DEP/DUA/1/47/03 (Normalised version)

Robert Gibs

(1789)

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No 16 Robert Gibs at 27.

Of disease of this patient must own am at loss to form any decided opinion or even probable conjecture.

But reason I think to believe that different parts of complaint little connection with each other.

Of all his affections, most important & distressing the peculiar headache to which subjected.

This while of long standing at same time occurred suddenly.

And has been attended with such [appearances] such for example as fits of epileptic [kind] as would lead to supposition that depends on some cause within brain.

Or at least on some cause within cranium acting upon the brain.

And if this case in all probability anything we can do will at utmost serve only to alleviate.

At least if cause of fixed nature

And of this strong presumption from long continuation & obstruction with which has resisted different modes of cure.

To headache can have little doubt in ascribing vertigo, & affection of vision.

But besides these is subjected also to pain & stiffness in joints

Particularly in those of lower extremities.

Is affected likewise with swelling & ulceration of ankle.

And often distressed with unease from flatulence in alimentary canal.

These however either accidental circumstances or of little importance.

And if in any degree connected with headache at the utmost consequence of it.

Hence removal only to be expected by combating headache.

And unless some of them should occur to very urgent degree, would probably hardly be object of practice

Although therefore disease somewhat of complicated nature, yet may I apprehend view affection which is to be principal subject of treatment here as example of Cephalea.

But at same time of peculiar nature

And as at loss to form any probable conjecture respecting it, can hardly venture to say anything either with respect to prognosis or practice.

And accordingly in particular remedies employed will rather be directed on empirical footing than any rational principle

Have here begun treatment by employing extract of Hyoscymine & powder of Valerian.

The first an article which have often employed in cases of violent pain in any part of body.

And in these cases, especially in Cephalea, have I think seen it attended with very considerable advantage.

Have also, if am not much mistaken observed similar affects from the Valerian.

And particularly in what are called instances of Nervous Headache.

But of effects of these articles reserve observations till again speak of case in order of list.