DEP/DUA/1/25/18 (Transcript version)

John McKenzie

(1780-1781)

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John McKenzie.

Hist of case when this patient came under our care not many sym

Yet reason to suppose that these constit dist & diff affect.

At least affect of head & back such as here occuring seldom obs. connected.

And in pres case of very diff [stand].

At time of admiss headach when had been compl of latest date was also most urgent.

Headach a morbid affect in diff diseases very distress.

Notwith this however in some syst not consid as constit genus of disease.

But in others on contr. divided even into diff gener.

Hence appellat of Cephal. Cephalea Hemicran. &e.

These howver consid as distinct without any prop. diff.

At same time whatever term empl. have no doubt that headach may occurr as idiopath as well as symptom of other affect.

And such am inclind to think, was case in inst before us.

For while no partic affect of other parts of syst. to which could be referrd was attended with vertigo & Tin. aurum

These while pointing out more partic affect of head, gave some indicat also of severity.

And although had not given rise to disorder of many funct. yet had reason to suppose from circum mentiond that would not be slight.

And this the rather as had already cont & that too without any consid intermiss for space of six months

From appear however at pres not entert much more fav hopes of speedy conclus.

And this am I own in good meas disp to attrib to med here employd.

How far this the case howevr [more] partic under obs in pract.

But before that, must here obs. that this not only part of affect.

Is distressd also with pain in back.

And from stricking to region of [kidney] some ground for presum. that of [Nepr] kind.

But this suppost invalidated by want of [other] sympt of nephrit.

And when consid that patient affected with stomach compl. eructat, &e more prob. that proceed from flatul.

And that in conj with what now ment. to be reckond a dysp. sympt.

This part of compl when patient came under our care, less urgent than other.

Had however been of longer cont

And although reason to hope that would be less distress, yet still ground to concl. that would prove more obstin.

And accord while patient now in great meas free from headach [dyspept] affect. still remain.

This however not merely to be attributed to greater obstin

Or at least not to be consid as having [resisted] active med since came under care.

For till last report no med order directed with view to stom compl.

Before that pract empl, solely calcul. for removal or at least allev. of headach.

And for this purp. used a med to which in many simil inst. have before had recourse with success.

That is extract Hyosciam.

This artic has long had place in diff pharm.

And indeed has stood in [list] of Ednr Pharm since estab. of Coll.

But still much older date in pract

Will find long section on it in writin of Dioscord.

Points out these diff species of this veget.

And gives to all of them charact to which still consid as univ entit that viz of strong Narcot veget

Accord in his arrang. immed subj to diff. species of papaver.

On one of these species of Hyosciam viz Albus, bestowes high charact.

Partic as means of allaying pains.

Of two formr however [flavus] & niger his words are, ambe insania gignunt & soporem adeoque viz in commune usum [recipiunter]

And accord though place in lists of Mat Med, yet in reality but very little empl.

Of three species ment by Dioscor. Hyosciam niger the only one which native of this country.

And of this Dioscorid observes, niger ceu deterrimum improbatur

Even from this charact however ground for concl. that under prop manag. might furn useful & activ med

Accord. after Cicuta was one of first of those artic which became subj of experim with Dr Stork of Vienna

From his trials repres as med of very great powers & highly useful in variety of diff affect.

But of this as well as of other artic introd very diff opin formd by those who made after trials.

And while many disp. to deny utilit altogeth none who had so high opin of effic as Dr S. him

At same time few cautious or attent pract. who had not opport of seeing active powers.

And no one I believe who has used with due caut. the extr. of Hyos. prop. prep., who can now entert. [doubt] that very consid effects may be obt. from it, without smallest hazard.

In these effects is indeed true that approach to opium.

A med with admin & influ of which, much better acquaint.

And which therefore will in com. pract. be in gener. preferrd.

At same time must observ. that sedat med diff not merely in degree.

Each seems to have determ & pecul effect.

And in case of no two artic does influ. seem to be precis the same

Accord in certain circum one will often have affect of allev. pain, [allow] inord action & procur. sleep, while anoth gener. esteemd more powerf. tried in vain.

This then suff. reason for wishing to have witnessd in pract. effect of diff. ones.

On this acct. in pres. case, where might have expectd allev of pain from opium, yet chose rathr to make trial of Hyosciam.

Must farther obs. that encour. to this trial by success which have had from Hyosciam in formr simil cases.

In severe headach have found it attended with advant when various meas partic both opium & camphor tried without effect.

Must farther obs. that have been disp to think that when allev of pain obt. by Hyosciam more perm than from Opium.

This however mention rather as matter of opin than as conf. by suff accur or extens observ.

But whethr well founded or not is at least very gener agreed that has less tend to bind belly.

And accord. free from very great inconven. often result. from opium.

On these acct. therefore am inclin to consid introd into mod pract as valuab. addit.

And I think were not disapp. from use in case before us, of effect which might have expected.

Here extract given in form of pills.

And addit of soap with no other intent than to give suffic mass.

Taken to extent of grain in space of day

A quantity which have in gener found suffic for prod effects of [Soporif]

Here however less intent to procure sleep than to allev pain.

And therefore given at once only to extent of half a gr.

Even this dose had he thought influen as procur more rest during [nigh]

But no effect in prod drows in day.

While at same time obs. to mitig headach.

Hence therefore while no obj to trial, had it in power to cont it.

And from contin for space of forthnight, affect so much allev. that he gave up attend.

Here cannot absol. assert that compl. removed by med.

Yet when consid formr contin, as well as state when came under care at least highly probab.

After absen for some weeks patien has again returnd to attend.

This however not with view to headach with which now very little affected but to stom compl.

And accord have ord. mixt with Aromat Tinct & Cinnam Pepper mint water.

From this had in view the afford. warm stimul to stomach & the expuls of wind

And thus hoped to obt if not remov. at least allev of stomach compl.

If this obt. shall hardly consid patient as longer obj of pract.

For from what have already seen may concl. that unless symp urgent are not to expect regul attend.

And in pres state of affect not of such import as to claim much attent.

Am in hopes therfore that without farther med may soon be able to dismiss [him]