DEP/DUA/1/13/19 (Transcript version)

William Brown

(1777)

---

Wm Brown.

Disease of this patient in some respects a very simple one.

Consists entirely in an affect of the sense of vision.

Though not an entire abolit of the sense yet manif. impaird.

And that too without any obvious affect on affection of organ.

But while this wanting have at same time evid of affect of nerve.

For although pupil still cont. to contract is not with same celerity as formerly

Farther to be observd that [such] [apper] as here take place, opaque subst viz seeming to float before eye, a common appear. in incip stage of amauros or gutta serena.

An affect totally arising from [insen] of optic nerve.

And which may be effect either of compress. to optic nerve, of torpor in [urine] fluid or of any simil cause.

While at same time these may either operate as giving total or partial insen

Can be little doubt that affection in case before us is of this nature.

And although at pres. gives but little inconven. yet hard to say to what length may yet proceed.

Am inclind to think that this patien less alarmd than ought to be.

For must own that not entirely without appreh. regarding prognosis.

True indeed that several circum in this case somewhat favourable

Has as yet been but of short duration

And such appear of objects floating before eyes even to greater degree & for longer time which of themselves have afterwards disappeard without med aid.

Besides no circum here such for ex as headach vertigo or like indic any fixed cause.

Not therfore to be consid as very singul, if should soon termin favour even without any measures.

Yet must be observd that other partic threatning danger.

And among these may justly [illegible] consid progr. which effect has already had.

Though but of three weeks standing contract of pupil evid affected.

And objects floating before eyes seem to suffer even daily encrease.

Unless therefore progr. soon stopt may in no long period termin in total loss of sight.

Or even suppos. progr. to be stopt may contin stat. in pres. situat.

And well known that affect. of this kind often of most obstin nature.

In so much that by many med consid as of no avail.

Am far therfore from thinking that affections of this patient to be consid as triffling.

And look upon termin which may take place as extremely doubtful.

Only however with respect to affection of vision.

For here no ground for imagining [that] disease will either have fatal termin or even affect health in other respects.

In practice in case before us have had opport of doing very little.

As affect gives no great inconven to patient probab thinks it unnecess to bestow much attent upon it.

Considering disease to depend on [insensib] of optic nerve thought that sole aim in cure was restorat of due sensib.

And as one of most powerful agents for this purpose had recourse to electric

From state of weathr howev at time when patient first applied, had not oppr of using this practice in mannr that could have wishd.

And patient soon gave up attendn with affection pretty nearly in same state as when came under care.

Should he again return would not probab think of any other med till had given fair trial to electricity.

And in pres situat unnecess even to suggest what future meas. to be followed.