DEP/DUA/1/11/01 (Normalised version)

Daniel Forbes

(1776-1777)

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Dan Forbes.

A patient whom some may remember had formerly occasion to treat in Royal Infirmary¹.

Then offered some observations on nature of disease.

And made several fruitless attempts to cure

Am now very apprehensive that shall not at present be more fortunate.

For must own that still retain same sentiments as formerly.

And am very doubtful respecting nature of disease

Were we to affix any particular name would call it Vertigo.

And this indeed adopted as Genus by most nosologists².

But perhaps to be considered rather as symptom than properly a disease.

Temporary vertigo frequently consequence of many different causes.

Sometimes from plethoric condition at other times from affections of stomach or like

Is very generally if not in every case effect of inordinate motion of muscles of eye.

Bodies seem to move in consequence of change of place of object on retina.

And this will equally believe to happen whether body really in motion or whether eye moved without being sensible of it.

This last take to be case with our patient.

And from long continuation must necessarily conject it to be effect of some fixed cause

Opinion I own is that depends on some tendency to Paralysis.

This more probable from sight being somewhat impaired.

Without at same time any obvious lesion of eye

May farther remark that such vertigo with headache often forerunner of Amaurosis

And am I own suspicious that will yet terminate in this manner in present case

Would fain hope however that will at least have slow progress.

And thus shall have opportunity of trying what aid can be derived from medicine.

Yet must own that after what already done expectations by no means sanguine.

Apprehend patient to have even better chance from accidental changes of system than from medical aid.

And accordingly when formerly under care entertained hopes that might be cured by erysipelas of head which supervened.

In this however event showed that expectations ill grounded.

And after recovery from that affection continued in same state as before.

Hence I own now less expectation from any succeeding affection.

Well known however that as febrile affections will sometimes induce so will often carry off parallel in very [illegible] manner.

Is however at present our business to try what can be effected by other means.

Had occasion as have already observed to treat this patient during last summer for very considerable time.

Then tried with him great variety of different medicines.

Some of them on principals already mentioned others on more empirical footing.

But principally of Stimulant Antispasmodic & Tonic kind.

Among others then prescribed electricity.

But from different accidental particulars from bad order of machine in hospital had not opportunity of giving it full trial.

And is principally with view to this that have at present taken patient under care.

From best attested accounts would appear that electricity has often succeeded by perseverance

And on this account shall probably be sole remedy which will employ with present patient if should continue with us for some months to come.

At least any other remedy used either be from accidental occurrence or as mere placebo

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Explanatory notes:

1) The Royal Infirmary of Edinburgh, established in 1729.

2) Nosology is the branch of medical science dealing with the classification of diseases. Individuals referred to in the case notes as nosologists were commonly those who had published nosological, or classificatory, medical texts.