DEP/DUA/1/20/08 (Transcript version)

Elizabeth Corbert

(1779)

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Eliz. Corbert.

Case of this patient pres. with examp. of affect of complic nature.

And although not improbab. that all parts of disease to be consid as proceding from same cause yet to be consid as quite unconnected with each other.

And indeed if as patient suspects are really to be attrib to cold, probab. that diff parts induced by action of this at diff periods.

For princip parts of affect are here of very diff durat.

Here two very distinct sets of symp in pector. affect & compl. of left side.

Former of these which consist of cough & dyspn with expect of viscid whitish coloured matter, have now cont. for sever years.

And as without any appear of Phthis every reason to presume that that merely catarrhal.

This, in our clim with lower class of people in partic a very com. [comp]

And in gener. attrib with great justice to the cold to which exposed.

Very freq. partic in advanced period of life [assumes] chron. state.

That this therfore should be case with our patient now near 50^th year of age by no means strange

Nor can we consid other sympt to which subj. as being singul.

These consist in affect of left side from crown of head to false ribs.

Parts diseased although not dep. of power of motion natur. to them nor of sensib to touch but affected with pecul. numbness.

As far as judgem can be formd by applic of hand are not depr. of natur heat.

Yet to feelings of patient herself are affected with sense of coldness.

In these partic may here be [obser.] that have not common sympt entering defin of paralys.

Yet cannot admit of doubt that in this part of affect have tend. to such a state.

And while loss or dimin of sense & motion are conseq of want of due influ of nerv. power, to same cause also are we to referr numb., as well as sensat. of cold where yet does not actually take place.

For if in some inst of paralys from failure of circulat parts become [illegible] more cold than natur, in others though heat contin to equal degree patient yet depriv of ordin sensat from want of due commun.

This then seems to be condit of affect with pres. patient.

But if in some inst. variety in sympt of paralys. still more in [illegible].

Not unfreq. occurs as a partial general affect. But still oftener occurs as a partial disease

As affect. partic organs of sense has justly been consid as giving foundat to partic gener. of disease.

Thus for ex when gives insensib of Eye or Ear constit genus of [illegible] [illegible] or the like.

But besides this divis of gener carried still farther.

Sometimes observd to affect whole of one side while other perf. sound.

And in one case affect entirely conf. to super. in another to infer parts.

Hence terms of Hemip, Parapleg &e

The forming howevr of each of these separ & distinct gener am I own incl. to consid as improp. divis.

And where no import funct. partic affected reckon it suff. whatever be limit or extent of affect to consid it as inst of partial paral.

This appell. then would give to inst before us.

And although an affect so situat as pres. & circum not every day to be met with yet cannot consid it as great singul.

But besides local paralys. extend over about one half of left side pat. affected also with anoth sympt. not less distress. & more alarm. which [als] to be consid as part of paralyt. affect that is const. vertigo.

This indeed sometimes merely effect of inordin action of muscl. intended for motion of eye.

By this circum an involunt motion of [eye], gives an appar. motion to surrounding bodies.

[But] besides this often also effect of impress. made on brain.

Hence in reality same sensation with respect to surround object [altho] do not see them.

And when eyes shut patient yet retains feelings of motion in own body.

Here may have been effect of [either] cause.

But as conjoind with paralys. greater reason to suspect latter

And may readily suppose both to be effects of same cause. proceed from same origine.

But besides sympt plainly refer. to catarrh. or paralyt. affect. others mentiond in case with regard to which more room for doubt.

And hard to say whether to be [referd] to one or other or uncon. with both.

What I princip allude to is [sense] of straitness immed above [stern.] with which patient at times affected.

With this we are told she is attackd at irregul interv.

But partic observd to come on in after noon.

When does affect her sense of strict so great as to threaten suffoc.

In this state however cont only for few min. when again return to nat. condit.

This appear. although rather uncomon as otherwise, admits I think of possib explan. either on suppos of Catar. or Paral

But should I own be inclind rather to look upon it as being an affect of spasm. kind.

And such very common with females either having hyster sympt or without these

Upon whole however even taking it as separ affect consid it as less [claim] attent than other circumst.

With regard to prognos. formd here diff opin, of diff parts of affect.

Catarrh compl. had reason to [aprh.] would prove ted.

And although may for pres. be [removd] or allev. yet reason to dread return either from [viciss] of weather or any accid expos to cold.

At same time nothing in app. which had put on at any period from comm. which could be consid as threatn dangr.

This however by no means case with respect to paralyt. compl.

These indeed partic as occurring [illegible] well known freq. to termin in tedious & even incurab. ailment.

Yet in cases so recent as that of pres. patient reason to look for diff [termin]

And circum of pres. case on one hand give some reason to dread fatal termin & on other to hope even for speedy cure

Paralysis here much more alarm from conjunct with vertigo.

For gave reason to presume that cause of affect situated within [illegible].

And from encrease of compress. might suppose that would prove even sudden fatal.

Well known that this by no means unfreq. termin of paralyt. stroke.

And should not be surp. if soonr or later affect of pres patient such concl

Yet greater reason I think to hope for entire remov of it.

Has not suddenly attacked patient to any degree of viol.

Is yet of so short durat as to be readily within period of artif cure.

And while natural cure in some cases occurrs even at [later] period from fever, diaph. haem, or like so at earlier periods not only from these but sometim even spont.

From all these circum then, joind to relief which patient has already had reason to hope the best.

In treatmnt of this case diff morbid affect to which patient subj. seemd to require the fulfil of diff intent.

Catarrh affect partic Dyspn. to be allev. by remov. secr. mucus from cells of lungs.

While again prev of return of Dysp. to be expected from restor of secret to natural state

Immed relief of Paralys. must dep of restor of due degree of nerv. [pow] to affected parts.

And this again to be lookd for either from means encreas. that power or from remov of cause dimin it.

Pecul sense of strict at top of [stern] in as far as in as far as a separ affect and of spasm kind to be counter by remov. tendency to inordin action.

With these diff intent various pract. might here have been had recourse to.

Yet while sever meas calcul. for each some from which might expect benef on diff. princip.

This will more partic appear in offer. few remarks on pract. already directed.

Had first recourse to applic of Blist between the shoulders.

From this hoped that might obt some good conseq. both in catarh. & paralyt. affect.

And from applic between shoulders expected that should make some [illegible] both from head & breast.

Vertigo indeed conj. with paralys. [might] have seemd to indic applic to head itself.

And to this prob. should have had [recr] if had contin viol.

But could in this way expect less influ on affect of breast.

Wishd therefore first to try this meas.

Especially as back both admits of applic of larger Blister & gives rise to more copious disch than head.

And here wishd not only for induct of immed. disch but also for contin of it for some time

In operat of Blister, as far as obv. affect to be expected, were not disapp.

But while followed by very cop. disch. most of sympt also somewhat relievd.

Still indeed compl. of same sense of [numb.n] in left side of head.

But vertigo with other disagr. [sensat] referrd to intern parts less distress to her.

And at same time both cough & dysp consid easier.

These then suff. inducem for contin.

But bound state of belly to which [patien] now subjected a circum which imagind requird being obviated.

While of itself cause of uneas. was at same time unfav to affect connected with determ either to head or breast.

Was with view of obv. this that had here recourse to Pil. Gum.

Tenden. indeed of these as open belly not very great.

But here hoped that as taken to extent of ten gr. in day might be suff for purpose.

And espec. led to use of them in this case as consid them as means of obviat spasm affect giving [illegible] of suffoc.

For of this although mitig of other compl. patient still compl.

Cannot be posit in assert. that from these good effect.

But while contin under use, for space of forthnight, sympt for [which] intended almost entirely disapp.

Although however paralyt affect almost entirely gone, & almost no return of sense of strict at top of [stern], patien rather more distressd with cough than before.

And now seemd princip to be [affec] of diffic in expect. muc. secreted.

For this purpose then while still contin the drain as before, substit to pil [Gummos.] those of Squills conj. with calomel.

From these indeed did not look for antispas. power.

But expected that while equally effic in moving belly would have more effect in acting as stimul at lungs.

By this means while promot tenden to excret, would will at same time, from altering state of secret fluid, tend to facilit disch.

At least in many other inst have found this affect from use of Squills.

And when united with Calomel. have ever observed that operate more cert as stimul. both to kidn & to excret by lungs.

Am in hopes that by use of this med conjoind with contin of issue & espec. if have more warm & steady weather, which at this season to be [expect], catarrh compl. soon so far mitig that farther attend on this acct unnecss.

And if no farther return of Vertigo or encreas of affect of left side of face shall not consid it as [requist] to have recourse to farther meas with this view either.

If on other hand recurr of vertigo with encrease of affect of head may here I think expect some good conseq. from evac

And with this view may have [recourse] to repeated doses of purgat. at prop. intervals.

If without return of vertigo numbness of parts affected & feeling of coldness augm shall be inclind to try effects of topic applic.

Not so much with view to any influ which will exert on these, as to affect effects of impress on extrem of nerves commun to brain.

As such may try frict with [illegible] as powder of Must. seed. Vol. Linim &e

But should expect still more from elect sparks drawn from part.

Am however in hopes that none of these meas will be necess.

And that patient may soon be dismissd from farther attend here