DEP/DUA/1/38/49 (Transcript version)

John Montgomery

(1785-1786)

---

John Montgomery

Concern case of this patient, was I own, when came under our care, a good deal at a loss.

And although now, so far allev. that have I think, reason to look for fav termin, yet must own that these doubts not removed.

This pat. affected with sever. sympt prob. unconn. with each other.

This partic the case with respect to affect of head & breast.

For while former a compl, but of recent date, to latter had been subj for space of sever. years.

And although during that time prod of no inconsid uneasiness, yet much less alarm & distress. to him than headach.

Considered him therefore as princip our patient for Cephalea.

This affect, it is well known may [arie] from very diff causes.

And accord to partic cause induc. it treatm very much varied.

As occurring however, in this country, chiefly arises if except what depends on aff of stom from one of these causes

From Rheum affection of [integ] of head.

From tenden to intermit fever.

Or from condit of sensib extrem of nerve about head.

These three spec. disting by titles of Cephalea, Rheum. Interm & Nervos.

And here no circum occurrd [leading] to decis judgem to which to be referrd.

Or rather some ground for susp of all of them

From being so much affected by cold some count to sup of Rheum

From Tinnit aurium as well as watchful during night, ground for susp. that of Nervous kind.

While again period exacerb. & remiss as well as sweatings with which these attended, gave reason to believe that depend on tend to interm

And to this suppos. the pale & leucophlegm app of patient was also fav.

To this I own of these suppos. ment. was most inclind.

At same time, uncert. such, that could not help being doubtful as to prognos.

But on any view, had no reason to be appreh of danger.

And although on suppos of being nerv, or even rheum. more ground for appreh than if depend on interm dispos. yet in any view hoped that in no long time be overcome

That event, would now fain flattr myself, is nearly accompl.

And if, during course of week, cont as well as at last report, will considr farther attend as unnecess.

Whether however such an event takes place or not, am I own disp to consider relief which this pat. has already obt. as in great meas owing to remed here empl.

Treatment you will observe, here chiefly conducted, on idea that Cephal. dep on dispos to interm fever, or in other words was of aguish kind.

Accord. had recourse to use of Peruv. Bark.

From this indeed had reason also to hope for benef. on other view of the disease.

And in headachs, both of Rheum & nerv. kind, is unquest often prod of good conseq.

But in latter in partic, the nerv headach, have I think seen still greater advant from use of Valer.

An artic the influ of which on nerv. syst. in gener. unquest very considerable.

And which in cases of Ceph. Nerv. have often empl. with best affects.

Here therefore directed Bark & Valer [in] conjunct.

And if from latter, little to be expected as combat aguish disp. at least from thence no obj to use.

From this comp. though taken in doses only of Jii at first some sickn at stom.

But neither to such degree, nor with any other affect, which could lead to discontin of use.

And from slight sickness, as conseq at least of Valer. more reason to hope for good effects.

Because affords at least proof of its exert. action on nerves of the stomach.

But whether conseq of med or not

In short time after empl. begun, affect very consid mitig

And while by contin, influ as excit sickness removed, not only free from tinnit aurium the attend of headach, but likewise cough & dyspn much allev.

Prob. however more conseq of some degree of restor of health in general, than of any partic influ of remed on the catarrhal affect.

Still however not entirely free from affect.

For not restord to sound sleep during nights.

But this reason to expect will be conseq of return to usual lab.

And if contin in same easy state as at last report, shall consid farther attend as unnecess.

But if in this disapp, future meas must be accomod. to state in which shall then find him.

And in that case, may as formerly suggested, have recourse to Hyosciam or Camph.

But now, greater reason to hope, than when first began treatm of case, that neither will be necess.

But that patient, in short time may be dismissd free from his affect