DEP/DUA/1/21/10 (Transcript version)

Alexander McIntosh

(1779-1780)

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Alexr McIntosh.

Case of this patient consists of but few sympt.

And these at same time very dist. markd.

Consists of Princip compl pretty severe pain cheif conf to one side of head.

And this attacking patient only at stated times.

For observ. cheifly & with greatest severity from eight in morning till 12 at noon.

In every other respects are told enjoy usual health.

Headach then to be consid not merly as princip but as only sympt of disea

From this then natur lead to look for affect among gener of Cephal. Ceph & Hemicran.

Among these gener. however more distinct in name than in any other partic.

Under each many species comp.

And under genus of Cephal. one disting by title of Interm.

To this, pres. affect may with appar. prop. be referrd.

Yet to be observd that Ceph. interm. [partakes] much more of nature of interm fever than of Cephal.

And is by pract, used in former that cure to be expected.

Would wish therefore rather to referr it to Gen. of interm than to any of genr of headach.

And here in as far as to be consid as interm. from type most naturaly look for it among quotidian.

Under genus of quotid in syst of Mr Sauv. two species to either of which might with appar. prop be referrd.

These are Quotid partial & Quotid Cephalag.

Here unquest in as far as interm exists occurs in partial manner.

But interm or Quotid partial as commonly described attended with sympt. not occur in pres case.

For there as disease commonly [oc] is attended not merely with pain but but with all sympt of interm.

Thus for ex. arm, leg, or whole side affected with coldn, tremb. followed by heat & succ by prof tho partial sweat.

In this manner parox return with same regul. as when affect gener.

But here though regul & period return have no such conc of sympt.

And only affect to which is subj. is the pain.

Hence then with much greater prop to be named Quotid Cephal.

And while thus decis in opin as to name & nature of affect. equally little doubt with regard to origin.

For before commen of pres disease had been subj to an [autumn] interm

And although know no partic cause from which that to be acct for yet could be no quest. that this to be consid as sequel of it.

From these consid in hopes that should have little diff in cure.

But here agreeab. disapp. in its taking place sooner than expected.

This consider as have been affectd by first prescrip directed use viz of Emetics.

Of advant of these in interm in general need say nothing.

Use confirmd by daily observat. & indeed know no practit disp to deny effic.

But on what princip operate more a matter of dispute.

Can be no doubt that often advant as emptying stomach & upper part of alim canal.

And in this affect sordes of diff kinds of accum there to great degree.

In so much that by some cause of affect consid as partic seated in disorder.

Hence emet & sometimes even cathart necess prepar to [exhib] of [bark]

But while consider theory as to seat in intest canal, to be groundless am of opin. that operates also on other princip.

Partic by gener concuss which prod

Was however I own rather as prepar. to Per. Bark or some simil med than than from hopes of effect cure that here empl. emet.

Now however inclind to think that success which have had, has arisen more from concuss than evac

For from first emet, which althoug operated briskly not attend with any obv. bilious disch derivd great benefite

And after second had no farther return of compl.

In this situat might perhaps have given up farther use of med.

But thought at least that the trial of some tonic would be prod of no inconven.

And with this view had recourse to the med which was intent to have used if disease had cont. more obstin

That is Willow Bark the [Cort] [Sal] [alb]

This med among other veget indig in Europe lately tried in France as substit for Peruv. Bark.

And said with best effect

Hoped therfore that here might have had simil influence.

Under use disease did not [return] & patient dismissd cured.

This howevr could not lead us to ascribe any thing to med as consid him to be cured by Emet before begun.

In as far therfore as to form opin of it from [facts] must be in future trial