DEP/DUA/1/45/16 (Normalised version)

William Wall

(1788-1789)

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William Wall at 23. N^o35.

Respecting case of this patient [no] room for doubt.

As well as that of William Torrence which immediately precedes it, is a distinctly marked instance of Epilepsy.

This sufficiently evidenced by method of attack of fits.

By obvious convulsions.

By falling to ground.

But above all by total abolition of senses during fit.

For this hold to be great characteristic in such cases, distinguishing Epilepsy from convulsive strictly so called, & from hysteria.

For in appearance in other respects [think] nearly approaching to it.

In this case several circumstances occur which may perhaps be considered as singular.

Such for example as accessions occurring only during day.

Their making attack without any previous warning.

And their not being succeeded by any fatuity.

But at same time, though contrary are more common, none of these to be considered as very rare occurrences.

And some of them even favourable circumstances

Such for example as want of fatuity after fit.

For this much more even than violent convulsions considered as mark of severity of the disease.

For while two leading sets of symptoms are, abolition of sense & convulsive agitation hold former to be by much most considerable.

And inductive not merely of stupor after fit, but of constituting fatuity during interval in my opinion strong marks of irrecoverable disease.

Must however be observed that all peculiarities here not to be considered as equally favourable.

Thus rather unfavourable than otherwise that occur without any [previous] [warning]

For by this means deprived of any opportunity of anticipation.

And farther [argues] that stimulation inducing attack, more immediately [applied] to brain itself.

Must also be observed that in this affection prognosis always very uncertain.

For in some instances even [apparently] most slight & transitory cases, will obstructively resist every mode of cure.

And in others where affection very obstructive & long continuing will yet yield to spontaneous changes occurring in system.

But with regard to present case as far as a judgment can be formed from circumstances neither appearance very slight nor very obstructive.

And upon whole not without hope of cure.

With view to this as well as in case last mentioned is here also intention to make trial of Cuprum Ammoniala.

And if here successful will I think be strong proof that in some cases at least product of very material benefit.