of uncomm sensib, whatever diff of opin may be entert, with regard to class of med to which referd no dispute.

And accord not disapp. in obt wishd for effect in inst before us.

For even from first dose of opi. tenesm entirely removed.

And that too although taken only to extent of single grain.

For that the prop of Opium in gr x of Theb. Pil. the dose here ordered.

From this suff. evid that by no means from large doses of opium only that good effect obt.

On contr. am for my own part persuaded that by these even disap

And partic as giving confus of head which might otherw. be avoided.

But whatever requis in [cases] here a grain suff.

When directed Opium howevr at same time adv. also a small prop. of Crem of Tart.

To this led from two circum both view to belly & urine.

For while urine scarce, [illegible] freq. inclin to stool, belly bound.

And had reason to think that this would be still more the case on use of Opium.

Accord though urine restored [with] Crem of Tart yet bound state of belly contin.

Hoped however that even [same] quant might be prod of des. effect after [omiss] of opium.

And this as perfect relief [from] tenesm seemd now no longer requis.

[Advis] therefore Crem of Tart alone.

But what has since been effec do not know.

For have seen nothing more of pat. here.

This however am I own inclind to attrib to having no farther occas for assist.

And to look upon case as ex of benef. to be reapt even from mod dose of Opium in remov of very obstin & distr. Tenesmus