DEP/DUA/1/35/18 (Transcript version)

William Henderson

1784

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Wm Henderson. June 19 1784

In affection of this patient, have a disease in all probab. simple & uncomplic.

While at same time to certain extent at least nature not obscure.

For in dimin power of motion, have evid proof of paralyt tend.

And to this also, conj. at least with want of motion, for some length of time, would attrib stiffness.

While pain, though most freq. paralysis attended with loss of all sense, by no means a rare occurr in that affect.

Nor indeed can this seem [wonder] even where sense of [membr] is destr.

For well known that pain, wherever impress may be applied, [alw] referrd to extrem of nerves

Thus often supposed to exist in parts that have been amput for years before.

May therefore a fortiori be imag. to take place in a part still rem. though insensib.

But besides this, other ways also in which paralysis attendd with pain.

While some lose funct entirely others may be in pecul. morbid state.

And even in prog to total paralys not improb that [there] may exist if not encreased, yet morbid sensib.

Of this I think evid in [sense] of augm heat which often occurs & that too where no morbid heat or even dimin of natural heat.

But in whatever way to be expl. the fact unquest.

That viz paralyt member, often affected with severe pain.

This view therefore may without hesitat be taken in pres case

But if to Paralysis would referr pain, may still more to the same source attrib wasting of arm

This indeed by no means in every case occurrs.

For sometimes even when Paralysis of long standing, limb yet contin without any app loss of subst.

And by no means very far from being a necess conseq either of loss of sense, or motion.

That however should take place in Paralysis, cannot seem strange

For evid that dimin of any partic part, may be conseq either of uncommon abstract from it, or want of usual deposit.

Is indeed diffic to conceive how in prod former effect, Paralysis can have any influ.

But in latter may readily have effect.

For wherever from Paralysis circulat through the limb affectd must necess influ both quant of nutrit mattr carried to it, & likewise mode of applic.

Hence then rather surpriz, that does not more freq occur.

For circulat often manif affected.

And can farther readily conceive that state of circulat in extrem vessels may be affected, though not manif in pulse.

Here indeed might at first occurr as obj to suppos, that pulse app. same in both arms

But from this can inferr only that affect rather in extreme vessels, than in larger arteries.

And that prin depends on want of due applic of nutrit matter.

Upon whole then all sympt of the case, may be consid as marking Paralysis.

And here you will observe was the conseq of a cause rather uncommon.

An accid injury viz from fall.

But though this not often obs. yet cannot seem strange that should prod paralysis.

For while that disease often from affect of nerves at source origin, so often also injury in course.

Viewing affect in this light progn cannot I think be very unfav.

Or at least certainly much bettr chance of recov than if reason to [susp] higher seated, fixd, & encr.

For well known, that when nerves even totally divided, will yet in process of time, be again united, so as fully to exercise [funct]

May therefore more readily [expec] recov, of funct, where merely bruised or injured.

But on other hand to be obs. that affect has already subsisted for consid length of time.

That during this period, has been rather encr. than dimin.

And that paralysis attended with wasting, very gener consid as making progr to irrecov state.

Hence then some caution requis in progn.

And Yet upon whole reason I think to hope the best.

Espec as hitherto no modes of cure have been tried.

Here if conject well founded, great obj to be aimd at, is the restorat of vigour due nerv energy to affected part.

And with this intent, have you will obs, had recourse to Elect.

Of effects of electric, as answering this intent, had occas to speak at our last lect.

And in partic [pointed] mannr in which suppose sparks drawn from part, to have effect.

As a powerful vig & a penetrat stimul.

While at same time obs. that was only from course of due [contin], that could prop. judge of affects.

Hence then although hitherto no great benefite, yet unless some change in sentim, shall think of steadily persist in same course.

And indeed may be obs. that app. rather favour than [otherwise].

For since use first begun although use although his mother thinks that pains rather aggrav. yet motion of arm, more free & more consid.

Am therefore in hopes, that by proper contin aim may be accomp

And if this not the case, expect of recov, will I own be less sang.

Still however may with some prospect of success, try friction & cold bath, a mercur course conj with warm bath, or many of those various remed recommended in Paralys.

But in this must be determ by circum of patient at the time.