DEP/DUA/1/27/19 (Transcript version)

Ann McDonald

(1781-1782)

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Ann McDonald.

With regard to disease of this patien when came under care not without doubt.

And although now dismissd free from affect. yet doubts not altog. remov

Here indeed sympt but few in number.

And only one partic distress. to patien such as is very freq. occur. viz Headach

Besides this indeed had also som stom compl.

But these at times only & with no great degree of viol.

And seemd altog unconn. with affect of head.

Hence then consid them while more urgent sympt subs. at least as being hardly obj of attent.

And was solely with view to headach that selected this patient as subj of lect & pract.

For with this also some other sympt as inab to move arm evid & immed [connect]

Headach while often occurs as as sympt of other affect so likewise often constit prop. idiopath disease.

At least this view taken of it by greatr part of nosol. & pract writers.

In syst of Dr Cullen indeed has no place.

In this however cannot help [think] that has errd as much as those [again] who have divided it into var. gener.

For in some syst. is foundat of various gener of Cephalal Cephalea Hemic &e.

In all which however no essent differ.

Or at least, less diff betwen these than between many spec. ref. to [each]

For under every one of these gener diff species compl.

And can be no doubt that among headachs occurr as idiopat disease, consid diff occurr take place

Viewing whole then as one genus whether empl term Cephal. Cephal or or any other still to be consid as of diff [spec]

For as arising from diff causes both nature & sympt consid varied

Into all these varieties here out of place to enter

May only observe that here prin doubt was whether arose from affect of teeth or was what may be calld mere nerv. headach.

That is Cephal depend on pecul sensib of integum.

Well known that from affect of teeth very obstin headach often prod.

And in case before us these manif in such state that might easily give rise to it.

For very much rotten.

To these circum anoth also to be added rend suppos. still more prob.

The circum viz of pain begining in teeth.

For from thence obs. that propag upwards & downwards with great viol.

But although from these reasons presumpt that immed excit cause depend upon tooth yet did not consid this as suff to acct for whole sympt.

For although pain in toothach freq. as severe as can be conceivd yet very gener app in diff state.

Hence therefore concl. modif. of affect which here took place to dep on pecul state of sensib. in that side of head here affected.

And when here consid that affect entirely conf to one side some might be disp to give it name of Hemicran.

This however I consid as an unnec distinct.

And viewing whole species as prop compreh under term of Cephalea would give to pres affect from concern which suppose disease of tooth to have as induc it, the name of Cephalea Odontalgica.

With regard to opin of termin as already brought to fav concl. need now say nothing.

May only remark that if conject as to influ of tooth in excit it well foundd reason to fear that pres relief may not be perman.

And that the rather as did not submit to pract which was strongly recom to her extract viz of rotten teeth.

But whether relief obt. perm or not have little doubt that to be attrib to med here directed for patient.

With regard to direct given in pract had here two obj in view.

Consid rotten teeth as cause by which severe parox of headach excited advised remov of these.

But imag that was only in conseq of pecul sensib of nerves that pain here occup whole side of head & with so much sever. reckond it necess to employ means for counteract this also.

To pract directed with first inten have already obs. that patient would not submit.

And this perhaps in some degree arose from relief exp from med prescr. with second view.

With that intent directed pills consist of combin of opium with Camph.

Both these artic well known to have very consid & powerful effect on nerv energy.

The first of all artic which have yet a place in Mat Med has most powerful effect in allev. pain.

And of course in strict & prop sense of term justly to be esteemd most powerful sedat in [use].

But although judge of compar sedat effects of diff artic from degree to which capab of allaying pain yet as have often had occas to observe no two sedat. the impress from which precis of same nature.

And by combin often a very diff impress prod from what results from either.

This partic the case with regard to sedat powers of Camph & Opium.

For while latter pure vegetab. gum, so as to be readily solub in water former all [pung] of veget essen oils in gener. by no means admit of ready union with water

In so much that very consid influ as excit sense of heat both in mouth & stomach.

Has however in many cases also very consid effect both in allaying pain & induc sleep.

And with view of answ. these ends, has not perhaps been found more benef in any affect, than in headach.

In such cases often also [correct] that confus of head which opium apt to induce.

Hence then from combin many advant may be expected.

Under use headach of pres pat soon very much relievd.

In so much that after contin for forthnight reckond farther empl. unnecess.

While employd however [condit] to which before subj was augm.

With view of obviating this employd Pil Aloet.

By these purpose effect [answd]

And as during course of week had no return of headach reckond farther attend unnecss.

Dismissd patient therefore in the belief that from Opium & Camph united had obt if not radic cure at least compl. tempor mitig of affect before very distress to her.