DEP/DUA/1/31/19 (Transcript version)

James McAlister

1782

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Decr 21^st. 1782. XXIII

James McAlister at 18 complains of loss of motion in the left arm which he cannot raise to his head excepting by the assistance of the other hand

On any sudden attempt to move it he feels a pain in the Os Humeri & especially at both its articulations. The heat is always below the natural standard. The motion of the forearm & fingers also of the same side continue [unimpaird].

He is trobled with fits in which he falls down suddenly without any previous warning. In these his whole body is convulsed, he bites his tongue & a froth comes from his mouth sometimes tinged with blood. There continuance is various, sometimes they terminate in a quarter of an hour sometimes they last half an hour or more. They are preceded by no aura during their continuance he is perfectly insensible & speechless. He does not regain the power of utterance for some time after the convulsions cease, & he has no memory of what passes but does not seem fatuitous.

Every morning from the time he awakes, till 10.a.m. he is troubled with headach. His neck & body are distorted. There is a prominence of the right shoulder & another of the left hypochondrium.

He is sometimes very thirsty tongue & appetite natural, belly very loose. He was first affected with the fits while getting his first teeth, & since that period he has been generally trobled with them three or four times in the month of April. But he has had only one fit in three years till some time in Febr last, when, while he was sitting with a book in his hand, he let fall the book, & immediately fell down himself.

The fit was very severe & continued for more than half an hour but he did not recover his speech for six hours afterwards. From this time his fits have been frequent & immediately after one of them, about three months ago, he perceivd a loss of motion in his arm with a sense of soreness. He had generally a fit once a week, through the summer, but they have lately been not above once in three weeks.

They are sometimes induced by anger, grief, or fear, to which he is too apt to give way. His paralytic symptoms seem to be encreasing, & prevent him from work. He had a blow on the crown of his head, about six years ago. He has never taken any medicines, but when he was in infant, his mother has put his feet in warm water during the convulsive paroxisms, which she thinks both mitigated the paroxisms, & shortned their duration

This has not been tried lately.