DEP/DUA/1/42/35 (Transcript version)

Nicolas Hayley

(1787-1788)

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N^o5^th

Nicolas Hayley at 50.

Disease consists almost solely in pain of head.

And therefore little doubt in referring it to genus of Cephalea.

At least as taken in extens sense & compreh. diff. gener. of Cephal. [Cephal] & Hemicrania.

For among these am inclind to thin that no good grounds for distinct.

But while thus referr all idiopath headachs to one spec genus. must be allowd that very diff. gener. species.

And accord under each mentiond [many] enum by nosol.

But without entering into consid of other species may remark that a very freq. cause of headach is a Rheum affection of Muscles & [integum].

And of this formerly gave it as my opin that had example in pres. case.

Was partic corrob. from severity on becoming warm in bed.

And likewise from affection on chan of weather.

For few who can with greatr prop be stiled living baromet, than those subj to rheum in any form.

Resp. this suppos. however some diffic from cause to which patient attrib his affection.

viz. consid local affect arising from extern injury & prod exfol. even of bone

Not impossib therfore that irregul growth may have taken place.

And that thus const cause of irritat afforded, which impossib. either to remove or perhaps even to [counter]

At same time this suppos I consid as least probab.

And nothing at least to deter us from attempts to cure.

Here even suppos local irritat yet when consider exacerb. & remiss presumpt that had effect only in [cons] of pecul. state of irritab.

And if entirely of rheum kind, from circum with which attended, partic aggrav on heat of bed, may concl. it in that condit.

Hence here resolvd to make trial of valer.

An artic the influ of which on nerv. syst. unquest very consid.

And the rather encour to trial as in many former inst. have found it very benef in cases of headach.

Chiefly however indeed in those strictly of Nerv kind

And to these, cases depend on morb. irritab, if not precisely same have at least strong analogy.

Perhaps only diff in situat.

Morbid condit in one exist in nerves of sensat. in other in those of mov. fibres.

This directed to be taken to extent of three tea spoonf. a day.

Which consid as medium dose.

And indeed as much as most stom will bear.

While however directed Valer. had also recourse to Pil. Aloet.

To these led from tenden. to costiv with which disease attended

For although at time when came under our care belly regul. yet this only the effect of med.

Consid contin of regul. disch as necess to cure.

And chose to obt. it rather by med with which were acq. than by pat persist in use of one of which knew nothing.

Here directed aloet pill as being of all cathart [whith] which am acq. best for countract. habit costiv.

At least where no partic obj to empl. as haemorrh. or like.

Aloet pill, to extent of gr V, seld any other effect, than mere evac of cont of intest.

Seldom does more in this way [than] the induc one or two easy stools

And unless great tend to bound belly seldom fails in prod that effect.

Indeed often operates as well as dose of double quant.

For operat by no means prop to quantit taken.

Accord in pres. inst. obt. from them every effect to be wishd for.

Kept belly gently open.

Cannot however say same with resp. to powders.

For notwith regul use of these head contin as sever as before

Still however did not desp. that by contin might be prod of des. effect.

But while directed that should pers. in use wishd also to try effect of some topical applic to nerves [part] [pain]

And this the rather as pain now almost entirely seated in forehead.

Well known that in such cases topical applic from influ on subcut nerves, very consid & very immed effect

This partic remarkd from various artic of antispasm kind.

And that too both of stimul & sedative kind.

Thus recourse sometimes had to Op. either as diff in spirt under form of L. L. or Anod. Bals. or in solid state as in form of Opium. Patch.

Recourse often had to artic oper. as [rubefac] as Vol. Linim Horse Rad Root. Must. or like.

But of all artic none more celeb. than vol. Linim of Dr Ward.

This consid diff from volat linim of our shops.

Of both indeed the active basis Volat. Alk & Camph.

But while one made with oil the other with alcohol.

And whether from this or other circum is both more penetr & more immd in action.

To this artic am inclind to think that Dr Ward owed not a little of [reput]

Cert that many who went to him distressd with viol headachs sent away perf. easy.

Mode of appl. it was by rubbing a little on palm of hand & keeping it app. for some length of time to forehed.

Conseq. every [gener]. was a compl. remov of headach at least for some time.

And although cure commonly but temporary yet remark that

This artic have not unfreq. directd in simil cases & with good effect.

Now howver less common than once was.

For has given way to an artic of a still more powerful & penetr. nature viz Vitriol Aether.

Of all the artic with which am acq. know no one more powerful in acting on sensib extrem of nerves to which applied.

And in this manner tending to allay both inordin action & pecul sensib giving pain.

In headach in partic have often seen most immed relief from extern applic.

With contin of former med [thus] directed that should be tried in pres. inst.

And in effects from it were not disapp.

For soon prod very consid allev of pain in part to which applied.

Is however one of those artic in use of which should not long persist.

For from contin effect dimin.

After this remiss therfore judged it improp to contin applic to forehead.

And in hopes that if afterw. necess. might reap from it more adv. directed that should be omitted.

Patient at this time thought that pain at part of head formerly ulcer was rather encr.

By this led to think of trying effects of issue from neighb.

Directed therfore applic of blister to back part of neck, & that should afterwards be kept open with episp. oint.

But though disch consid yet prod of no benef.

On contrary thought that affect rather aggrav.

In this situat could not hope for much relief from contin

And as had now made fair trial of Valer. reckond it unnecss also to persist in use of that artic.

In this situat thought it adv to try mitig of pain by Opium.

This prescribd under for of Pil. Theb. to extent of gr X om. n. that is one of Opium.

This with those unaccust to employm. reckon at begining at leas a full dose.

And would app. that was so in pres inst.

For under use consid mitig of headach.

This then suffic inducement to direct contin

And am hopeful that by means of it, still farther relief may be obt.

By condit howevr in which shall find patient, must be directed either to farther contin, or to alterat of plan.

But not improb if circum shall seem to require it, that may again have recourse to Aether as means of mitig, & to Peruv Bark with view of securing advant.