DEP/DUA/1/45/52 (Normalised version)

William Torrence

(1789)

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William Torrence at 26. N^o34

Formerly observed that could have no hesitation in pronouncing disease of this patient a distinctly marked instance of Epilepsy.

And since that no circumstance has occurred tending in any degree to alter opinion, as to nature of disease.

Must also I am [afraid] still likewise hold same sentiment respecting termination.

Observe that all circumstances taken together case a very unfavourable one.

When consider how many even of apparently slight instances, prove incurable could here entertain but little expectation of recovery.

And this still afraid will be ultimately the case.

At same time [appearance] since came under our care rather favourable than otherwise.

And this I own disposed to attribute to medicine here employed.

Use viz of Cuprum Ammoniala under form of pills.

Of this article though far from considering it, as generally or even frequently successful in Epilepsy must own I entertain a favourable opinion.

And this also as will observe from Dr Cullens Materia Medica¹, the opinion of others.

In what manner operates must own am at loss to say.

Little doubt, that action solely effect of influence on stomach.

And more probable that operates by removing predisposition to disease, than exciting cause.

That from tonic powder takes off a condition of [moving] fibre, without which those inordinate actions constituting greatest part of fit could not occur.

At same time, some facts, particularly its influence as anticipating fits, even from short [previous] use, which give presumption that may operate also in another manner.

That from impression made on stomach induces action of brain, different from that which takes place in Epilepsy.

And that thus prevents morbid action.

But whatever principle of operation, have from repeated experience no doubt, that have often seen it product of good effects.

In obtaining these great objective to manage it in such manner as to produce [illegible] without stimulating effects.

For to [intermittent] use of copper in general its stimulating powers occur as [strong] objection.

Accordingly blue vitriol, Verdigris etc hardly venture upon internally unless as emetic.

And when accidentally taken often even proves poisons.

But in Cuprum Ammoniala where [appearance] brought to saline state by volatile alkaline have a milder & more manageable medicine.

Still however can seldom be ventured on, at least at commencement in larger dose than half a grain.

And accordingly that quantity enters each of Pill e Cupro of our Pharmacopoeia².

From this however, dose to be gradually increased as found that patient can bear it.

Here therefore from beginning with singe pill have now gradually increased it to extent of nine in day.

And has continued use for above a month.

Even to that quantity borne without any inconvenience.

And during use, though not free from fits, yet these much less frequent.

But what perhaps to be considered as still more favourable circumstance is also less affected, with stupor than formerly, & mental powers in different respects improved.

These then strong inducements for still persisting in giving this remedy a farther trial.

Some indeed objections to continuing above a month at a time from apprehension of dangerous consequences.

From repeated experience however can venture to assert that after uninterrupted continuation for several months, never saw any bad affect from it.

And in my opinion, only ground for alarm, is not from persisting in use, but from large dose at once.

For in this way apt to give rise to very distressing vomiting.

Hence therefore no hesitation in persisting in employment till full & fair trial.

But at same time as formerly hinted, am still apprehensive, that in end shall not find it product of desired effect

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Explanatory notes:

1) An official publication containing a list of medicinal drugs with their effects and directions for their use. The Royal College of Physicians of Edinburgh's Pharmacopoeia was first published in 1699.

2) William Cullen, A treatise of the materia medica (1789).