DEP/DUA/1/42/05 (Normalised version)

Nicolas Hayley

(1787-1788)

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N^o5^th Nicolas Haylely at 50.

In case of this patient an example of obstinate & distressing cephalitis.

Though in name different from last affection & in situation very remote from it yet less different in nature.

For presumption of being also a headache of rheumatic kind.

As well as former case some grounds to suspect that also in part consequence of obstruction to discharge in neighbourhood of affection to which system long habitual.

Here however local affection more considerable.

For according to account given us there had occurred even exfoliation of part of bone.

And not impossible although cannot be discovered that there has taken place irregular growth giving constant cause of irritation.

If this case, reason to fear that all remedies we can employ but of little avail.

And indeed from any attempts to cure hitherto made no [flattering] prospect of success.

But some circumstances at least giving presumption of its being connected with state of extremity of nerves in part.

And is on this ground that have here directed a trial of Valerian.

An article from which in other obstinate instances of Cephalitis have I think seen very great benefit.

And from which here not [without] expectation.

If fails mean to try an issue a remedy naturally suggested by account given us of origin

If succeeds gives probability to conjecture of patient

But of this afterwards.