DEP/DUA/1/11/13 (Transcript version)

James Lind

(1776-1777)

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On Satu last dismissed from attend Jas Lind

Formerly pronoun disease to be Epilep.

And consid it to be prod of disease of Mother

Not however as having affect in hered. manr

For with his mother induced only by a partc accid consid time after his birth.

Nor as commun by infect from contact as she suspected in conseq of sleep. in same bed.

For no ground to suppose that epilep in any degree infect.

But as being what may be calld a [catchin] affect in conseq. of princip of irrit.

Well know that sever. nerv affections of this kind

Ex even in in so simple an action as that of yawing.

Will sometimes be propag. through a [whole] company

Still more manif in hyster.

When one affected with a fit all other in ward will also follow

Pres not only case in which I think have seen it hold with regard to epilep

Some may perhaps rememb. [my] having formerly made this remark in R. In.

Had there an epilep patients whose fits indeed very dreadful.

Partic from pecul. shreiking with which attended

In so much that fits would freq alarm whole ward.

Was lodged in room with anoth patien who had never in her life been subj. to any such compl.

But who was of habit rathr delic & irrit

This last patient howevr soon after other having a fit affected with one in every respect resemb. epilep.

And charact to be such in as far as frothing at mouth, total abolit of sense & other circum can go.

On these grounds then conclud fits of pres. patient to be epilep.

Must indeed be allowed that since treatm begun no circum has occurd partic corrob that suppos.

Nor on othr hand have seen any thing to discredit it.

Can see no reason for presum that in pres. case any decept.

And own still retain formr sentim respec affect under which laboured.

In this case was not I own disp. to look for fav termin which has now taken place

Consid epilep to be in every case a [illegible] affect

And know no remed on which can with any deg. of confid depend for cure.

In every case therefore look upon cont to be uncertain.

At same time observd that from idea of cause look on pres. to be a case in which better chance of cure than most others.

And was led to entertain hopes princip from suppos. that no local affect.

These hopes even more than satisf.

For patient has under our care obtaind if not perfect cure, at least susp of diseas much sooner than expected

Has not only missd fit at regul period but even when subj to exciting causes by which used formerly to be induced.

Reckon it therfore unnecss. that should at pres. any longer contin attend.

Would not however from this be understood to pronounce that perf. cured.

And should not be surprizd at hearing that has again return.

Especially when consider that still contin exposed to same occas cause by imagind it at first induced.

Yet cannot help thinking that some grounds for hoping this may not be case.

In treatment of this case remarkd that might proceed on two diff. footings.

Either by attempt remov of exciting cause

Or by endeav to induce such change in state of Ner. energy that although exciting cause remaind should cease to have former affect.

Is on this last princip. that appreh releif most freq. afford in epilep.

Partic as anticip fits.

Would seem that certain mobilit in nerv energy & irrit in moving fibres necess even in cases of local affection.

Hence releif sometim obtaind from Tonic where epilep even prod of exost. within scull.

On this footing then proposed to attemp cure in pres. case.

And through whole treatment found no reason to alter plan.

On first applic of this patient presribd pil. caerul. a new form of Ednr. Pharm.

Need not observe that only active part here totally a prep. of copper.

And here perhaps that metall in mildest saline state to which can be reduced.

Introd of use of Copper into med would seem to be of very antient date

For best history that I know if it may referr you to an inaug. disser. De [Cup.] pub. at Univ of Edinr. about 20 years ago by Dr Russell.

In pure metallic state not active on human body.

But would appear that sever prepar of it as [squance] verdegris &e employd at least extern in med as early as days of Hippr.

But internal use long consid as poison.

And indeed stim affects such that dare not use great part of prep. even in small doses.

Partic remark with respect to Verdegris.

In all saline states howevr not equally violent action as stim.

And from astrin power extern was conclud that might have same affect on syst from internal use.

Found that of all prepar. those with neutral partic [Ammon] salts the least vir virulent

Accordingly such a remed introd & recommend by Mr Boyle undr title of Ens. Ven.

He bestows on it high [enam] in all diseases with univer laxity.

After his time howevr much neglected till again introd into practice by some Germ [writers].

Partic in Berlin Transact & in [illegible]

Since that time not unfreq. used in epilepsy.

And alledged often with consid success.

Not howevr to be imagind that any remed which will succeed in every case of epilep.

Is however a great deal if have one which will succeed in some cases.

Have myself used pres. remed in sever othr instances besides this.

In some cases could not say that was of any benef.

In others had I think manif good affect.

But in no case have I seen so remark benef as in pres.

Would by no means howevr repres as in instances of greatest success.

A case partic in circum much more obstin recorded by Dr Russel in dissert mentiond above where prod [powrfl] cure.

There indeed long cont. & to consid exten

Even to dose of nine gr 3 times a day.

Is one of these med [howvr] which from stim affects requires always to be begun in small dose.

Prescribd for pres. patient then at commen single pill.

That is gr ss of the cup to be [reaped] every morning & evening.

Even from this at first some degs of sickness.

But as neither vomiting nor looseness soon ventured to double evening dose.

As then such med more easily born than with empty stomach.

Under this quantit. freq. of fits soon dim

And what still stronger indic of dimin of irrit did not cont to be affected as had formerly been with startings during sleep.

Soon after fits entirely left him.

In place of encreasing therefore thought it more advis to dimin dose.

Even with this some suspic [of] its exciting vomiting.

But whether from med or state of stomach immat

This by no means intent in view.

Hence entirely omitted med.

But that might not suddenly give up powerful tonic ordered as succeed. Peruv. Bark

And after contin of this for week without any threatning of return of fits reckond it unnecess to keep patient longer on list.

Have accordingly dismissed him.

And shall have much satisf if learn that contin free from any return.