DEP/DUA/1/45/14 (Transcript version)

John Murray

(1788-1789)

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N^o33. John Murray at 34.

Resp. case of this patient very doubt both as to name & nature.

Prin compl. & indeed that of longest contin headach.

This most nosol. & pract writers consid as constit a prop. genus of disease by itself, Cephalea.

And I think with prop.

For although freq. sympt as of fever yet often also idopath.

And that too as dep. on morbid affect, both in [integum] of Cran & in its contents.

But in these great divers of affect & requir very diff modes of treatm for removal.

These however in their nature often very uncert & obscure.

For although anatom of brain minutely investig, nothing yet done towards ascert use of diff. parts.

And still as ignor respect funct of partic parts as if did not know of their exist.

Hence then in all affect compl. of head in partic, necess to take into consid every circum whch can through [light] on nature of affect.

Here however besides headch [anoth] remark affect also takes place.

A great dimin viz of vision.

This indeed so consid as almost to incapacit him from following usual employm.

Is indicated also by uncomm dilat of pupils.

But at same time uvea by no means depr. of contract power.

For on immed action of light after prev darkness shews ready mot.

Hence may concl. that not so much an affect of musc fibres as of sensib nerve at extrem of eye the retina.

Here both headach & dimin of vision as it were const sympt.

Hence may concl. that depend on some fixd cause.

And in all probab. the same with both.

Thus led to referr headach rather to some cause within brain than to any morb. condit of integ.

And in this view must look upon it as a more serious & import affec.

For if no worse conseq. may at least termin, in compl. amaurosis.

As having seat howevr within cranium may yet arise from various causes.

May be effect merely of condit of nervous power.

Or may be effect of [compress] arising from schirros. tumour, water or various other causes.

Is chiefly on first of these grounds that have here had recourse to Camph. & Electr.

And on last may hereafter empl. blisters, mercury, digitalis or like.

But of pract is not at pres our business to speak.