DEP/DUA/1/32/26 (Transcript version)

Richard Tooky

(1783)

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Rich. Tooky.

Respect. disease to which this patient subj. no room for doubt.

At least can have no hesit in pron. prim affect to which he is subj to be an ex. of Paralys.

And in state of disease in pres. case no very remark singul.

Affect you will obs. conf. to one side.

But this much more freq. than to have it gener. extended over whole body.

Whether one or other side affected has name of Hemipleg.

And in this state of disease often compl. extended over one side, in so much that even one half of tongue will be affected.

But as with pres patient more remarkab. in partic part.

And most freq as in this case, partic obv in leg & arm.

In greater part of inst when Hem occurs both sense & motion affected

Sometimes however even entire loss of one without any affect of the other.

And here will obs. that is powr of motion which prin if not only affected.

Has not however proceded to greatest length.

And consists rather in dimin than total loss.

Would app however that not merely conf. to volunt. muscl.

For from state of pulse, reason to inferr, that action of vessels also affected.

With same celerity pulse obs. consid weaker than in right.

With this paralyt affect of left side anoth circum also conn.

Freq. attacks vizr of severe cramp

In this I think have an examp of truth of Aphor. Atonia gig. Spasm.

By this however would not be understood to mean that in every inst where atonia takes place [Spasm] a necess. conseq.

For truth of such an assert. no one I appreh. can contend.

But on other hand as little doubt that with loss of tone there freq. occurs unus. irritab. or dispos. to inordin action.

And of this have an evid examp. in case of pres. patient.

Consider cramps therefore if not as part of paralyt. affect at least as being depen on it.

But same obs. cannot be made with regard to anoth partic in pres case

Disch viz of blood from the anus to which freq. subj.

This can have no hesitat in consid as being a haemm. affect.

Not to mention other partic put beyond all doubt from their at first app. under form of extern excress. mariscae or haemorrh. tum.

With such app. it has not unfreq. been obs. remarked that even Paralys. has been obs. to altern.

And in some cases haemorrh. affect has given compl. & fav. termin to that disease.

Might at first therfore have been consid as a circum rather desirab. than otherwise.

But after having now contin for some months without any such effect can view it only in light of superv. disease.

And therfore as a circum leading to more unfav. progn. than should otherwise be disp. to pron.

But even indep. of this affect from circum of case itself, hopes here cannot be very flattering.

Affect occurs in a patient, app. at least to decline of life.

And accord to all app. farther advanced in constit than in years

Has already subsist for consid time for space even of sever years.

And during that time has been grad. encreas. in degree.

A circum giving susp. of much more obstin disease than if arrivd at height at once.

From these circum I own very suspic that will baffle utmost efforts for removal.

At the same time would be wrong to repres it in light of an incurab. Paralysis.

Though has contin for three years yet neither to be consid as having passd period of natural or artif cure.

For even after longer standing in both ways the affect has been removed.

And besides this cannot consid pres paralysis as of very worst kind.

For from acct of patient reason at least to supp that has derived origin from cold.

Hence may presume that depends rather on change in condit of Nerv power than [on] any comps on [illegible] either in course or at origin.

This then some encourag. at least to attempt treatment.

And accord to idea given of affect this to be accompl. by restor. nerv. energy in affected parts.

That energy of nerves depend on somewhat derivd from brain cannot be denied.

And in my opin most probab. consid as a secret. organ.

Or rather perhaps a collect of secret. organs.

Hence an affect of some nerves indep of condit of this power in others.

And hence by action on extrem of nerves that part of brain from whence have origin [acted] [upon] to higher degree than others.

Is in this manner that would acct for good effects of diff topic applic. frict with Nerv. ointm & the like in such cases.

But above all would thus expl. influ. of Elect. the remed to which had here recourse.

Elect. now long celebr. in paraly affect.

And although has [by] no [mean] answ. expect. even gener. entert of it, yet for my own part consid it as most active mode of cure.

Have indeed in my own pract tried it in many cases where after fullest & fairest trial ineffect.

Yet in others have found it success. where every other mode of cure has faild

And am even persuaded that when does fail as freq. happens from want of prop. [adin] or due persev. as from want of power in the remedy.

Hence more success. in hands of professed [electric]. than of others.

Must however be also admitted that while in some cases unsuccess. in others will give flatter hopes where yet in end disapp.

For by no means uncomm. that after cert. progr in cure disease becomes as it were stat.

[Hence] therefore in giving opin of affect even after first trial pract should always speak with great caut.

For this remark the circum of the case before us afford even some foundat.

For will obs. that from first trial accord to pat. own acct. obtaind very consid advant.

But these benefits neither [increased] nor even contin.

For since that affect again rather augm.

This however prob in part at least to be ascribd to want of due contin of Electric

For from state of weaker cond of machine & other circum since this pat came under care has been freq. interrupt.

Was prin on this acct. that with pres patient have had also [recr] to anoth remed use viz of Camph.

A remedy on which I own in cases of Paralys. am disp to place consid confid.

Here however cheif depen still is upon Elect.

And hope that late [causes] of interrupt will soon be affect [remove]

In that case is my intent to persist in Elect. till has had a full & fair trial.

And if this shall fail must own shall have still fainter hopes from Camph, [Ammon] Merc [Water] Bath or any other remed that can employ.