DEP/DUA/1/12/21 (Transcript version)

William Stuart

(1776-1777)

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William Stuart affords ex of a dises. of which have had very lately occas to treat in practic course.

An instance viz of Paralysis.

In this case however motion merely [impaird].

And sensib very little affected.

While at same time circulation in great measure in natural state in affectd part.

And these parts very little if in any degree wasted.

At same time howevr extent of disease by no means inconsid

For both leg & arm affected to equal degr.

And as not want of sensib. which is almost only thing that could shew evid affect of other parts of side may conclude that affect [extern] to other parts also.

And that paralys here realy what may be calld haemiplegia.

By some consid even as a genus.

But perhaps if at all to be [used] employd with more propriety merely as a specif. [nam]

Here from what formerly deliv. will naturally occur that both for Prognos & practice several quest suggested.

And of these first & princip whether in pres. inst loss of motion from alter in condit of cond. med or channels by which that med. conveyd.

On suppos. of latter whether depends on eros. compr. or any other cause.

And supposing compress. whether at any part in course of nerves or at origine.

My conject respecting pres. case is that complic.

And that Here disease seems evid to have derivd origine from [sequence] of preceding [affection]

Was in success. attackd with Small Pox measles & chin cough.

And by these left in pres. situat.

Probab. rather as giving rise to compress than by any other means.

That this compress. howevr does not act on nerves in course suff. proved from exten of disease

Would seem that operat confind to one hemisphere of brain.

And there probab. acts as altering state of secret by that hemisphere.

Or in other words giving degree of action of that hemisphere furnishing nerv. fluid with less than nat. degree of mobility.

This conject as to cause of pres. paralys would not lead us to favourable prognos.

Especially when with a patient at period of life when disease constit subjected to so many changes has already subsisted for several years.

By natural means compression [howev] may yet be removed.

And if this affected from restorat of due action of brain disease may be comp cured.

But even without this by artif means may yet admit of being allev.

And is with such a view that have put pres patient on use of electricity.

For imagine that although cause of comp remains yet action of brain may be so far altered as to give at least greatr deg of mobil to nerv. fluid than has at pres.

And this wish to [affect] both by shock acting upon system in general.

And by sparks drawn from affected parts giving pecul. stim to extrem of nerves from thence commun to origin

Has now cont electric for near space of two months.

And has unquest been so far prod of good affect.

Arm has even in some meas. changed external appearance

Is somewhat more plump & full than formerly.

And with this has recov. consid deg of motion.

May howevr observe that motion as yet be no means completely recov.

And that progr. greater at first than has been for some time past.

Am affraid that pres. one of those [inst] where although from first appearance [faint] hopes yet will not be suff. entirely to rem the disease.

Cannot help thinking that this in some meas. corrob. conject. respecting compress of brain being origin cause.

For electric cannot be supposed to remove this.

And while compress remains, although action of haemisph of brain affected [may] be in great meas. yet cannot be entirely restored

If however does not [tire] of attend, [shal] yet be disposed to cont. this remedy for some length of time.

At that too without any other [comp]

Princip that may see what can be done in this case by electri alone.

If howevr find that makes no farther progress have next thoughts of [reconsider] an issue in neck.

By which some chance at least of [removg] serous compress from brain.

For if of any other kind can now hardly expect removal of it.

[Present] also a case [where] something might I imagine be expect from [stimul].

But consider patient as at too early for trial of any strong med of this kind.

And same also an object to a mercur. course.

In case of failure of measures already suggested then if do not try some remedy from which still less to be expected shall probab. leave patient to make trials of other remedies when better able to bear them.