DEP/DUA/1/37/33 (Normalised version)

Alexander Henderson

(1785)

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Alexander Henderson

Disease of this patient might be said to consist almost entirely of one symptom.

Severe pain viz of his head & that too entirely situated in fore part.

But neither affected circulation nor [respiration]

While at same time appetite & excretion continued in natural state.

Here then, might I think consider it as an example of idiopathic headache

At least if such a disease can ever be said to exist.

Has it is true been by some alleged that never to be considered in this point of view.

And accordingly some of nosological¹ systems as for example that of Dr Cullen where does not enter

But on other hand, by other systems as Sauvages considered according to [manner] in which modified as constituting several genera.

Thus have given place to these different genera of Cephalgia Cephalea & Hemicrania.

For my own part am inclined to think that equal error on both sides

But unnecessary & improper to [multiply] genera where no advantage from it in practice.

But no reason, why pain of head, should not be considered as constituting a genus, as well as any other.

Indeed has much more influence on system than almost any other part.

Hold therefore that Cephalea with propriety considered as a genus of disease.

And of this had I think a manifest example in case before us

As to prognosis after favourable termination which has now taken place no observations need be offered.

May only remark that from nature of disease itself, should have been inclined to hope favourably.

For although sometimes obstinate yet this upon whole rather a rare occurrence.

And often after being very severe terminates without aid of any medicine.

When this not the case, different articles which often successfully used in removal.

But besides these circumstances had here farther grounds for hope from another particular.

What formerly happened to patient when under our care for same complaint

As then readily yielded had reason to expect similar conclusion on present occasion.

Hence then termination which has now occurred no more than reason to hope for.

But at same time in judging from former occurrences may here also draw another conclusion.

Have reason to fear, that on trifling accident will again be subjected to recurrence of affection.

And indeed may be observed that after this disease once becomes habitual few more difficult to be entirely removed.

For present however at least removal has been obtained.

And this I am inclined to think may in part, if not altogether attribute to medicine here employed.

Began practice you will observe by directing for this patient the use of an Emetic.

Emetics in cases of headache often very serviceable as unloading the stomach.

For from viscid sordes collected there by general sympathy headache often produced.

When this however the case not only reluctance or aversion to food, but even in general natural vomiting.

Here therefore from state of appearance had no reason to expect, any such affect.

In every such case however unloading the stomach of some consequence.

Has at least the effect of rendering that viscus more susceptible of action of other medicines.

And was here chiefly as an [introduction] to use of valerian that had recourse to employment.

Of use of this article in a variety of affections of the nervous kind have already had occasion to speak.

And as such, consider that pain to be, which in most instances constitutes cephalea.

But whether this conjecture well founded or not have often in former practice employed valerian against cephalea.

And that too with best effects.

On grounds therefore of former experience here expected that would be attended with good consequences.

And in that expectation were not disappointed.

For after use begun very considerable remission obtained.

During employment indeed had from some accidental circumstances a severe return.

But this of short continuation only.

And in no long time had it in our power to dismiss him free from the affection.

An affection which am I own disposed chiefly at least to attribute to use of the Valerian.

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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.