DEP/DUA/1/26/18 (Normalised version)

Elizabeth Waitman

(1780)

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Elizabeth Waitman

After observations made at last lecture on case of Robert Blair little need now be said of present.

And especially after remarks then made on case of Thomas Culbertson.

As well as these two, consider affection of this patient also as being of Paralytic kind.

And if excepting circumstance of sense of burning heat, is without an uncommon appearance.

This indeed it must be allowed not a very frequent appearance.

Much more common to discover an actual diminishment of heat.

And indeed but in rare instances when both sense & motion entirely lost, in which does not occur

Particularly if, which then generally the case, there takes place failure of circulation & wasting of limb.

But although diminishment of heat more common, such an appearance as here occurs far from being rare.

In my own practice have oftener than once had occasion to meet with it.

And occurring too at least from account of patient to much greater degree than in present instance.

In one of most remarkable instances of this kind that ever met with Paralysis had affected both lower extremities.

And while deprived of power of motion in both legs with very little [remaining] feeling, this uneasy sensation confined [entirely] to soles of feet.

There however so intolerable feeling of heat, an almost insufferable unease.

Here however to be remarked that consisted in mere feeling only.

For from repeated trials with thermometer was found that heat not in reality augmented.

On contrary from these trials appeared that thermometer less raised than when applied to other parts.

And in every other instance of same kind which have had opportunity of examining no actual increase of heat.

Hence then would appear that when does occur, is merely affect of morbid condition of Nervous Fluid, or medicine communicating impression to the brain.

And in this view, may be esteemed less uncommon appearance in Palsy than at first might be disposed to conclude.

Here in other respects paralytic affection, had gone to no great extent.

Had been of no long continuation, & no attempts had been made to removal by proper medicines

These circumstances therefore rather favourable as otherwise.

This indeed could not be represented as case with every particular in history

And nothing in favour of patient that near 60^th year of age.

Was also perhaps rather unfavourable as otherwise that had arisen from a Rheumatic affection.

For when this the case motion frequently lost from change even in state of moving solids themselves.

Often from stiffness of [ligaments] & [illegible] & in some instances even from actual anchyloses at joint.

In present instance however no appearance of this kind

Nor can patient be considered as at period of life when recovery rare.

And not a little in favour of such an event that since treatment begun complaint considerably changed for the better.

After having so lately had occasion to state general principles of cure in Paralysis cases need not now say anything respecting these.

Was here aim to restore due mobility to nervous power.

And with view of accomplishing this have had recourse to same practices as in former case

Use viz of Electricity & of Camphor

But here Camphor applied only externally.

Hence nothing here to be expected from it on principles which stated in remarks on case of Culbertson.

And indeed in as far as progress hitherto made in cure am disposed to attribute it to electricity.

By continuation of which am in hopes that cure may here be completed.

If this not the case however, shall probably here also employ the Camphor internally

And if after [failure] of present practice proves successful will give me still higher opinion of it than before.

If this also fails cause to which is attributed would lead me to trial of Mercury.

And if none of them successful should have little hopes of cure by other means.

Shall then be disposed to view it as one of those instances of Paralysis which although slight in appearance yet incurable in nature.

Yet if attendance continues measures adapted to circumstances may still be employed.