DEP/DUA/1/40/38 (Transcript version)

Peter McGregor

(1786-1787)

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Peter McGregor.

This patient though introd into register only on 27^th of Octobr was however under care at Dispens. from begin. of that month.

And is alr. contr. I must own to my expect. dismissd from future attend as not requir farther aid.

Contr. I must own to what had reason to appreh. when selected him as subj of pract for Col. Cas.

Was then indeed under consid diffic as to precise nature of case.

And must acknowl. that notwith favour termin which has now tak place that diffic. by no means remov.

Still as much at a loss as ever respect nature of affect.

And must own can form only very vague conject as to grounds by which termin brought about.

From history of case will readily perceive that prin diseas an effect of his eyes.

Consisted not in entire loss of sight, but in very consid dimin of vision.

And this evid not conseq as in cases of Caligo of any thing extern. to pupil.

While however this not the case may still arise from variety of causes.

But most freq. is either conseq of want of due transp in [illegible] transm rays of light.

Or of want of due sensib in nerves to which these should be comm

First constit that disease which among pract auth in gener. known by name of Cateracta

And which known also by name of Glaucosis - Gutta opaca &e.

Last again constit that disease known by names of Amaurosis. Gutta serena. Cataracta nigra &e

In most inst the distinct betwn these two affect perfectly easy.

Commonly obv. even on slightest inspect of eye.

For in Cataract the opacity is obvious.

And accord you will observ. that while one name of gutta opaca, other that of gutta serena, as nothing obv on inspect.

But notwith this easy distinct in gener. had some doubts to which to be referrd in pres. case.

Prin affect indeed what [charact] amaurosis.

viz uncommon dilat of pupil & want of contract on expos to light.

This great mark of affect in [illegible] state.

And in advanced or severe inst for often arises to utmost height at once no power of contract whatever.

But here there also took place a change in app. of humours.

For pupil, which has in gener app of being perfectly black as being perfectly void of colour, had somewhat of whitish cast.

This would necess. therefore be attended with some dimin of transpar., & of course diffic of transm of rays.

Might therefore be sole cause of want of contract as well as of dim of vision.

And accord no improb. suppos. that disease an incip. cataract.

But while app. not so far markd as to render this certain, to be remarkd also that some circum against it.

For though colour of pupil somewhat changed, yet, as obs. in histor of case, no obv. dimin of transp.

And could hardly be supposed that rays so far obstr. as to give all that dimin of vision & imperfect degree of contract which here took place

Hence then reason to inferr that sensib also dimin.

This the more probab. as here an affect of both eyes.

For though catar in both eyes at same time not uncom. yet very rarely at least happ. that have same progr.

Rend farther prob. also by cause induc. it

Was ascribd you will obs. & prob with just. to being much exposed to heat of sun.

This is, may supp, to combind action of heat & light.

Causes by which well known, that state of sensib of optic nerve, very readily affected.

Hence then was I own disposed to consider it as at least princip of that kind.

And this suppos, at least, somewhat corrob. by termin.

For happend in more sudden way than could expect remov. of catar.

From all these circum then was formerly, & still am disp to think, that chiefly examp. of slight amauros.

But must still be obs. that with restorat of vision colour of pup also changed.

And also, that progr in way of grad encr, more slow, than at least comm case with Amauros.

Hence then still not altogeth without doubt that there occurd at least a combin.

But on this suppos or indeed suppos either amaurs of cataract separ. should have formerly been disp to give very [eron] progr.

For if had given sentim of term of case when first came under care, or even when first introd into regist should have been disp. to give very unfav. opin.

Both amauros & [catract] to be consid as very obst. disease.

Former in great major of inst. I have met with has proved incur. by any remed, at least with which I was acq.

And partic nothing allev. by pract here empl. after fullest & fairest trial.

Though at same time in other inst am much deceived if have not seen cures by electr.

But upon whole in greater numb. of instan of amaurosis, have reason to fear that will prove obstin & in major of instan incurab.

Same also may be obs. respect cataract.

At least as far as that to be effected by medic aid.

For even in most advan. stages is often subj of chirur. operat.

And either by [depress.] or extract of crystall. lens. compl. cure effected.

But as far as remov. to be effected by med has very seld if ever been effected.

No doubt indeed that const. change goes on in every part of body.

That by valvul. lymph absorb. even firmest & hardest parts of bones carried off.

Hence similar change may take place in crystal. lens & without regener of disease.

But at same time are as yet I appreh acquainted with no remedy by which partial augm of action of these or indeed of any other lymph, to simil degree, can be effected.

Hence then supp. either disease to take place [singul], are affect in which cannot give fav. progn.

And this much less the case when conj.

But still must be admited that suppos. [conj.] here more fav, than in greater part of inst.

For though dimin of sight consid. was still but recent case & at utmost to slight degree only.

And although own, even from this, should not be disp to foretell simil fav concl, if anoth case occurd in simil circum. yet serves at least to shew that in such ought not to despair

And that in most these recov may sometimes be speedily & even unexp. effected.

While however such has taken place in pres. case, must own at a loss to say to what to be attrib.

And is with no great degree of confid.

But before speaking of pract may be prop. to obs. that affect of eyes not only compl. to which pat subj.

Had also as will obs. from case a small phlegm. formd at angle of lower jaw on right side.

And this after contin for some weeks, had just about time that case taken, termin in suppur.

Besides this affected also with slight cough of few days stand.

But consid neither of these as in any degree connected with pres affect.

And neither looked upon them as subj of prognos or practice.

To affect of eyes treatm empl in this case solely directed.

This pat as already obs. under our care for some weeks before began to select cases for Col. Cas.

But treatment empl. from the begining was same.

Here from idea which had of natur of affect placed prin. hopes of recov. in electr.

This need hardly obs. a remedy often empl. in paralyt. cases.

And in certain circum of these I am inclind to think more success than any remed with which are yet acq.

From analogy then natural to employ it in Amauros.

And accord long recomm & used in that affect.

In my own pract have freq. empl.

Must however acknowl. that but seldom with success.

At same time in these inst have not found greater benef from other modes of cure.

And in one case at least, think that was attended with very consid [benef.]

But while look upon it as one of best remed in Amauros. consider it also as well suited for inst of Cataracta.

Evident that [these] restorat of transp. of crystall. can be effected only by absorpt of opaque matter.

And little doubt that valul [lym] absorb. [access] to this as well as every other part of body.

When therefore absorpt even of [hardes] bones, simil remov. may take place also of this.

And if any stim in nature by which can forward this by encr. activ of lymph at part, is I appreh. electr.

But at same time must acknowl. that have no exper of its prod such an effect.

And [where] remov. by operat [inadm] would be improp. to have recourse to it.

But where this not the case app. to me to be at least ration trial.

And partic in such inst as pres. where disease by no means decidedly pres. but from grad dimin of vis & slight change of app. reason to susp. begining.

Here then seemd to me in every point of view, remed. best adap. for pres. case.

Electr. for medic purpos. exhib under diff. forms.

But in such an affect as pres. noth or at least very little to be expected, either from shock or simple insul.

Was alone from stream, or even sparks, drawn from eye that could expect, any consid action, on seat of the disease.

Directed therfore under form of Scintilla with which [Aura] very comm. is necess. comb.

But besides electric. here directed also Pil. ex Camph.

From Camphor have I think in some inst of paralysis seen great benef.

But here I own had recourse to it more with view of engag. atten of pat. than any thing else.

For as from state of weather & other circum can hardly promise on regul. electrif every day unless [someting] else done when interrupt happ patients apt to desert.

Hence then in gener. find it necess. to employ some other med regul contin at same time.

And to extent that Camph here empl. could not expect any other effect than that of engag. attent.

Under these med pract. contin for some time without what could be calld any obv. benef.

But at [last], a sudden & very fav change took place.

And with change in app of eye to state perfectly natur. sight also restord.

This so suddenly effected, as to leave it at least very doubtful, whether could be attrib to the electr. which not before obs to have any influ

And especially so as with recov. anoth circum took place.

Suppurat viz of gladul. tumour on neck.

Not impossib that with this, the change in eye may have been connected.

At least cert. that in some cases even from very triffling natur disch remark changes induced.

Especially when that has hapn in neighb of seat of affect.

But on pres occas. recov did not take place till disch had entir ceased.

And not imposs. that may have been operat of nature [withou] aid of any med.

Yet am I own disp. to think that at least some presumpt that benef. here derivd from Electri.