DEP/DUA/1/45/40 (Normalised version)

George Sim

(1789)

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George Sim at 27. N^o28.

In disease of this patient as formerly observed have a distinctively marked instance of a paralytic affection.

And as then suspected likely to turn out obstinate.

At same time not without hopes of being at least so far able to bring about recovery.

That is to restore, strength & power of voluntary motion, at least to more perfect state than when came under care.

For although disease of this patient of considerable standing, yet can neither be considered as past period of natural or artificial cure.

And in both ways no doubt that recovery sometimes takes place.

In former way, is chiefly effect either of spontaneous evacuation, or stimulation.

And these accordingly, as it were indicated for artificial remedy.

In advanced periods of affection however very little to be expected from evacuation tending to [remove] [comprehensively].

And if cure to be accomplished is by stimulating increased excitement of nervous power.

These may be employed either topically as acting on part particularly affected.

Or generally, as acting upon system at large.

And here will observe have had [illegible] to them in both ways.

Began by directing first on pained & weakened parts with Volatile Liniment – or Liniment Ammoniac of London College.

At least although not in same proportion a mixture of Camphorated oil with volatile alkaline spirit.

This need hardly observe a powerful stimulant to [sensible] parts to which applied.

And indeed not only operates as [illegible] but often even as exciting proper blister.

Influence of this stimulant not only exerted on nerves to which applied but if these not altogether insensible communicated even to [Senses].

And thus exerts influence on that part of brain from which derives origin.

With this external application however, combined also use of Camphor internally.

An article which from impression it exerts, on nerves of stomach, has very powerful influence, on nervous system in general.

And in some former instances of paralysis have I think used it with great benefit.

But after continued these medicines for some weeks, progress to cure at utmost but inconsiderable.

From this therefore led to conjoin with them, the use of electricity.

An agent which need hardly observe perhaps more effective in removing obstinate paralysis, than any other with which yet acquainted.

[Hence] directed it under form of sparks from affected side.

As from this mode of administration, more I apprehend in such cases to be looked for than either from shock on one hand or insulation on other.

Under these medicines, [notwithstanding] unfavourable weather, patient has evidently [made] some progress to recovery.

A circumstance encouraging to continuation.

But at same time is only by long continuing course that in such case any material benefit to be expected.