DEP/DUA/1/16/05 (Transcript version)

James Sheriff

(1777-1778)

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James Sheriff.

This patient in some respects in same circum with last mentioned.

Since applied for our assist. has never been obj. of practice.

And indeed must here observe that when took him under care was very doubtful how far would be able to attend.

Selected this however as being an ex. of an affect not commonly occurring.

And although attend diffic yet hoped that anxiety to get relief might have led to meas. for surm. it.

As this howevr has not been case can now say very little concerning it.

Shall briefly howevr point out idea which had, & doubts entert. respecting case at time of admission.

And at same time shortly mention grounds for appreh. respecting terminat.

Can be little hesit in pronoun. that greater part that sever. perhaps even most of sympt here of paral. kind.

And here as often happens in Paralys the affect occurrs partially only.

In this way sometimes conf. entirely to a partic limb. Sometimes partic organ as [mot] of speech.

But most freq. one side of body affect

And this so common a case that has even given rise to a generic name. Hemip

Here however divis. between sound & morbid parts in diff. mannr.

For while super. parts retain natur state infer. subj. to consid dimin both of sense & motion.

And this also in some system disting as partic genus.

Thus with Sauv. Vogl & Linnaeus has denom of Praplex. Parapleg. &e

When consider causes of palsy easy to see in what mannr such affects should take place.

For well known that for presev. of sense, & motion, free commun by nerves necss.

At same time certain that princip nerves at least to infer. extrem for long time connected in course.

Hence then in common subj. to various injuries, during this course.

Thus while Haemipl. very gener. [consis] of affect of nerves at origin, parapleg commonly conseq. of accid to which subj. during course.

Partic strokes on back even without either dislocat or fract. of verteb.

For when these occurr affect very generally in short time mortal.

Probab. then that in such cases given compress. in conseq. of effus. of blood.

Or perhaps paral. may arise from mere concuss. of nerves.

But although inst rare where parap. from cause acting at origin of nerves yet sometimes to be met with.

And to me pres. seems to afford example of it.

For here no ground for suspit of any injury in course of nerves

And not only evid of affect of head at commen of compl. but still ground for presum exist.

Patient affected with severe headach as first sympt of pres. disease.

After that subj. to injury in this part in conseq of fall.

To these circum may farther be added that when came first under care headach still cont. with great viol

From these circum then strong reason for presumpt that cause of affect rather at brain than any where else.

May conclude therefore that cause of paralys. exerts influ at that organ.

Diffic indeed to conceive how comp. at brain should not induce an affect more general.

And partic why should not affect [pain] supplied with nerves through whole trunk of body as well as in infer. extr.

But when consid ignor. respecting brain then very little to be wondered at.

Many observat indeed made to elucid anat. but very little known as to use.

May however conclude that no part without it use.

And till funct of each prop. explaind must remain in dark respecting many phaenom.

Hence then to consider it as at least less surprizing that paralys. so [part] & so remote from brain should yet arise from compr. there.

But suppos. compr. at brain becom next subj of inquir what are to conject as cause of this compr.

Well known that may proceed from various circum. ex. Exostos of scull, blood, purul mattr, or water.

From all these many appearance in common will be induced.

And unless from exciting cause progr. of affect or other concom circum. not to be disting from each other.

Here to be remarked that of all other condit, fall most ready to give rise to extrav of blood.

But when affect from this cause in general sudden. arise at height.

In pres. instance howevr progr. much more grad.

And at same time attended with sever sympt. which very rarely if ever from that source.

Vomiting indeed a sympt in comm to sever. affect. from this source diff causes.

Any may be ment. as usual [conseq.] of [compr.] or even concuss of brain.

But start during sleep crying & grind of teeth all pecul. marked as symp of Hydroceph. or compr. from water.

And as of same kind also may [ment] freq. flushing with which said to be affected during day.

These indeed well known to be also a set of sympt often arising from pres of worms in intest canal.

And of this may be supposed to afford some presumpt. that patient had disch. one of lumbric kind some [month] before first attack of pres affect.

At same time well known that from worms most anom sympt of nerv. kind will sometimes arise.

Yet never heard of any inst. where had given rise to such headach or such paralyt. affect.

And hydroceph attended with so many sympt of worms that from this source is every day mistaken.

Hence then of two reckon suppos. of water most probab.

To hydroceph. may be consid as some obj. that has not had common progress of that disease.

But here to be rememb. that progr by no means fixed.

And that disease even of diff species

Certain evid here that affect not of that kind which would term hydroceph of [illegible].

But compress may be either from water collected in ventric or lodged between brain & scull.

And from pecul of sympt here was inclined rathr to latter of these opin.

Yet upon whole

And indeed But here little foundat on which could rest conject with any great confid.

Upon whole therefore very doubtful respecting this affect

Yet in [whatever] light view disp to entertain no favour. opin as to term.

Paralyt. affect whatever cause seldom easily removed.

And partic obstin [when] affect of comp.

But besides reason to dread obstin, here ground also for appreh. danger.

From long cont & viol pain of head presumpt at least of local affect.

Especially danger. where had [induced] train of sympt here pres. & which [prob] arose from it.

And if conject as to nature of local affect well founded viz that consist in collect of water is an affec generally at least consid as certainly fatal.

Hence then had patient cont. under treatment although might have found more probab conject as to nature of disease yet little hopes of being of service to him.

And even after all case of such nature that probab. true cause of affect to be discov. only by [dissect.]

From circum now mentiond is pres opin. that would be found to depend on collect of water between scull & brain.

Or what in contradict to Hydrocep of Ventric & of integum I would [term] hydroceph of cranium.

Was on this ground presumpt that on authorit of Dr Percival which had occas to mention in practic lect. & which now publishd in Med Com. had [thought] of trial of Calom.

But inability of patient to attend precluded us from opport of seeing affects of it.