DEP/DUA/1/14/05 (Transcript version)

Nancy Cameron

(1777)

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Nancy Cameron.

Disease of this patient one with respect to which no room for dispute

And while indicated by most evid [mark] exhibits what may probab be consid although not as great singul. yet as aston phaenom in anim. oeconomy.

That disease to which this patient subjected is a Hydrocephal can admitt of no doubt.

Of this affection have formerly had an example in case of Ann Ramsey.

In speaking of her case occas. to make some remarks on defin of disease as entering nosol. system, & on species into which think that ought to be divided

Then remarkd that considered most useful divis to be into three species.

Hydroceph of the Ventric of Cranium & of integum.

Can be no doubt that in pres. inst. have an example of second kind.

Of this size of [head], dist. between [sentim] & partic [feel] of [contors] give incontrov. evid.

Although howevr disease of same name & nature with that of Ann Ram yet in some respects exhib phaenom essent. diff.

There had several circum which might have been supposed necess. conseq of compress on brain

Senses both external & internal [mann] affected

With evid idiotism [there] occurd [illegible], dilat of pupils, & total blindness.

And although not same opport of judging of other senses yet little reason to doubt that these also affected.

Here however with very consid enlargement of cranium & dilat of [illegible] senses unimpaird.

Or rather in as great a state of [perf] as could be lookd for at early period of eight months.

Of all organs of body affection of brain exhibit most aston. phaenom.

From slightest [compress.] or injury very generally most dreadful conseq.

Patient being even soon cutt off [sometimes] by convul or other viol spas. affect sometimes by apoplectic torpor.

But although this generally yet by no means universally the case.

And partic inst. where brain will suffer much without great affect of syst.

Not unfreq. even wounds carrying off part of subst. without death.

And as in inst before us very consid compress without inconven.

For that such must have taken place from a [prop.] [unadeq.] capab. of distend sutures could admit of no doubt.

Yet to be observd that the more early the sutures separated the less the comp. must be.

And hence probab. reason why with even greatest swelling senses least [impard.]

Notwith this however want of affect of senses always to be lookd upon as a circum rather favour as otherwise.

For when in end does prove fatal gener happens by affect of brain.

Want of such affect howevr not so far favourable as to give hopes of recovery.

And to be observd that this disease in general to be lookd upon [as] of most fatal tendency.

And in instance before us no grounds for presuming that will be more [favourab] than is in gener. the case.

Reason indeed to conclude that more rooted in habit when born with patient.

But in pres. case are told that not of above two months standing.

To be rememb. howevr that commencement here dated from time at which obvious enlargement first observd.

And child then but six months old.

May reasonably conclude howevr that had exist. for some time prev. to this

And that therefore if not congenit at least took place at very early period of life.

And that was [illegible] the more probab. from being refer. to no ob. cause.

Besides to be remarked that from time at which first observed progr. comparat speaking must have been very quick.

In several respects then a case even more unfav. than common.

And reason I think to appreh. that without artif. cure might in no long time prove fatal.

From greater part of practices [howev] but little I appreh. to be expected.

At least know of no cure remedy of which any practit has ventured to speak with confid. as removing the affect.

And tender period of infancy by no means well suited for very active meas.

In as far however as cure to be attemp must be [vend] at on same general princip. as in other drop. affect.

First & perhaps even princip part of cure must consist in evac of water already [effused].

And afterwards this end obt. if it should be found necess. the prev. farther [effus.] second object of attention

No doubt that disch by artif [outlett] most speedy mode of evac.

But besides that can expect no more from it than from [lapsing] in dropsy opening into [head] liable to many objections

And at utmost admiss only as giving possible chance of cure in most depen cases after other remed have faild.

Of all evac by natural outletts perhaps no one more powerful both as promot absorpt of [seros.] & as disch absorbd serum from syst. than purgat.

While at same time perhaps no one better accomod to infant state.

From such consid then resolvd to make cheif attempt to cure by means of these.

And was with this view that had recourse here to mixt. of Tinct of Jallap with common syrup.

Jallap long ranked among [hydogen] that is among brisk purgat.

But till lately I beleive very little employd at early periods of life.

And in general consid as in operat too severe for the inf. state.

Of late however have often employd it & I think with advant. as a purgat at early periods of life.

How far would be advis to employ it in subst cannot pretend to say.

But in formula here [employd] [that] is tinct diluted & covered with syrup am satisf. that is even for children both an effect & safe purgat.

For introd of this formula are indebted to the Sutton. inoculat.

[Compact] of Tinct of Jallap with [syrup] is great med employd by [them] as purgat both during prepar. for small pox & during course of cure disease.

Ease & certainty of operat. in such cases a strong recommend. to it in other affect where purgat. necess.

And now perhaps few in more freq. use with children where brisk operat [require]

While with infant state give [illegible] prefer to all others as an evac of contents of intest. so reckon this the best wherever requis to evac from syst.

And if requis. in any case unquest is in such as pres, where not merely evac, but absorpt. also necess.

Was here therefore intent to have persisted in use for some length of time, & to be have pushed it to as great extent as circum of patient would allow.

But although hoped that in operat of this as purgat would not be disappointed yet great doubts how far would be [cond] to cure.

For of all cavit of body generally allowed that absorp from cavit of cranium the most diffic.

And although persuaded that every part of body [furnished] with absorb. yet great reason to beleive that from cavity of scull less numer & smaller than from othr parts.

Means therefore of promot absorpt will necess operate with greater diff.

Hence while attempted to augm it by encreasing evac from a natur outlett aimed also at same [aim] by exciting disch from an artif one

And was with this intent that [ordered] blister to back which intended to have kept open.

How far these meas. adopted [have] or how far they had any affect [have] not been informed.

Learn however that the mothr has since applied to anothr pract. who has advised her to do nothing as giving best chance of recov.

In this situat may believe am not very anxious for patients returning as reckon it by much most probab. that affect will at last termin fatally.