DEP/DUA/1/18/06 (Transcript version)

John Lenin

(1778-1779)

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John Lenin.

Sympt of this patients affect very few in number.

Whole narrat of compl. when came under our care cont in single circum of weakness in small of back & thighs

This however to such extent as to be cause of pain on motion.

And thus rendered totally incap. of following usual employm that viz of Mason

In this situat then subj. to as [great] distress as if app. much more numer.

And before came under our care by advice of diff. pract. had tried various remed without affect.

Or at least if gave relief was not such as to enab to return to employm

From this therefore although affect but to [apper] inconsid had evid of its import.

And only hopes of being of service to him in great meas. rested on being able to determ name or nature of affect.

And With regard to this must own that not without diffic.

Here no prop loss or dimin of sense or motion.

Parts as sensib to feel as ever had been or as any other of body.

Compl. indeed of having been at times affectd with sense of remark cold.

And no doubt that is no unfreq occurr in paralys. for parts to lose usual heat.

But with our patient as far as had any opport of examining it did not seem to be any real dimin of heat.

To feel of bystander not colder than other parts.

Power of motion also prop speaking neither lost nor dimin.

For still same command of [affectd] parts, and same easy motion as before.

Affect then solely consisted in not being capab of same powerful exertion or for same length of time.

This in sense of Mr Sauv. strictly referable at least to his gen class of debilitat.

Occurrs however as quest of import here whether this debilit depend on injur to simple solid or on want of due nerv. infl.

Causes by which induced such as might cheifly be supposed to prod affect on former footing.

Had first receivd viol stroke on back from cart.

By this indeed may suppose that there may have occurrd compress or at least concuss of spinal marrow.

And in this way strokes of back prod even of worst conseq.

Of this had lately opport of seeing most melanchol. inst.

A Gent. from stroke on back which had not even effect of doing any obvi injur to parts inst affected with total paral of legs.

And although some months since accid happened still contin in same situat

There however affect not to part reciev injur but to parts below.

Could therfore leave no room to doubt that was from affect of spin marow.

But in pres. case appear very diff.

Either confind to injur parts or extend only to small dist. from them.

Could not therefore suspect affect of spinal marrow.

And that this not origin of disease still farther conf. by accid afterwards augment it.

Effort viz in lifting stone.

This a much more probab cause as overstreaching solid than as affect spin. marrow.

Hence disposed to reject that suppos. as to cause of affect.

Still howevr does not immed [follw] that depends merely on injur to simple solid

For may also proceed from injury to nerves in muscles themselves.

These although not renderd incap of exerting every funct. may yet be so far injured as to have funct impaird

And although would not desire that partic [even] as simple solids may have receivd injur, yet own suspec such an affect of Nerves to have been prin disease

And to this opin led in first place by want of app of obv. injur.

Still more by grad progress of pain.

And lastly by sense of coldness where yet no obv loss of heat.

For by from this led to concl. that while gener. cause of heat unimp. power of nerves as commun impress. made on extrem altered.

This then opin of nature of disease to which patient subj when came under care.

And with this opin must own totally at loss to say what name should give it

Know no name which according to strict nosol. defin can be applied to it.

Of all affect howevr according to our idea most nearly appr. paralysis.

If then to give it any appellat would be that of being a paralyt affect

But in all such cases & even in paralysis strictly so calld both progn & treatment must dep. much more on idea of nature than name.

And must own that on opin which had formd was very doubtf. with regard to what would here be termin.

Respect affect of nerves in gener. perhaps more at loss than in most other cases.

Where app even slight will yet be found highly obstin.

To be consid then as unfav circum in this case that many inst of Paral [illegible]

And that disease of pres. patient often contin for consid time had already resisted various modes of cure.

Yet according to opin had no reason to suspect any fixd affect.

And even suppos actual rupt. hold that nerves may be regen reunited in parts

Or at least may be propag into these by elongat.

On these grounds then was disposed to look on pres. affect as not incurab.

And imagind even that by length of time alone some chance of recov.

This howevr supposd might also be promoted by proper meas.

And as greatest part of remedies before employd directed to suppos. of affect of simple solid had more ground for expect on footing already mentiond.

And in these hopes event has now shewn that were not disapp.

This I appreh in some meas. to be ascribed to mode of cure [prossec].

From what already said of nature will conclude that consid great obj to be the restor. of nerv. or what may be calld vital power in part.

State of Nerv powr consider as depen on two circum.

Will be affected by state of communicat between part & source from whence nerv. fluid derivd.

But still more by condit of fluid to be conveyd.

How far indep. of quality, mere quantit of fluid has effect to me seems a very diff quest.

Yet must own that disposed to think that part more or less of vital power in propor. to quantit.

Where therefore wish to encrease vital power must be in one of three ways.

By removal of causes giving any obstruct to channels by which conduct.

By giving to higher degree that state of Nerv fluids which in oppos. to state of torpor term excitement mobility.

Or by encreasing quantity of nervous fluid in affectd part.

By all these diff means appreh. that musc vigour in as far as dep on nerv energy may be encreased.

Or when morbidly dimin restored to natural state.

In pres. case was inclind to imagine that actual injur might have been done to nerves by way of rupture

To remed this however could do nothing farther than already done.

Consid therefore princip chance of recov. to be in lattr way.

That is either by augm mobilit of nerv. fluid in in diseasd part or by encreasing quantit.

Was as means of fulfilling both these intent that had here recourse to Electr.

Possess many diff modes of cure by which these intent often answerd.

But must own know none which consid. as by any means equal to electricit.

Elect. a remedy which in practice of med indep. of degr. to which used or of direct. given may be employd in diff ways.

How much may be diversif hard to say.

For cannot help thinking that resp. admin. many partic yet to be discov.

In pres. practice however employd in three diff ways.

By insulation. By sparks. By shocks.

Insulation or as by some calld simpl electrif by others elect fomentat is when body placed on none conduct.

And when in this state chargd with electr fire in same manner as [illegible] [illegible] or far

From this patient no obvious feeling.

Yet from exper. appears that induces very consid changes on syst.

Has partic been observd to acceler. pulse encrease quantity disch. by perspir.

But besides this seems as it were to have general effect of encreasing vital power

And this manif not only with regard to human syst. but with subst. possess much less of vital prin.

Thus for example in chick in ova must suppose some degree of anim life

And in seeds of plants of vegetab. life

For bringing That these may be brought to more active state certain condit indeed requisite.

With one a determind degree of heat for certain length of time.

With other heat conj. with moisture

But though these to certain extent necess yet with super degrees power entirely [destr]

By applic of electr. fire tendency to vitalit in both subst now mentiond is evid augm.

At least this may inferr from very ingen & seemingly accur. exper of Mr [Kea] a German writer.

Has found that in anim kingdom [simpl] electrif. promotes hatching of ova

And happens not only with regard to those of fowls but of butterflies & diff insec

Has found that in veget kingdom promotes germin of seeds

And that growth both more certain & more exped when [perv] to being sown have been for some time insulated.

How this to be acct for perhaps on very diffic to say.

And by diff. Philosoph. diff. expl.

Yet whatever partic manner Can be no doubt howevr that pres. of electr. fluid to certain extent gives activ to prin of life or veget.

Observed indeed that in this condit even sparks drawn from insul. eggs or seeds destry power of hatching or germ

But still [to] be explaind from what observe of gener influ of this fluid.

And even sparks in this state prob same effect as viol shocks where [great] degree of anim.

From shock of strong electric mach. many anim may be suddenly killd.

And that influ of this fluid much more than suff for killing even hum body appears from affects of thunder.

Effects however of sparks & shocks in some measure proceed from motion of this fluid.

But where body merely insul. & chargd with it have most simple state of exhib.

And in this condit appears that encreases vital energy.

Am persuaded that this mode of exhib may often be attended with great advant.

And may be practised where others inadmissible.

Requires however much pains on part of administ

And cannot be done to much advan without very strong machine.

In two other modes therefore hence means of admin. more gener. employd

For second mode of admin that viz by sparks, body first insulated as in case of simple electrif.

And afterwards drawn off not by estab commun with negat electrif side of [illegible] but by disch into ground.

Here besides formr affects acts more immed as stim to spots from whence dich made.

And stim power evid operates both on sanguif & nervous system blood vessels & nerves of part to which applied & on moving fibres.

Stim to sanguif system evid from tempor inflam which often excites.

Sometimes even goes length of exciting vesicat.

These affects can only excit as encreasing action in vessels.

And that acts also on moving fibres of muscles strictly so calld appears from instant contract.

Occurr from elect spark in same manr as from prick with needle or other mech stim

And this even occurrs in circum where power of volunt motion has sometimes ceasd.

But although some effect in both ways mentiond yet inclind to ascribe by much most consid part of power of sparks as remedy to still third cause.

Influ viz in acting as stimul to nerves at part from whence sparks drawn.

In this way inclind to think that more partic operates as encreasing nerv energy in part.

And this probab does as augm both mobilit & quantit of Nerv. fluid.

Is an agent giving pecul stimul to extrem of nerves on which acts.

By these no doubt that commun to sensorium.

Of this evid from sense of pain excited

But besides acting on sentient princip can be little doubt that operates also on brain as secret organ.

At least, if as most physiol disp. to believe brain is a secret. organ.

In this case stim to extrem of nerves will have same effect as stim to excret. ducts of other glands.

Am disposed to think that [thus] may both augm quantit & alter qualit of secret.

Imagine that on this princip will operate in some cases as restoring lost sensib in others as renewing morbid removing morbd

In as far however as these affects the result of sparks do not suppose them to operate on whole brain.

That nerves take origin from diff parts of it cannot be doubted.

And strong presumpt that in partic parts state of secret may be altered indep of what happens in others.

This at least corrob. by many [illegible] arguing morbid condit of Nerv. fluid.

In these evid indications of partial mobilit & torpor.

Can have no doubt then unless suppos of nerv. fluid totally erron that secret at one part of brain may be attend indep of what happens at others.

And is as prod such alterat that drawing of sparks to me appears to operate as powerful remedy.

Besides two already mentiond howevr a third & still more common method of exhib electric than either.

That is by shocks.

These the conseq. of sudden passage of electric fluid through body in any [direc] given it.

Are given by forming immed commun between plus & minus sides of jar or phial

And by making body part of course which electric fluid must take.

In this manner has immed action on parts through which passes.

That this the case appears from dreadful affects of lighting on edif of diff. kinds.

But even evid from slight electric shocks with weak machines.

Thus for ex every place of coating of phial to which disch applied evid markd

And by very sligh [shok] hole struck [illegible].

In this manner then, will as stim, exert to still higher degree, affects of sparks to parts through which passes.

But besides this evid acts on syst in gener

And in this way hold that operates as general stim both to Nerv & Sanguif systm.

When indeed to very high degr. have already observd that proves inst fatal.

And this some have consid as evid of sedat power of electr shocks.

Although at same time admit that sparks evid stimul.

But in what manner death hence induced by viol shock not pres businss of inquir.

Perhaps suff to say that prod immed dissol of connex between sentient & corpor. parts of frame.

This hold to be ultim cause of all death.

And among many other causes may be ultim affect of high degree either of stim or sedat power

Have little doubt that shocks to infer degree stim to syst. in gener.

Of this evid from quickening circul. exciting sweat, & giving gener agit of whole system.

Thus then have endeav to give some view of princip on which this powerful remedy oper in cure of diseases.

By insulat encreases vital power.

By sparks operates as stimul to moving fibres, blood vessels & nerves from which immed drawn.

And by [shocks] as stimulus to sang & nerv. syst. in general.

From former mode could not expect much in pres case

While at same time no obj to use of two latter

By this therfore determ to try these in conjunct.

And from even first [commn] was sensib of some relief.

Progr of after cure although slow yet unif.

And in little more than space of month patient dismissd free from compl.

In pres case therfore as well as last treated evid example of good effec of electric.

And must own have higher opin of effic than find most practit at this place [illegible]

Am far from asserting that will be successful in every dis to which appl.

Many cases of Paral in partic totaly incurab by any means.

Yet convin that has often seemingly faild, where from prop [manage] & due persev might have succeeded.

And that may with advant be extended to diseases in which hitherto little employd

And cannot help thinking that a good electr. machine a part of medic appart which every practit should possess