DEP/DUA/1/23/06 (Normalised version)

Nanny Gray

(1780)

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Nanny Gray.

Symptoms to which this patient at present subjected such as occur in many different affections.

And in general not connected with each other.

Principally consist of pains attacking very different parts of body.

Head Side Breast. Stomach etc

In these then cannot I imagine look for characteristics of any one affection.

This however it may be alleged not the case with regard to principal part of affection to which subjected

Pain viz of head.

This although much more severe at some times than at others, is yet in some degree constant & very much fixed to particular part.

May be expected therefore that should look for it under those [genera’s] characteristic symptoms of which is headache as Cephalalgia. Cephalea. Hemicrania etc

And perhaps as being an affection of chronic kind, without fever & not confined to particular side of head, may with more propriety get name of Cephalea than any other.

Under this denomination however affections of very different nature comprehended.

And for determining most proper treatment, inquiry respecting this becomes necessary

Here however when consider former ailment of patient little difficulty.

For in history of case are informed, that was formerly subjected to Hysteria occurring in most regular & distinctly marked form.

That then was subjected also to same headaches as it presented.

And that although other hysterical symptoms for some time removed, yet this has continued.

Can have little doubt then in [considering] that present headache of hysterical kind.

Especially when consider that headache so common a symptom in hysteria as to have obtained even name of Clavus Hysterica

Although however consider it as being a hysteria symptom yet in present form perhaps denominated from headache.

And consider it as more exactly [applied] to Cephalalgia Hysterica of Mr Sauvages than to any other disease.

From this view of name & nature cannot I apprehend look upon it as being a highly dangerous affection.

For with regard to nervous affections in general may be observed that much more alarming than really dangerous.

And this particularly the case with respect to hysteria

In many instances however proves very obstinate.

And after continuation which has already had, cannot I imagine look for sudden favourable termination.

Yet to be observed, that upon whole, affection for some time past, has been upon the decline.

And has not hitherto at least resisted any powerful medicines.

For according to account given us none of late used.

And the rather hopes of success as since began medicine directed, affection considerably abated.

Upon whole then flatter myself that may yet be able to dismiss patient if not free from complaint, at least with symptoms considerably mitigated

This I think in such a case as present, chiefly to be expected from what are called Nervous medicines.

That is, from such articles whether of stimulating or sedative nature, as have influence in counteracting inordinate affection of nervous power.

And indeed this chiefly effected by strong & peculiar action, either as Stimulant or Sedative.

To article from either of these classes might I apprehend in instance before us have had recourse with some probability of success.

And is in such instances as this that immediate relief often obtained from Volatile Spirit to nose.

But still more from similar application to affected nerves.

Such for example as Wards Volatile essence – Aether or like.

But if these often of advantage still more certain & permanent relief from sedatives.

And that both from immediate [application] & likewise from action on Nervous System in general.

Thus in many such instances very great relief from Laudanum.

But in [preference] to all these here recourse to a sedative of which must own have very high opinion.

That is the Extract of Hyoscyamus or Henbane.

Need not observe that this one of those articles lately added to the Materia Medica¹ by Dr Stork of Vienna.

That influence of this article on animal system very considerable might with confidence be inferred, from its having been very generally ranked among poisons.

This you will find the characteristic given of it by different writers.

Particularly by Sir. Robert Sibbald in his Scotia illustrate².

Even in his writings however, represented as application to useful purpose, & particularly from narcotic powers.

By experiments & trials of Dr Stork more generally introduced into practice.

And although has not answered expectations of all who have used it, yet for my own part, cannot help thinking that have found it product of best effects.

Effects more nearly those of Opium than any other article with which am acquainted.

Yet still hold it to be very peculiar narcotic.

And often applicable where opium cannot with propriety be employed.

Particularly as has rather effect of opening than of binding belly.

In several instances, similar to present, have I think seen it product of best effects.

And from what has already occurred in present case, am led to hope that may furnish with another example of efficacy.

If pains shall continue [much] relieved while at same time discharge by belly regular, have thoughts of conjoining with Hyoscyamus [some] Peruvian Bark.

And from thus securing advantage, may be soon in condition to be dismissed.

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Explanatory notes:

1) Latin term referring to the body of collected knowledge about the therapeutic properties of any substance used for healing (i.e., medicines).

2) Robert Sibbald, Scotia illustrata; sive, Proromus historiae naturalis (1684).