DEP/DUA/1/31/10 (Transcript version)

James Hamilton

(1782-1783)

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James Hamilton.

Disease of this patient of very distress. nature.

And what a still more disagreeable consid little hopes of speedy termin.

On other hand since came under our care notwith diff pract. rather aggrav.  than dimin.

Is however entirely a local affect. being almost solely confind to left thigh & haunch.

But with regard to nature of this affect or name to be given it some doubt.

From situat, course & natur of pain as well as from aggrav. during night, presum that of Rheum. kind.

And consid Ischias as merly a modif of Rheum to disting it from more gener. affect might give it that name.

But to this opin cause to which affect traced may be consid as some object.

Traced to accid blow from fall

And that too giving injury as far at least as can inferr from his own descript. in such situat that Sciat nerve may have suff. from it.

Is indeed true that cert. injur done to nerves as cutting & even [illegible] often rend them totally insensib to [every] impress on parts below.

But on other hand sometimes followd by such affect of [coats] as to give even very excrut. pain.

And that too even when attended in other respects with some paraly sympt.

Is to affect of this that Dr C in his syst. has given name of Arthropuosis a term not empl. any other nosol.

And which he has been led to employ from circum of the affect often termin in state of purul.

For from this origin reason to beleive that the Psoas abscess often arises.

But although this perhaps most freq. tenden, yet can be little doubt than in other cases termin in paralyt state.

And indeed an affect. referrd to head of Ischias as derv origin from such a cause introd into many pract syst.

Accord among other species of that affect. Mr Sauv. disting one by title of Ischias a subluxatione.

These nerves as well as other [sensit] parts supp. to be injured by what may be calld partial luxation.

But this species of Ischias [canno] with prop be reckond affect of Rheum kind.

While again to Dr Cullen term of Arthropuos. is strong obj in pres. case that termin in pus will not prob. take place

But from what has been said of name will form some idea of conj. as to nature of this affect.

Look upon pains as having [proceed] from injury & affect of nerve in [conseq] of accid blow.

And consider this affection as now degener. into paralyt. state.

From this view opin of termin of disease cannot be fav.

For perhaps no part of syst in which when local affect takes place have it less in power to remove them than in nerves.

To be farther added that affection has now subsisted for consid length of time

During that period many remed tried in vain.

And as far as we have had opp. of obs. has even been encreas. in viol.

In so much that from diffic of walking almost [incapacit] from attendance here.

And from this circum indeed have been obliged to desert that mode of cure from which I own expected more than from any other.

From all these circum then taken togeth. must own that hopes of benef. this patient very faint.

And have no expect. that will leave us in better situat than when came under our care.

At same time besides pract already tried still some other modes of cure which may be used at least with some prosp. of success.

Before patient came under our care among other pract. had employd frict with Camph Spt of Wine.

And although not sensib of any partic advant from it, yet thought it worth while to cont. it.

For on suppos of local affect, both from frict & penet. nature of Spt [migh] have expected some good conseq.

With this however directed use of a stimul in its nature much more penet. viz. Electric.

Elect. fluid acts not merely on superf. parts but even pervades in its active state the subst of the body.

Of this can be no doubt, from perfor even with holes, many subst through which cannot find ready pass.

Hence then by sparks drawn from paind part expected consid influ on diseased nerve.

But this mode of cure had never in pres case a fair trial.

For patient from pains & diff of walking often unable to come to the wheel.

And when did come, from unfav state of weath. was not unfreq. disap.

In this situat, little could be expected from the electric.

Although therefore a mode of cure in which I own as much confid as any other thought it advis at least to delay till more fav. opport.

In this situat have now had recourse to anoth remed. the activ of which unquest very great.

I mean Camphor.

That Camph a very powerful effect on Nerv energy no one will deny.

And whatever may be mode of operat have I think in some paralyt cases [seen] from it very consid effect

On this course has now contin for space of some weeks.

But must own without deriving from it any consid advant.

This howevr not yet suffic to led us to desist use.

For from long contin only that much benef. to be expected.

Is therefore intent if patient able to attend us to contin for some time longer.

And if this shall fail have two other trials in view.

The Arnica Montana & Mercury.

If either successful shall I own be inclind to attrib much to the power of the med.

At same time reckon it more prob that disease in state which will resist every mode of cure we can empl.