DEP/DUA/1/26/13 (Transcript version)

Agnes Millar

(1780)

---

Agnes Millar.

Sympt of this case by no means uncommon.

And in my opin what are most urgent very distinct mark an affect, very freq occurr in pract.

I mean Paralysis.

To definit indeed as introd into Nosol syst. cannot be consid as having exact correspond.

For these disease cheifly marked by impaird sense or motion.

And in these must be allowed that gener & essent charact of the affect [consis]

Here again circum most distress to patient is pain.

And although motion imp may be consid as not so much from want of power as sense of uneas.

For are told that on any motion pains partic severe.

And that from this cause dare hardly venture to use left arm.

Into definit of Paralysis however pain hardly ever does not enter.

While at same time constit essent circum of an affect in which motion often defect viz Rheumat.

Rheum also often affect of that cause to which compl. here attrib

Expos viz to cold

These circum then may give some ground to susp that to be viewd rather as Rheum than Paralyt affect.

And this the rather when consid that Paralysis freq conseq of Rheum.

Here however And although does not appear from hist of case, that ever under form of acute Rheum, yet would not pos assert that this no share in origin.

Here however at least less matter to determ in what state compl may formerly have been, than to ascert nature at pres.

And if compare state of sympt when patient come under our care with hist of Paralys. will appear that many stricking marks of the affect.

With regard to pains may be obs. that in incip state of Paralys. these by no means uncommon.

And that too even when no complic of affect with Rheumat.

But besides pains here parts affect also, with evid numbness.

Are accord to hist of case in that state termd a sleeping of parts.

A condit which although may occurr in transit manner from sligh causes, partic from compress of nerves yet when taking place in perman way always indic tenden to Paralysis.

But besides these had also [sensat] of matters creeping in parts.

This sympt among partic authors has obt name of formecation

From supposed analogy to sensat which would be given by applic of Ants to the part.

And when taken along with [numb.] ment above, can have no hesit. in consid parts diseased as being affected with stupor formicaris of pract authors.

A condit which may always be justly consid as first stage of Paral.

To these sympt however as indic this affect still anoth to be added.

Situat viz of affect.

Here will observe entirely confind to one side

Affect limited to left side of head neck & shoulder.

And while left arm in diseased state, right entirely without compl.

This limit indeed, to one side, a circum sometimes occurring in Rheumat.

These however must be allowd a very rare case

While on other hand nothing more common in Paralysis.

In so much that this modif of disease disting by partic name Haemip.

And here may obs. that among nosol writers numer gener formed of Paralys. Parapleg, Hemipl. [Parapl]

In all these however nature essen the same.

And May with just stile the whole paralyt. affect.

And from view now given reason to concl. that all sympt enum to be consid as of this kind without any compl. with Rheum.

At the same time, that such complic in some degree subsist, is at least no improb. suppos.

While however reason for susp such complic, so also some presum that not only one here occurring.

For besides local sympt of left side already ment. others also here occurring

Is affected also with impaird appet sense of [graval] pain at scorb. [cordin] & thirst.

Would however at same time seem that stomach ill suited for indulg of this appetite.

For on taking drink soon again rejected by vomiting.

Besides these sympt anoth also no less distress.

Affect viz of Respirat.

This we are told long attended with pecul sense of anxiety.

These diff sympt. may indeed by also connected with paralys.

And at least no [absurd] in suppos that arise from paralyt affect extend both to stom & diaphr

At same time am here inclind rather to entert diff opin.

For such sympt in Paralysis are at least extrem rare

And in hemipl in partic although both infer & super extrem of one side totally dep both of sense & mot. yet vital & anim funct freq cont. unimpaired.

This then some diff to suppos of connect.

But still greater from attending to origin of these compl.

For while paralyt affect began only about a month ago & from obv expos to cold has been affectd with stom compl. partic thirst & vomiting for space of three month

While affect of breathing had begun even 12 months before.

If connected then with affect of side would appear that tend. to Paralysis of much older date than cause to which attrib.

But much more probab that no connexion.

And That affection to which subj in diff respects of compl. nature.

And that as such to be viewd both in progn & pract.

At time however when came undr our care affect of left side most consid & most distress compl.

Viewing it as are disp to do in light of paralyt affect, cannot speak with confid of termin.

Unless indeed where attack sudden & to great degree with affect of ment, as well as [corpor] funct, seld mortal.

But even in slightest cases, freq a very obstin affect.

And every day inst of its prov. incurab. by any means.

Should not therefore be surp if yet found to baffle every effort.

Upon whole however circum sympt of case but slight, & of short durat.

And what still more favour since commen rather mitig of [sym]

Hence then with regard to this part of affect hopes of fav termin

In stomach compl also and affect of breathing nothing at pres at least of alarm appear

But from durat which these have already had reason to infer obstin

And the rather as in pract paralyt affect will be first & princip obj of attent.

At least if no new occur in case shall only think of turn attent to these after have seen effects of trials with view to formr.

And here in gener prin, upon which cure to be cond often very great diff.

In all paralyt affect indeed, in gener allowed that nerv power at the part is dimin.

And that therefore cure to be expectd by restor of due influ

While however morbid condit here to be comb. ultim from variety of diff morbid affect remote causes these prod effects in diff ways

But partic either as affect nerv power itself or channells by which conv.

Hence then restorat of Nerv energ. at any part prin to be exp on one of two prin.

Eithr viz by remov of condit of Nerv power unfav to ready mot.

Or by remov of causes giving obt of channells for conveyance.

When cause of compress exists & can be effect removed most cert case.

But rarely however that can [illegible] this to be case.

And when highly probab. still but rarely of such nature that removal can be effected.

Even when this the case howev still something to be exp by alter in state of Nerv power

And upon whole perhaps greater numb of inst where if not cure at least allev on this gener princip.

Even where this the case however still something to be expected by alter in state of nervous power in part.

In case now before us no circum giving presumpt of compress.

Hence endeav hitherto empl. entirely directed with a view to restorat of due nerv influ by affect Nerv power itself.

And this may be looked for either by means affect nerv power over syst in gener. or those more immed acting on those parts of brain from whence nerves leading to affected [must] have origin.

For many circum rend it at least probab. that brain not merly to be consid as one, but rather collect of secret organs.

And although cert causes affect whole, yet that state of separat at partic parts may be consid [altered] indep of others.

Is on this idea that can I think can best expl action both of gener & topic remed in cases of Paralysis.

And to both in inst before us had here recourse.

As a topic applic directed [friction] of parts with Volat. Linim.

Need not obs that effic of this artic which formd of Camp. oil united to Vol. Alkali, effic entirely depends on Camph & Vol. Spt.

Oil serves no other purp than to give form, & at same time modif to other artic

For while without some ment. Camph cannot be conven. applied, serves also to restr action of Vol Alkali, & also to prolong effect by [prev] escape.

As thus modif while influ applied by itself, although transit might excite pain & vesic has in gener nothing more than effect of [illegible]

While such however conseq of action of blood vessels of part, makes also powerful impress on Nerves.

And even in parts affected with para Paralysis, if power of nerves in commun impress, not entirely destr, impress thus made immed commun to the part of brain from whence have origin.

And from this impress reason to hope that alterat in state of nerv power proceeding from that [part] of brain may be prod.

Is I appreh on this ground that to expl advant. which have often seen result from this applic in simil cases.

And with view to these had here recourse to it.

While this empl. however, as topic remedy, had at same time recourse to one of more gener nature.

Use viz of Camph taken intern with a view to affects from action on nerves of stomach.

Of this subst. had lately occas to deliv sentim in remarks on M. M.

Then obs. that whethr with greater just to be viewd as Resin, Gum or essent oil, yet affect of Nerv influ from action on stom both consid & pecul.

And as affect whole, most, unless some morbid state occurs suff to [prev] it, have influ also on nerv power in paralyt members.

Is thus at least that would expl. good effects which in inst of paralys have I think oftenr than once seen result from use.

Am very far indeed from [illegible] it as a remedy which will succeed in every or even in most cases.

Yet some inst in which think have seen evid good conseq result from use.

From these then here led to have use

And as most conven form for introd to any consid extent given in pills

In this way taken to extent of gr X in course of day.

And while prod of no inconv. appears, by last report that both pain of arm mitig & sensib more perfect.

Is I think more probab. that this proceeded from med used than from any other accid circum.

And gives at least encouragem for contin of course.

If however after prop trial not found prod of desired effect, & if pat contin attend, others meas may be employd.

And still hopes from Merc. Elect. Warm bath, Vap. bath &e.

Or might with some prospect of success have recourse to Arnica or to cold bathing

But at same time if Camphor fails shall have less expect from any of them.

And indeed somwhat to be doubted whether attend of patient will be such as to give opport of fair trial, even of Camphor.

Still less if Paralys affect shall prove obstin have we prospect of doing any thing with view to other compl

For is at least wish to pay no attent to these till paralys. removd

And meas then to be taken must be accomod to condit in which shall remain

If however from encrease of affect in pres form any meas shall seem necess. may prob with view to [resp]. employ blister, with view to vomit some veget bitter, & aromat comb. with opium.

But in this also cond must be regul by circum.