DEP/DUA/1/23/10 (Transcript version)

Robert McLean

(1780)

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Robt McLean.

At pres subj to but few sympt.

And these I think making a disease suffic obvious.

Disease consists in pain weakness & sense of coldness over great part of body, but partic lower extrem.

These the remains of a disease for which already treated in the Infirm by bleeding, cupping, blist. sweat & simil pract.

From history therefor as well as trea treatment can have no doubt in concl. affect to which patient subj to be Rheum.

Of this disease have elsewhere endeav to shew that there are four diff states or stages.

viz of Inflam. Irritab. Aton. & Paralys

Into pecul sympt of each of these cannot at pres prop to enter.

Suff. to obs. that consid case of this patient as being in last of these viz the Paralyt.

Or at least in progress from that of atonia to paralys.

On this [suppost] with regard to the disease cure must be ted if not diff matter.

Much indeed depen on due regul & persev, on part of patient himself.

And if this wanting, which not improbab, may in end, be disapp.

Still however neithr [ankylosis], [concret], nor contract to such degree as to give disease appear of being incurable.

Meas therfore for recov. may at least be prop & tried.

And this I think to be princip brought about by restorat of nerv energ. to affected parts, which preced state of inflam has had affect of dimin

With this intent recourse had with greatest advant to artic of purely stimul. nature.

And often also to those comb. with stim power, some degree of evac

Is I appreh from operat in this latter manner, that to acct. for benef. which in such cases derived from large doses of Vol Elix of Guaiac.

This med long since has had place in pharm & employd in various diseases.

But seldom in larger doses than few drops, or utmost tea spoonful.

Need hardly observe that use to extent of sever. drams or even an ounce in Rheum cases, first introd by Dr Dawson of Lond.

From his recommen. has of late years become very fashion.

By the exper of many pract. who have tried it, his observ. in great meas at least confirmd.

In my own pract, have often employd it with very great success.

Must however observe that have found it less applic in inflam, than in other states of Rheum.

But partic in the atonic & paralyt.

And especially where latter occurs in such a state as to bear, & even to indic some degree of evac.

From these consid then, appeard very prop med in pres. inst.

And therefore began pract in this case by direct. use of it

Here employd Elix as comb. with mucil of G. Arab.

Which of all artic I have tried, find to be most effect, in covering pungency of Volat. Alkal. menst.

These mixd to equal parts, exhib to quant of ℥p.

That is two drams of Elix taken at each dose.

From this quantity some obvious operat in way of sweat.

Not however to such extent, as to prev, even encreas quantity of med.

Directed therefore employm for [follow] week to double this dose.

From which hoped that without any evac giving inconven might [encrease] good effects from stimul.

But with this encrease, had at same time recourse to anoth very powerful stimul.

That is electricity

Into any inquiry respect mode of action in cases of paralysis & other nerv. affect, cannot at pres prop to enter

May only observe that utility in such, confirmd by very extens exper.

And at least certain, that no state of Rheum in which of equal service, as when has proceeded to atonia or paralysis.

While by encreased dose of Elix [sweat] so far augm, that could not push it to any greater extent, from electric, patient denied at least tempor. advant.

By this therefore determ at least to contin in same course.

If patient regul in attend on electricit & in other respect following [out] course directed some prob of success.

But if notwith regular are disap shall have less expect of cure.

And am acquaintd with no other meas, in which can put equal confid.

May still however suggest as [when] even in this event deserve to be [tried], the use of Mercury, & Vapour bathing.

But at same time must observe that here have prop conven for neither of these.

And not improbab. that pract with pres patient may be termin by trial of plan already begun.