DEP/DUA/1/22/18 (Transcript version)

James Robertson

(1779-1780)

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James Robertson.

In case of this patient an affect in some respects simil to last.

For here also princip part of disease consists in fits, during which patient falls to ground.

If however in former case was disp to consider these appear as giving examp of Hysteria, here consider them as exhib an inst of Epilep.

But if in former inst many grounds for doubt, here very little room for ambig.

Both age & sex of patient against suppos of hysteria.

For with male sex, must at least be allowed, to be a very rare affection.

And if not altogether excluded from it in after life, is yet not a disease of boys.

Our patient however has as yet arrived only at 11^th year.

And had we are told an attack of pres. disease even by third year.

A period at which may safely vent. to assert that Hyster never occurrs.

But if these partic thought not suffic, all doubt removed by other circum of affect.

Here fits not of short durat. [descr] in former case, but cont. for an hour or upwards at a time.

During that period, with convuls motions, total abolit of sense dist. markd.

That this the case, evinced by extreme want of recollect of what done about him during course.

While again pain of head & breast common conseq of epilep access.

Here then may I think without hesitat venture to pronounce disease an example of genuine & idiopath [Epilep]

Epilep in this [stile] well known to proceed from a variety of causes.

Of these some remov. by art, others not.

Progn therefore must in great meas depend on knowl of this circum.

And here with regards to partic cause, cannot even pretend to form any conject.

Hence then, in giving judgem as to termin, must be very much at loss.

At same time, can here see no ground for giving very fav. opin.

Disease well known, to be in its nature an affect very gener. obstin. frequently incurable.

And is nothing in fav of patient, that has begun with him at so early a period of life.

For although not precisely in same form, yet can be little doubt that must consid as same disease affect begining at period just mentiond viz third year of age.

Is indeed true that prop epilep compar. speaking but a recent disease

And that constit of patient in progr of life yet to undergo changes from which some chance of remov.

In this way however recov. not soon to be expected.

And if shall take place under our care will necess be led to attrib much to med employd.

In epilep meas sometimes taken with view of anticip fit.

Not unfreq. during contin of fit with view of mitig or shortening it.

But of all meas those of greatest conseq are means empl. for prev return.

And is entirely to this last intent, that pract here used, have been directed.

To understand how this to be affected must consid on what an epilep fit depend.

Reason I think to presume, that is effect of what may be calld morbid [actn] of brain.

As this however cannot be prod [withou] some irrit exciting cause, so cannot prod [efec] unless acts on pecul irrit constit.

And therfore if by prop means can either remove irrit causes, or remove that state of syst, in conseq of which morbid action of brain induced, can alone have effect, return may be prev.

Is I am inclind to think on latter of these princip that are to acct for operat of med here employd.

That is Cup. Ammon. or copper reduced to saline state, by means of Vol. Alkali.

This artic has now for consid time been in use against epilep.

And by some very highly extolld

Partic by Dr Russell in an inaug dissert professedly on this subj.

For my own part would be very far from [repres] either this or any other artic as what will succeed, in every case, or even gener. in epilep.

Yet whether conject as to mode of operat, well founded or not, have no doubt in asserting, that have seen it prod of complete recov.

In pres inst therfore, began it with intent of giving fair trial, as far as circum would allow.

But, consid tender age of patient, did not at first venture upon it, even to extent, in which enters one of Pil. caerul

Was however intent grad to encrease dose, as found that stomach of patien would bear it.

And accord have now encreased quantity, so far, that takes it to extent of two gr thrice a day.

During this course cannot say that any change has occurd which can give flattering hopes of recov.

Yet may at least venture to assert, that affect nothing aggrav.

While at same time no circum has occurd to make us desist from trial.

Is still therefore intent to persist grad augm quantity.

Cannot now howevr have opport of seeing, much more of it, during pres course.

But if in end success, shall consid it as strong example of effic.

If not, shall be led to have still more unfav opin of case than have already expressd.

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Have now stated sentim & [endeav] to expl grounds of pract in cases of 40 Pat.

As winter sess draws near concl. prop at next lect. to concl this part of busin. with gener review of cases not termin [althou] formerly spoke of them