DEP/DUA/1/43/02 (Normalised version)

Thomas Stevenson

(1787-1788)

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N^o36. Thomas Stevenson at 25

Disease of this patient consists entirely in diminishment of vision.

And that too without any obvious affection of external parts of eye.

Even on [illegible] inspection no very manifest disease.

While at same time pupil [retains] very considerable power of dilation & contraction

From this however led to conclude that not the effect of insensibility in optic nerve, or extremity.

For in that case no contraction of the pupil on exposure to light.

And on more minute examination of eye appears that internally has not usual transparency.

That crystal lens of whiter colour than natural.

Or in other words that there takes place what among ancients in opposition to Gutta serena had name of Gutta opaca.

Among more modern practitioners this known under different appellations.

But particularly under that of Cataracta

In systems of Sauvages & other nosologists¹ this divided into various species.

But that of our patient an example of the Cataracta vera of Sauvages.

Dr Cullen anxious to reduce Number of genera has referred Cataracta to [more] extensive genus of Caligo.

Including all diminishment & loss of vision, from any opacity in eye itself.

And according to his system is an example of the Caligo Lentis.

But whatever name may give it, is evidently a disease, where diminishment of vision the consequence of morbid condition in the crystal lens.

An affection by no means uncommon. And even in most advanced stages often admitting of complete & perfect cure.

In these circumstances however, only to be brought about by chirurgical operation.

And by this means, the diseased crystall. sometimes completely exhausted sometimes depressed.

In this latter case, soon [disappeared] from being dissolved in [Aqua] humour.

And accordingly many disposed to prefer it as being easiest operation.

But entirely foreign to our business to say anything as to comparative advantage of operation.

And in case of present patient, yet in an incipient state, not in condition for operation.

With respect to prognosis therefore, only question is, how far removed by other means.

Of this must acknowledge am [extremely] doubtful.

Can only I apprehend be effected in consequence of complete absorption of diseased [part]

And this while very uncertain can only be looked for in slow & gradual manner.

Have however no doubt that absent from every part of body even hard bones.

And that by due increase of [action] may carry off any part.

Is with view to such increase that am here employing electricity.

But of mode of operation as well as effects resulting from it, reserve observations.

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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.