DEP/DUA/1/34/44 (Transcript version)

James Duncan

(1783-1784)

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James Duncan. April. 24^th

To disease of this patient am very much at loss what name to be affixd.

And not less so with regard to nature.

While must also add that have never before in my own pract met with any in circum simil.

Once indeed had occas to treat a pat. where compl occurd in some respects simil to those here describd.

Was in a patient who had for long time been subj to Paraly affect of both legs.

With this was also affected with almost intolerab. sense of heat in soles of both feet.

And that sensat as in case of pres patient returned very much at regul periods.

These from trials made by the Themom. was found, that while burning sensat insuffer yet no actual encr. of heat.

And when was farther consid that occurd in parts subj to Paralysis, could be little doubt that was mere nerv. feeling.

And that in nature bore some analog. to those severe pains not unfreq. [referrd] to paralyt. parts [when] the parts themselves totally insens.

And which indeed with some probab. supposed to proceed, not so much from any affect of Nerv at extrem or as at course or even at origin.

For in both cases sensat still referrd to extrem.

And indeed the same often [exam] in cases of amput. where pain felt very severely as exist in foot or toe though whole limb removed many years before.

From all these consid then was inclind to look upon period feeling of morb. heat in case formerly alluded to as being a Nerv. affect.

And as being even in some degree connected with the Paralysis.

Here besides simil in other parts the period sensat. of heat, an evid resemb. also in anoth very stricking partic.

That is in paralyt. tendency.

For although pres. patient not subj, to any loss of powr in limbs or in any of those parts in which distressd with heat & pain, yet has a very consid paralyt affect.

Has now for some years been entirely deprived of sight from an Amaurosis.

Hence then, espec when consider short course of opt. nerves, reason to presume that other also affected at origin

And is in this manner that would expl. those pecul. sensat of heat & pain to which this pat subj.

But whether this expl. just or not can be little doubt that these to be consid as affect of Nerv. kind.

This may I think be with confid inferd from circum [seat] from evid want of any local affect & from period returns.

From this view progn. rather unfav than otherwise.

At least with respect to obstin

For although may not be attended with danger. conseq. yet reason to fear that will not be suddenly [rem].

And would not even be surp. if found to usher in more consid paralyt. affect.

Had this pat. been in such situat as enab. to attend regul. [here] should have thought of trying electr.

But his blindness & living at Leith made that if not impossib. or at least diffic

On idea therfore of its being a nervous feeling directed use of Zinc

And in some degree to counteract sensat of heat ordered as a refrig the Cream of Tart.

Since he began this med. has sent me word that sympt [somew] mitig

And as long as this contin to be case shall think of persist in use.

Yet must own without expect of deriving from it much benef.

At same time, notwith unfav. opin given, even on idea thrown out as to nature of affect may have sudden recov.

Or in same mannr as has grad come on may suffer grad decline.

And may concl. with obs that termin of affect of Nerv. kind, more [illegible] & unexp. than most [other]