DEP/DUA/1/20/02 (Transcript version)

Francis Ross

(1779)

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Francis Ross.

Respecting disease to which this patient subject not a little diffic

Although at same time princip part of compl. to which subj. by no means uncommon.

Disease consisted almost solely of one sympt. headach.

An affect which to be consider as perhaps a more freq. occurr than any other.

For not only occurs as an idiopath disease from great variety of diff cause

But takes place also as sympt of numer other affect.

Partic of almost all febrile diseases of stomach compl. & of various other [aff]

Here however absence of every other sympt would lead us to look for it among idiopath affect.

Of the idiopath headachs however the nosolog writers have endeav to estab. sever differ gener.

Partic Cephalal. Cephal & Hemic.

And under each have compreh. sever diff species.

Even gener. themselves however, diff prin either with respect to durat or extent

And with respect to species although certain that from diversit of causes require diff treatm. yet not to be [illegible] by sympt., & at least in many inst.

And such to case some to be case in instance before us to be.

Here indeed one circum mentiond which it may be suspected in some meas. connected with cause.

That is soft tumour on head. [about] meeting of Lamb. & Sagitt. suture

This we are told has made first appear. since headach first [comm.]

And are farther informd that subj to changes without any manif cause.

Such local affect however by no means rare without any headach

Or at least without any thing farther than mere local pain.

While at same time no circum indic connect. between this & Cephal.

And pain here cheifly seated in forehead.

In this uncertainty with respect to cause must be totally in dark with regard to prognos.

May only however observe that while cephalea in some inst. from transit & occas, in others from fixd & local [cause]

And when consider perman & contin in pres. case some presumpt for suspect. latter.

On this ground prognos must be rather unfav as otherwise.

This opin somewhat at least [corrob.] by obstin with which patients affect before came under our care had resisted diff modes of cure.

During treatment at this place endeav have not been attended with better effects.

And hence less reason to [regret] that attendance of patient has been discontin.

For here very appreh. that neither course on which had put patient nor any other that could have empl. would have been prod of any great benef.

Here must acknowledge that in pract to which had recourse directed rather on empyric footing than on any [ration] princip.

And this indeed necess conseq. of ignor respecting cause of affect.

At first directed for patient applic of blister to be converted into issue

From this whatever might be cause of affection imagind that no bad [conseq] at least to be appreh.

While at same time from giving change in mode of circulat & deriv from affectd parts some reason to hope for good effects

In many inst where topic bleeding whethr by leeches or cupping, where [purg] & other modes of evac in effect have yet found this prod of best effects.

And in inst before us seems at least to have given some allev.

For although disch both from blister & issue but inconsid was less affected with pain on back part of head.

Notwith this however both from smallness of disch & from contin of severe pain in forehead & towards left side naturally led to think also of other means of cure.

For this purpose had recourse to camphor an artic influ of which as affect nerv syst very consid.

And without exert [soperif] effects of opium yet powerful influ both as sedat & antispas.

Whether from these or any other [prop] can not say, but has freq been observd to exert very powerf influ. to be attend with remark affects as [allayin] obstin headachs.

And that too after common mode of cure ineffect.

Here therfore consid it as at [least] deserv trial.

Directed it in form of pills as being one of most commod states in which could be exhib to our pat.

Soap empl. with no other intent than to give form.

While by addit of aloes had in view the obviat costiv. with which patient affected.

This med our patient took for some days without any inconven.

But whether from Camph. from Aloes or from any other circum unconnected either with med or origin disease was seizd with very [severe] vomiting & [purgn.]

That these operat effect of pills not impossib.

With some partic states of alim canal such affects do arise from Camph

But this very rarely case when given even to much greater extent than in pres. inst.

And although affect of aloes to move belly yet seldom if ever that excite vomiting.

While even former effect from dose here given to be expected only to inconsid degree.

Am inclind therfore to ascribe effects which here took place either to origin disease or to some other accid cause.

As patient himself however susp. that arose from this cause was led to think of discont. pills.

And to this the rather induced as neither before nor after occur. mentiond. had this med any affect as allev. head.

On giving up Camph. however had recourse to a med in some respects simil to it.

At least empl. anoth of that tribe of med exert. sudden & pecul effects on Nerv. syst. viz [Hyosciamus].

Need not observe that this artic formerly somewhat in use, lately [more] partic introd into pract by Dr Stork of Vienn

To this, as well indeed as to all his new med has given very high charact.

And although his repres. not in every partic conf by others yet univ allowed that is an artic possess great [powers] degree to exert pecul [sopor] & sedat [effect] of opium without binding belly

From these prop. then might look upon it as an useful med, with intent of allaying pain.

And partic where this arises rather from pecul state of sensib in nerves than from pecul. stimul.

But in pres. inst not so much led to use of it on these princip. as on author. of other pract.

And partic on a case lately commun to me treated by Dr Huck of London.

There after every other remed employd to no purpose by means of [Hyosciam] a complete cure obt.

Consid it therfore as at least meriting fair trial in pres. inst.

But reckond it [prud] to begin with small dose

Taken to extent of gr i at bed time had [neither] influ as allev. headach nor procuring sleep.

This however did not consid as full or fair trial.

Led therefore to employ it to [doub] double quantity at first directed.

But since that have heard nothing farther of patient.

And as now reason to suspect that may not again return to attend here unnecess to suggest any farther pract. should pres. trial prove ineffect.

If contin return prob by conjunct of of Camph with [Hyosciam]

And failing this Electricit