DEP/DUA/1/41/14 (Transcript version)

Andrew Greig

(1786-1787)

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Andrew Greig. March 3^d 1787.

Disease of this pat formerly pron. distinct markd inst of Paralys.

And no reason to alter opin.

Still contin in same state as [before]

Where charact of Paraly. however consid varieties.

Diff partic with respect to extent, degree & durasituattion

But what still more remark perhap diff also in kind.

Or at least app of this.

For in some inst total loss of sense

In others total loss of motion.

Nay in partic inst compl. loss of sense in one side & of mot in other

This howevr am inclind to think depends not on essent diff [illegible] of affect.

But merely on being affect of diff nerves.

Where loss of sense condit giving paralys. exist only in subcut nerves

Where loss of motion exist only in nerves leading to muscl.

Hence to be expl. on precis same prin as other

Thus to be expl. in same manner as other varieties in situat.

Partic extent.

For more or less extended as greater or smaller numb of nerves affected.

In same manner also is to be acct for diff in situat.

For partic part only diseased when nerves leading to that part affec

Affect in this manner however have given rise to diff app.

Thus affect of each of organs of [sense] name by itself.

When affect of partic limb more strictly name of Paralysis.

When whole of superior or infer [half] of body name of Paraplexia.

When whole of right or left side of Haemipleg.

And of this latter modif of the disease an examp in pres. case.

For disease extended not only to left leg & arm, but in some degree also affects tongue & eye of that side.

And in parts diseased evid affect both of sense & mot.

Of neither indeed is patient totally deprived

For while some sensat from [impr] can walk tolerab. by aid of stick.

Thus app then that though far extended in syst. does not yet occurr to greatest degree.

And in expl. varities in degree perhaps still greater diff. than with respect to extent of affect.

Former Latter readily & indeed necess acct for from numb of nerves affected.

But this by no means so clear with respect to former.

Or at least may conceive limited dimin of power of sense & motion in any partic organ to arise from one of two causes.

Either from all nerves leading to part, losing in some degree power of exert funct.

Or while some contin to possess full energy, others totally depr of it.

Thus part supp as it were with smaller numb of nerves than before.

Hence dimin either of sense or motion as well as from state of torpor in whole.

Either of these then, possib causes of mere dimin of power of sensat & mot.

And in every case a diffic mattr to determ to which.

Perhaps in many inst both in some degree conj.

This I suspect happens in inst before us.

At least this am inclind to conject, from cause to which pres. affect attrib. when viewd in conj. with some phaenom.

Can I think be no doubt that nerv. power whether dep on fluid or not may possess diff degrees of energy.

Or in other words may be eithr in state of mobilit or torpor.

Of causes of torpor, one not least powerful cold conj with moist.

And to this affect of pres pat was you will obs. attrib.

But if from torpor merely should expect equal affect of every muscle.

This howevr by no means the case.

For motion both of leg & arm only at partic joints.

In former entirely at thigh, in latter at shoulder joint.

While power of motion at elbow wrist, knee & ancle entirely lost.

An evid proof that is in some muscles only that power of motion still remains.

Thus then in acct for degree of paraly here, would concl. that partial retent of power, effect both of limited degree of torpor, & of some nerv. [fibrillea] still prob, contin fully to exert funct.

Must however be allowed, that all knowl. yet acq of nerv power, can lead us to nothing farther than mere conject.

On this subj therefore shall make no farther observ.

With regard to prognos. formerly obs. that hopes of benef. pat. very faint.

And now I own still less than before.

Is indeed true that in many inst at early periods recov by mean of art.

And after period of artif recov as it were [part] yet sometimes affected by operat of nature.

Partic by viol [commot] & consid changes in syst. as fever or like

And here, could not be consid, as having compl. passed even former period.

But at same time such natur cure as have ment, always to be consid as accid & rarely occurr.

While after disease of three years durat, chance of artif recov. by no means great.

And espec. as at commen of affect most powerf remed tried in vain.

Or at least without effect of giving any better state than at pres.

Now the rather reason to desp. as some of more active remed empl. without any advant.

For must here obs, that those on which chief expect founded already fair trial without any benef.

These remed I need hardly obs. Electric & Camph.

On these remed patient put as soon as came undr care

And from both had at least some hopes.

Electr. now for many years celebr in paralyt affect.

And I am inclind to think with great just.

Am far indeed from consid as adeq to cure of every case.

Nay perhaps in major of inst after fullest & fairest trial unsuccess.

And others where although first effects give flattering hopes, yet from most industr. applic no farther progr to be obt.

Yet unquest, that where might otherwise succeed often fails from want of due applic.

And here the rather encourag. to give fresh trial from benef before derived from it.

For on first attack of disease entirely deprived both of motion & feeling in affected side.

And was he thinks by electric that these funct restord to pres. state.

That in this disease should have sometimes at least good effect not I think surpr.

For where state of torpor exist. this partic to be exp. from stim.

Espec from those acting [powerf] on extrem of affected nerves.

For where nerve not altog. incap of commun impress, is thus conv. to that part of brain from where derives origin.

Thus may expect greatest influ. in remov. local morb. condit.

Elect however as acting on extrem of nerves has pecul influ.

For almost every other stim to affected part can act only on subcut nerves.

But elect. of such a nature as actually to penetr. [part].

This abund app. from electri fluid marking course even by obv. injur to solids.

And may therefore justly be consid as local stimul. to deep seated as well as superfic nerves.

To these in memb. [subserv] to purpos of motion as well as of [rem]

At least as far as sensib app. from applic to surface.

Is thus then I am inclind to think that effects of electr greater than of any other topic stim.

But whether this conject well founded or not, that effects are more consid is I think demonst by daily observ.

And accord disp to entert greater expect from it than from any othr topic remed.

While however such my opin of this remed also consider Camph as not without use.

Can be no doubt that from this singul subst. a strong & pecul action on stom.

And that from this affect of nervous syst. in gener.

On this ground long accom in cases of paralys. as well as in other nerv affect.

And in some inst of my own pract have I think seen great benef. from it.

Among others may mention case of young lad of name of Culberton treated at Coll. Cas some year ago.

That also a case of obstin Hemipleg.

And after trial of variety of othr pract both in Infirm & at Disp. had compl. cure during use of Camph.

In inst before us howevr that as well as electric now pushd to consid extent.

And after fair trial cannot say that any benef derived from eithr.

Hence as have already said now look upon case as at least incurab. by artific means.

At same time, if can procure the arnica montana, of late highly celeb. shall make trial of this also.

And if here success. will I own give me high opin of [virtues]

If can not mean to try a practic which shall more partic mention in treat of next case Swinging.