DEP/DUA/1/29/16 (Transcript version)

Duncan McDonald

(1782)

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Duncan McDonald

Was our patient only for a very short time.

For not long after came under our care, are informd, that affect term. [fatal]

With regard to name of disease to which he was subj must own am very much at a loss.

But both from descript given us, as well as from what had opport. of [seeing] of it was inclind to look upon it as being a singul. affect.

Consisted of pecul kind of fits, to which in my own pract have not before met with any exactly simil.

To one of these was subj during course of attend at the Disp.

Much more easily rememb. [howv] than can admit of being describd.

Was evid an affect of the spasm kind consist of involunt & inordin action.

Was at that time without any affect of legs or arms.

But from motion of chest and adomen as well as gulping noise seemd in some degree to appr. to that inord. action taking place in singultus.

At same time however essent diff from hiccup, a convuls. motion com even with youngest infants.

Diff not more strongly markd in any partic than in Respirat.

For here in place of pecul & sudden sound in hiccup, respirat unif sonor. for some little time with a noise somewhat resemb. that which occurs in Croup of Inf.

And this again after contin for short space of time termin in total, cessat of respir.

Upon recov from this patient had again interval of perfect health

Unless indeed that const. encreased heat of skin indic some degree of fever.

But that this not very consid. app. from one want of dep & febrile anxiety which strong mark of that condit in inf. [state]

While same also indic by sucking freely as well as by regul of belly.

From these fits was seldom free for any great length of time.

But prin attackd him after taking food.

A circum which taken togeth with those already ment. gave indic of affect origin from alim canal.

Or at least of being excited by action there.

To these fits as have already obs. have never in former pract. met with any thing which had even near resemb.

At same time patient at such an age that incap of dissimil.

Here therefore no room for susp. that in any degree feignd.

And must own was much at a loss what conject should form as to nature.

But seemd to me from begining the most probab conject. that although app. diff from prop. epilep fits, yet were realy of that nature.

Epilep well known to be a common disease with infants.

Then excited by causes which totally incap of induc it in after life.

Well known also that in app. very much diversif.

And that what at first under other forms will afterwards assume state of most regul markd epilep.

This conject afterwards corrob. by future occur even in pres case

For afterwards informd that while fits contin freq. were attended also with convuls. motions of hands & arm

And perhaps still stronger argum in support of this suppos. furnishd by manner in which patient cut off.

For well known that epilep fits from whatever cause may arise, have not unfreq with infants in immed fatal terminat.

And whatever nature of fits might be, was at least from occurr of one of these that patient suddenly cut off.

An event which although some reason to dread occurr must own did not here suspect.

For although epilep [access] often prove fatal to inf. yet in most inst is only when they occurr take place with great sev.

This however, as far as could judge, either from what saw or heard did not seem to be case with pres patien

But must here obs. that from app. of one fit can never inferr [what] will be state of next.

And of this would appear from fatal termin, that had remark ex in pres. inst

In way of pract here from short time that patient under our care had opport of doing very little.

And this indeed in some degree also proceeded from uncert as to nature of affect.

Treatm however you will obs. proceed prin at least on idea already thrown out.

Here fits of so short durat. that a matter of much less conseq. to instig [them] during contin than to prev. return.

And was with view to prev that had here recourse to Calc. of Zinc.

A remedy for introd of which [among] regul pract. are indebted to Dr Gaub.

For partic acct of first cases in which he empl it, may referr you to paper in his Advers. where treats of it under title of Luna fixata Luddeman

A name given it by an Empyric in Holland who had some time before empl it as secrete nostrum

Cases related by Gaub. as well as many since pub by others, afford strong evid that in many nerv affect of hyster, convuls. & epilep. kind. has been prod of very consid advan

At same time would be very absurd to supp. that in every such case should prove infallib. cure.

These on diff occas. not only varied with respect to cause but many of them incurable by any means.

And accord as far as can judge from my own exper. although has often faild yet have in other cases seen manif benef. from use.

In that now under consid seemd [howev] to be prod of no good effect.

For after contin for space of week fits no less freq. than before.

And from superveening [convulsv] motions of hands, had marks even of encreas viol.

This however could have no diff of referring to progress of affect.

Prob. to encrease of excit cause whatever may have been.

Besides Zinc will obs. that empl. also another med. viz. Mist Oleos.

This cheifly intended to [counteract] partic sympt.

Pecul. affect viz of Respirat which took place.

This have already said [attend] with a noise somewhat resemb. Croup.

And seemd to me to be immed conseq of some spas. strict [about] head of larynx

In taking off such well known that impress arising from [applic] of oil [have] often remark effect.

Oily mixture therfore intended with view of allev this part of fit if should at any time be of long cont.

But equally ineff. in prod this effect as Zinc in prev returns.

And accord patient fell vict to fit not many hours after having been [brought] to [vis] [at] [this] [place]