DEP/DUA/1/31/36 (Transcript version)

Dugald McFeee

(1782-1783)

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Dugald McFee

Case of this pat. not now for first time subj either of pract or lect. here.

Was formerly a consid time under our care at the Disp. for same disease to which now subject.

For now as well as formerly can be no doubt that affect to which he is subj is Epilep.

Then indeed more distinct markd as such than at pres.

For at that time more freq app. under form of severe & regul fits.

And not only attended with convuls. of legs & arms, but also with total abolit of sense, foaming at mouth & every other mark consid as charact. Epilep.

At pres. do not app. in precisely same form.

Yet can be no doubt in consid him as still subj to same disease.

Fits indeed to which now subjectd in general not attended with convuls.

And although evid affect of senses yet abolit not such, as to make him fall to ground, or to prev. [volun] exert. for remov.

And accord. this in general affected by his rising up & walking about for a little.

There however with epilep. patien to be consid as threat of [illegible] fit.

And are even more immed [forerunr] of it in idiopath epilep than the aura epilep is in many cases of the sympt.

Accord. these often connected with prop & formal fits which sometimes follow sometimes not.

Thus when pres. pat. before under our care oftener than [once] subj to both in same [day]

Can then be no doubt that now these attacks of same kind as formerly.

And indeed even although never subj to any other fits than descr. in hist of case as at pres [inserted] into Regist should still have viewd him as an epilep pat.

When formerly under our care, from nature of pat. disease, from long contin, from early period at which occurred, & from cause by which induced led to give unfav. progn.

Still however nothing from which could be led to concl. that absol. incurab.

Hence therfore consid it as at that time afford opp. for trial of diff med, & meriting such trial.

Event however verified sentim of affect.

For after patient had been for long time under care & after a variety of med had had been tried, found that all endeav to remove affect in vain.

Reckoned it therefore most advis at that time to interrupt med even with view to future trial.

For has unquest. been found that remed failing in Epilep at one time have succeeded at anoth.

And at that time the rather led to interrupt as patient had opp. of spending some time in the country.

Well known however, that by change of situat, mode of life, & comp. disease has sometimes disap. even where no remed. employd.

Here however was not with pres. patient prod of so happy an effect.

For at the end of twelve months has again returned soliciting assist nearly in same state as when dismss.

In this situat expect. of cure could not now be reasonab. greater than formerly.

Opin. therfore is that shall again be under necess of dismiss patient without any matterial benef.

At the same time after interv of a year, not certain at least that by same remed formerly empl. cure may not now be accompl.

Besides this in pres. case wishd also to have opport. of trying other

Partic the Pil. Picea of which have already spoken, in treating of other epilep. patients.

On these acct. then selected this case as again, subj of pract & [remarks] for Col. Casuale.

Here with regard to cause imm excit fits are totally in the dark.

No partic circum such for example as worms or like from which any reason to conject that here immed excited.

Hence then nothing at pres. at leas occurs to be done with view of remov excit cause.

And as far as cure can at pres be affected, is I think to be done by remv of that state of syst. without which this cause although remains & cont to act could have no effect.

Is from operat on this prin that am inclind to think sev of remed empl in Epilep attended with that benef obs. to result from them.

Partic. Peruv Bark. Cold bathing Cup. Ammon. Calx of Zinc and like.

Whethr on same prin. to acct for benef. said to be derivd from Tar when empl. under form of Tar water will not pretend to say.

But if in any case has realy been prod of the effects attrib to it am inclind to think that in this way

Must however obs. that of these effects am extremely doubtful.

At least have now tried it in sever. cases & in none of these has any circum app. affording any corrob. of these assert.

Must howevr at same time obs. that cannot say these more benef. by other remed.

Hence from author on which was recom to me still look upon it as being a remed deserv. further [trial]

With a view to such was you will observe the first remedy empl. with pres. case.

His case however it now app. must be added to numb of those in which no benef from it.

For after trial for upwards of month affect remaining remaining in same state as when pat came under our care thought it time to make other trials

With that view had recourse you will obs. to Vitriol Alb.

This artic need hardly obs. consist of Zinc united to vitriol acid.

In this state unquest forms a subs. essent. diff from either in separ. state.

At same time little doubt that derives prop. from both.

Is as cont. latter that operates as a powerful astring.

While again to former must I imag attrib powers of oper. as an emet, simil to those of saline prep. of Antim, Coppr & sev other metals.

Here you will obs. had recourse to it as a prepar of Zinc.

Of use of this metal in form of calx as empl. in Epilep & Hyster cases have already oftener than once has occas to state sentim.

If however thus useful in state of calx may expect no less from it in saline state.

For in former its becoming [active] in the syst. must in some degree depend on state of alim canal itself.

Like other metal calces being insolub in a pure watery menst. may pass through alim canal [withou] becoming in any degree active.

And accord with these is very remark that effects of same dose from diff in state of stom very remark. much varied

While again in saline state, readily solub. operat very unif.

From these circum then reason to think that by exhib Zinc in saline state should obt a med in its operat more unif & active than that of Calx.

And accord [prep] & tried by diff [pract].

In reasoning however a priori should not I think concl. that always better fitted.

For in employm of this med, object is not to obt. stim but tonic effects.

Former however unquest much more readily induced by metal in saline state than in that of Calx.

And thus even with regard to pres med, well known that even from small doses vomiting freq. arises.

When this however takes place, obj. in view as counteract epilep, must be entirely frustrat.

This however an effect much more rarely to be appreh from Calx

While again from more grad & slow solut longer contin action on that sensib organ the stom.

In these respects then Calx perhap super to saline form.

Which however in reality to be pref. not to be determ by reasoning but by exper & obs.

And cannot here pretend to say that extent of my own pract suff. to warrant any conclus.

Have however used both in many cases.

And as far as my obs. goes have discov. nothing which should lead me to give pref to White Vitriol over Calx.

The latter I have always found a conven, as safe & in many cases a useful artic.

And must own can hardly say so much with resp. to former partic with regard to conven.

If this fail have next thoughts of trial of Peruv Bark with Valer.

And if app. attended with some success may conj the two.

In hopes that by the one [threatn] may be anticip by the other tenden to them prevented.

In pres case see nothing in circum which can lead us to entert much expect either from electric or Mercury.

Yet if other remed fail without any hazard to patient may have recourse to prud use of either.

More expect may be entert from cold bathing.

But bathing in water of any great depth with epilep patients always hazard.

Hence then could only venture to recomm shower bath.

Hence then in general preferr calx at least for first trial.

Here however had formerly been used to very consid extent.

Wishd now therfore to see what could be derived from giving it in this other form.

Now however after substit to Pil. Picea pat. has been kept on use for very consid time

But still without any matter [advn].

Hence then without persist farther in use have now thoughts of other trials.

And have some intent of here making trial of a remed, which am at pres using with some other epilep at least with app advant.

Use vizr of Mixt mixt of Vitriol aether & liquid Laud.

By exhib twice or oftener in course of day threatnings of access may be [antici]

And from this, while some benef to be expected nothing I imag to be dreaded.

If therefore patient shall contin attend so long as to give trial in success. to diff pract. recomm. may advise this also.

But if all unsuccess. little I appr will remain for us but to suggest anoth remiss from use of med.

Still however would not consider case as altogeth desper.

For certain that with years even without use of any remedy this disease has sometime contrary to all expect spont. disapp.