DEP/DUA/1/32/22 (Transcript version)

Margaret Sprots

(1783)

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Margt Sprots June 26^th

With regard to disease of this patient, must own that as to nam am somewhat at a loss.

But less ground I think for entert doubt as to nature.

Compl. consists you will obs. [entirl] in affect of left thigh & legs.

There however at some loss to determ whether should look for it among spasm or rheum affection.

For while markd by severe pain is also, not less so by inord. mot.

In former espec when consid temp. nature as well as accid by which pain aggrav & [relievd] as well as situat of affect, have strong evid of Rheum.

In latter involut agitat viz to which leg freq. subj. have all [leading] sympt at least of partial Chorea

And well known that such inord actions, though sometimes gener. or attacking diff parts in success. yet still more freq. conf. to partic part.

This affect however we are told at commen in a state somewhat diff from both these.

Began under form of severe cramp.

Which however from transit natur more under form corresp. to defin of Crampus than of Eclamps. of pract authors.

But however much resemb. to diff diseases am yet inclind to think that all these here origin from same morbid affect.

That are the conseq viz of pecu irritab. or dispos to inord motion in parts affected.

That mere irritab often the cause of pain no one I appreh. will deny.

And that partic so in many Rheum is I think from attent to [Pharma] put beyond all doubt.

Accord. in pract lect. where have opport of treating of affect at more length endeav to estab. four stages.

Those viz of Infl. Irrit. Aton. & Par.

And have no doubt that while due attent to progr of disease in ordin cases have evid of all these so that likewise require no [inconsi] variety in treatm.

But into this subj would be foreign to pres. busin. to enter.

Would only obs. that from irritat not merely pain resemb. those of Rheum., but that this morbid state, actual cause of pain, in many of most distinctly markd cases.

If however on this footing explan of pain, no less readily of inord. action or shaking through limb which takes place.

For in irritab. state by [slightes] stim cause action induced.

Thus in pres. inst seems freq. to have been effect of expos. to cold.

Nay to have arisen even from rest or rather from want of action.

That is, induced by most trifflin causes, such for ex as stim of circul. through the part, which however could have no effect while other actions take place.

Upon whole then from pecul. morbid irritab in muscles of leg & thigh affected was inclind to think that all phaenom in this case to be explaind.

On this idea opin as to termin could not be unfav.

Such affection although often ted yet seldom danger.

And here as both recent & slight hoped that in no long time might be compl. overcome

While on idea of morbid irritab progn proceeded so on same ground also you will obs. directed pract.

General intent which had in view were in first place to remove morb irritab.

But in second place, till this could be effected, to obv. conseq result. from it.

With view of answer. first of these intent had here recourse to Valer.

An artic respecting which it must be allowed very diff opin. entert.

By some highly extolld in all nerv. affect depend on uncom sensib.

And repres as a very effect remed against inordin motions result from thence even for Epilep. itself.

Others again look upon it as a very insignif remed.

And as of little avail in any case.

For my own part am far from entert so high an opin of it as some [pract]

At same time inclind to think that still less truth in sentim of those who hold it to be of no [avail]

Even when attend to pecul sensib qualit reason for pres. activ.

For has these to very consid degree.

Still more however may concl. activ from influ on other anim.

Effects on Cats in partic well known.

With them when in state even of app. best health very pecul. fondness for it.

And when eat to any extent induc such affect of nerv. syst. as may be consid to exhib marks of intox

In disease again led it as it were by natural inst.

And can be no doubt that often highly servicab. to them in those [illegible] affect to which so freq. subj.

On these however although in my opin good [grounds] for inferring med virtue put much less depend. than on exper. which have had of benef. result. from use of it.

Cannot indeed repres it as alw. or even gener. success. against those affect. for which most comm empl.

And indeed in many inst of Epilep, Hyster. & the like, every remd tried in vain.

Hence then from want of success. even in greater part of cases of these, no conclus to be drawn against it.

And even in some cases of these, as well as in many others, have myself had exper. of best effects from it.

Partic in inst of Nerv. headach.

On ground therefore of former exper here lookd for good conseq.

And as most effect form, of obt. these directed it in powder.

In some inst however not apt to sit very easily on stom.

Hence always prop. that should be begun at least in small doses.

And on this acct. at first directed it only to extent of a scruple, twice a day.

From use however even to this quantit only thought that she derived consid relief.

But during empl. a severe diarrh occurrd.

Will not pretend to say that this may not have been effect of the med.

But thought patient own supp. more prob. that was conseq viz of use of green vegetab. which had disagr. with her.

On this presumpt then did not lead us to discontin use of Valer.

But while directed contin had recourse also to use of anoth med

Employm viz of Pil Pacif or Pil. Theb. as are now more freq. calld.

Of these pills need hardly obs. that Opium may be consid as the active basis.

Besides opium indeed cont. also [other] artic.

But both soap & extr. of Liquor. intended merely to give form.

While Jamaica pepper meant solely as corrigen.

To be consid therefore merely as Opium Pill into which op. enters to quant of gr in every seven of mass.

From sedat. power of Opium imag might be attended with good conseq both as restr. looseness & allev. pain.

And in these affects were not disap.

For at succeeding report not only was looseness gone but pains also very much dimin

In short so little affected with any sympt. that wishd to discontin attend which from dist. of resid was rather inconv.

Wishd however that should attend us at least for some weeks longr.

And with omiss of Pil. Pacif directed contin of Valer.

Under this in hopes that may soon be entirely freed from affect.

And even some reason to think that may not again think it necess. to visit us.