DEP/DUA/1/31/14 (Transcript version)

Jean Stuart

(1782-1783)

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Jean Stuart.

This case as well as former but short time under our care.

And although does not app. from our register yet have the satisf. to say that has also termin fav.

But here must be allowed that more doubt in attrib recov. to med empl.

This however will more fully app. when speak of pract.

With regard to nature of affect [altho] disease slight yet evid lab. under complic.

Was manif subj to a catarrhal affect as indic by cough [hoarseness] & expectorat.

But at same time also lab. under an affect of paralyt kind in both superior extrem.

This again indic by dimin of [natural] heat by loss of feeling in hands & fingers.

But most of all by impaird strength of arms.

In so much that became incap. of exercisei usual domest empl.

And espec. we are told found herself unab. to wash.

An empl. indeed requiring as great exert of strength as any in which females usually engaged.

To this to be added as farther indic of disease, that was of opin arms were somewhat emac.

A circum which when it takes place always to be consid as a very unfav sympt in paralyt affec.

Of this circum indeed as not acq. with former app of pat. could not for ourselves form any judgem

But may venture to say that if did take place was but very inconsid.

Whether however took place or not from other sympt ment. paralyt tend suff. charact.

And here markd not merely in dim either of sense or of motion but of both.

Paralyt as well as catarrh affect here occurring but of recent date.

And both one & other attrib to same cause viz expos to cold.

That cold a cause capab of inducing either no one I app. can deny

This so freq. subj of delay obs. that with any attent obs. cannot be matter of doubt.

Cold however as inducing these affect probab. operates in diff. way.

And while catarrhal affect proceeds from change in circulat paralyt again to be attrib to change in nerv. power.

Influ of cold in affect state of circul is very manif.

Can be no doubt that as applied to the surface has effect of prod [const] of superfic vessels.

And while from extern heat size of these augm. from cold as much dimin.

Effect therfore of applic must be determ to intern parts

And accord to degree, to which takes place, state of intern. parts & other partic a very freq. cause of disease.

Hence in diff inst find it giving rise to Pleurit. Entert. Cynanche &e.

But of all affect none more freq from it, than Diarrh or Catarrh.

And from pecul. of habit probab. from state of intest canal or lungs with some unif prod former with others latter.

Of the two affect which here took place catarrh the most comm.

In so much that in vulgar lang. founded on daily obs. Catarrh has obt. the name of Cold.

But while these effects from [illegible] distrib of blood, can be no doubt that has also very consid effects on Nerv. powr

This perhaps more manif. with some other animals, than with human species.

For little doubt that by change in state of Nerv. power, the winter torp. obs. in some of them is prod.

There state of nerv power such that totally inadeq. to funct either of sense or motion.

Not only does every volunt effort cease but even strong impress. incap either of [rousing] animal or of excit even slightest sensat.

That this however the effect of cold not only proved from being induced at cert. seasons, but from being removd by artif as well as natural heat.

While therefore with some anim capab. of doing so much, may concl. that even with human spec. capab of doing something.

Although well known that human syst. better fitted to variety both in clim & food than most others.

Accord. from aid which we afford to nature by means of art, can bear without inconven, coldest temperat. in various clim in [illegible].

Yet no doubt that both from want of due precautt & state of syst at the time worst effects in this way often arise.

Accord no accur observer who has not enum cold among causes of Paralysis.

Our patient however exposed to cold under circum which could hardly escape observat.

Was engaged in harvest work in cold air during very cold season

And from nature of this work her hands & arms in partic necess exp. for very long time.

When therfore consider that was a cause which realy took place & that a cause adeq. to effect can have little doubt in consid pat conj. as well founded.

Hence then notwith diff. nature of two affect, may be consid here as in some degree connected.

But must own that my opin as to termin was very diff.

Catarrhal affect still in what migh be calld recent & even acute state

Sympt. very far from being severe.

Had marks even from state of expect of being somewhat on the decline

Had therefore reason to hope that even without aid of med. would soon of itself have natural & fav term.

This however I own I did not expec with regard to Paralysis

For is an affect which when does take place is in most inst. at least of consid obstin.

And after attended with evid [encreas] in greater part of cases incurab.

Of this sympt however althoug patient herself susp. of it, have expressd doubts.

And must be allowed that in case many circum were fav.

Was partic so that had arisen from an obv. extern cause.

That not connected with any local morbid affect either at origin or during course of nerves

But that proceeded totally from action on extrem.

When to these circum added that affect but of recent date had reason to hope that in no long time would have fav. termin.

And especially when patient guardd against farther occas cause & prop. treatm empl. to aid operat of nature.

Here treatm you will obs. begun by direct for pat. an Emet & frict of affected parts with Camp. Oil

First of these I need hardly obs. intended against Catarrh last again. paralyt. affect.

To operat of Emet as expect are I think to referr relief of cough obt. after its use

And by time of succeeding report was so easy that no farther meas. seemd requis.

From frict however little change induced in paralyt affect, which still cont. nearly in same state as formerly

Expected however that by contin due mobilit of nerv. power might still be restored.

But to aid this had recourse also to Camph internally.

From which, in some cases, & these too very obstin ones, am much mistaken, if have not seen very excell effects.

Here the rather directed it that patient might not consider us as inact.

Hoped therfore that might both aid cure & engage her to more regul. attend.

Under this course was intent to contin for some time

And hoped that by due persev. conj with operat of syst. might be means of accompl. recov

Went on with it for space of forthnight.

And during that time affect seemd evid to be upon decline.

Since that however about begin of Janr. have seen nothing farther of her at this place

And although I took down direct to her abode yet was not for a consid time able to find it.

When I did find it she was not at home.

Learnd however from husbands mother, that she was at that time perfectly free from affect.

As have not however seen herself have introd no report into register with respect to it.

At same time can have now little doubt that desertion has proceeded from having no farther occas for assist.

And am inclind to think that while cure prin to be attrib to oper. of nature was at least somewhat aided by meas. empl.

Partic by friction with Camph. Oil.

Prob. however not less from frict itself than from the impregn.

Although no doubt that this