DEP/DUA/1/30/26 (Transcript version)

Kath Gibson

(1782-1783)

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Kath Gibson.

This patient in no long time [illegible] from attendance.

And neither in history of case nor progress of cure any thing so pecul as to claim much attent.

Her affect when came under care consisted entirely in pain of back & lumbar region.

This was from begining disp to view as being of Rheum kind.

To this concl. prin led from obj which occurd to any other suppos.

Could not be lookd upon as effect of any sprain, otherwise would have been sensib of cause induc it.

Could not consid it as depend on calcul since vomiting, affect of [illegible] & all other sympt of calcul. here wanting

While again from occupat of [carrying] water very much expos. to cause of Rheum. Cold, conj with Wet.

And well known that region of loins a freq. seat of Rheum.

In so much that to this modif a partic name has been given that viz of Lumbago.

From these consid then pron. diseas to be Rheum.

Here however must obs. that besides diff in seat affect passing under that denomin, varied also in kind.

And distinct between diff kinds of Rheum of great import in treatment.

Here however cannot prop. to enter into these

May only obs. that in pract lect. shall endeav. to point out distinct into four diff stages of Inflam. [Irritab] Atonia & Paralysis.

And to mark sympt by which these may be disting from each other.

Here had no doubt in consid us as having example of Rheum affect in state of Irritab.

This suffic charact. by absence of fever & by aggrav of pain from heat of bed

That this idea well founded now I think fully conf. by progr & cure of [diseas]

For under treatm directed was very soon dismissd free from affect.

From this then any observat on Progn. may now be consid as entirely superceded.

Here however may remark that if had been to give prognos when first came under our care would have been less favour, than has turned out to be the case.

Rheum affect of this kind often very obstin.

And although completely removed for time very apt to return again

Did not therefore I own expect that patient would have been so soon dismss. from attendance.

How far speedy recov. here the effect of med employd can hardly not posit. [ven] to say.

From short durat of affect reason to presume that in nature but slight.

At same time little doubt that recov. to be attrib in consid degree to pract here employd.

Especially when consid benef. [whch] had lately occas. to see derived from same pract in case of J. Anderson.

There though seat of affect very diff, yet sympt. very much same pain imped motion.

In pres case as in that, cure trusted to use of Opium.

And here employd both extern & internally.

Of all remed with which we are yet acquainted no one influ of which in allaying pain can be comp. to opium.

And as prod this effect is unden. most powerful sedat of Mat. Med.

Where pain effect of any powerful chemic or mechan impress. such for ex as [distenss] irrit or like from [acid] fluids, encreased action of vessels or like, has yet the effect of prod such change on sent prin that influ of this impress less consid.

And in this manner pain even from these causes dimin or susp.

But has still more effect influ where pain effect of pecul. sensib.

For such the well known influ of opium on nerv energy, that for time at least compl. removes caus of pain.

Nay well known that by applic to cert. degree to nerve is rend incap of commun any impress. whatever.

And that by cert. degree of action on syst in gener. the sentient princip becomes totally insensib to every impress.

In pres inst therfore more to be expected from it, than if cause of pain had been state of active inflam.

For these susp. uneasy sensat, but without remov. cause.

Here operates again as induc a cond. oppos to that on which pain dep.

Is therefore in this state of Rheum affect. much more than any other that opium is indic

But in pres case partic indic by want of sleep during night.

For the counteract watchfulness [illegible] with those obliged to lab. during day always a matter of great conseq in cure of their diseases.

And In prod this effect opium in cert. doses on all hands allowed to have very remark. influ.

And that too whatever may be cause from which watchful. arises.

At least this the case, unless both very pecul & very powerful.

Here then expected that by extern applic of opium to cutan nerves of affected part irritab. state would for time at least be removed.

While by action of opium again on stomach uneasy impress comm from the part would have less effect.

In these expectat would app. we were not disappointed.

For from time that began these med pain very much dimin.

Progr. to recov. indeed was not unif or invariable.

For at one period after consid mitig pains again aggrav.

Probab. effect of some accid expos to cold.

At end of second week however so much easier & partic slept so well that reckond it unnecss to contin any longer the opium pill.

Still however thought, that when external applic of anod balsam omitted some tend to return of pain

Ordered therefore contin for anoth week

During that period remaind entirely free from any return of affect & in other respects in good health.

Hence then consid any farther pract as unnecss.

And accord has since continued to exert usual employm without any inconven.