DEP/DUA/1/12/23 (Normalised version)

William Bailey

(1776-1777)

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William Bailey.

Case of this patient consists of very few symptoms.

And these of a nature not unfrequently occurring

Consists entirely in lesion of vision.

And that too without any evident affection of eye itself

Can have little doubt then in referring it to an affection of Nerves of eye.

When a lesion of vision from this cause is sometimes total sometimes partial only

These by some nosologists¹ have been formed into different genera.

And in system of Mr Sauvages forms the two distinct genera of Calego & Amaurosis.

To definition of first of these case before us very accurately corresponds.

Apprehensive however that Dr Cullen has done better in referring both to one genus

For difference merely in degree.

And progress from one to other very frequent.

From what cause this morbid state of optic nerve arises in present instance will not pretend to say.

Little doubt however that cause whatever it is has induced a certain degree of Paralysis.

Yet disposed rather to presume that not the effect of compression.

And was I own willing to consider it as affection of morbid state of sentient extremities of eyes.

Principally as patient never complains of headache vertigo or any of those symptoms which commonly attend it when arising from complaint

And at same time as from change in position of eye state of morbid affection somewhat altered.

On this idea must own had some hopes that might have been of service to patient.

And if could not perfectly recover vision that yet present affection might have been in some degree diminished.

At same time insensibility of nerves in general when once acquired very difficultly removed.

And those of eye in particular much out of reach.

Hence probably it is that Amaurosis so often considered as an incurable affection.

And such I own am now disposed to think that case of this patient will be found to be.

Although however has now left us in no better situation than when came under care, yet would not be willing to presume affection totally desperate.

Apprehensive however that if does recover more chance of it from natural than artificial means.

Particularly may be cured by occurrence of fever or of Diarrhoea.

At least from both one & other natural termination have occurred to paralytic affections of still older date.

Would not even altogether despair of artificial cure

When began treatment of this case proceeded on supposition of Paralysis.

And as various remedies already tried naturally led to think of use of Electricity.

Of the affects of this in Paralytic cases have in different instances had occasion to speak.

And in affections somewhat analogous to present have found it serviceable.

Wished therefore at least to try affects in present instance.

And that too both way of sparks drawn from neighbourhood of affected parts & of shocks.

As patient however lived at a distance in country wished to use as little time as possible.

And on this account with Electricity conjoined the use of Camphor.

On these he continued for space of some weeks.

During which time gradually increased dose of the one & strength of the other.

At one period some slight appearances of relief

But soon after matters again returned to former situation.

And as now very little prospect of benefit patient was unwilling that should continue a mode of cure costing him so much trouble

For every time that electrified obliged to walk in many miles from country.

Proposed therefore that should make trial of a Mercurial course

At such a distance however could not propose that should be made under our direction

For in precarious weather would necessarily have been subjected to greatest danger from cold.

Advised him therefore on this account to put himself under care of surgeon of village in which he resides.

But whether trial will ever be made or not reckon very doubtful.

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Explanatory notes:

1) 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.