DEP/DUA/1/45/15 (Transcript version)

William Torrence

(1788-1789)

---

N^o34. W^m Torrence at 26.

In case of this patient a distinct markd inst of Epilep.

And fits without any pecul. Unless perhaps that we may cons. as such the occurr of fits with every comm charact of the disease.

Such for ex as obvious convuls motions, foaming at mouth, total abolit of sense during fit, fatuity after it, & like.

Of these charact even a few suff to charact. mark the disease.

But when all taken togeth no room for doubt.

And besides these in circum of this case many partic rather unfav.

Disease of its own nature very comm an obstin one.

And although not a few inst of undoubted cure, both by natur & artif. means, yet no doubt that very consid major of cases incur by any means.

But may [consid] it, as here an addit unfav. circum. that disease had origin without any obv. excit cause.

Is no less so, that has already subsisted for space of four years.

That during this length of time, in place of any dimin, has grad encr in severity.

But what to me seems [worst] of all, has induced with this patient what may be consid as const. fatuity.

In every inst of epilep. mental facul compl. susp. during some part of every severe fit.

And very gener. for some time after fit, a certain degr of stupor & fatuit remain.

But whenever const dimin of ment facult. argues much greater sever of disease, than even very [short] convuls.

And in my own pract at least, have invar found, those cases of Epil. incurab. which have given rise to const idiot, even although to very slight degree only.

Hence then hopes in pres. case I own but very faint.

Perhaps may consid it as only fav circum, that has not hitherto resist any powerf. remed.

But this fav circum only of negat. kind.

For arises merely from [these] never having been tried.

As one of most powerful of these with which am acq. have here had recourse to Cupr. Ammon.

And hitherto at least, appear from use not unfav.

But of affects reserve observ till future opp.

May only farther remark with regard to this case, that fits form occurd only during night.

And that when patient applied for our assist, was not so much from expect of compl. cure, as with the request that would turn attacks of fits from day to night.

Is a very comm idea, & that too not merely among vulg. that cert med have in this resp pecul & specif power.

For this however in all prob. no foundat.

At least for my own part am altog unacq. with any such med.

But at same time no doubt that Epilep more ready to attack during night than during day.

And prob. this conseq. of state of circulat at brain arising from recumb. post.

And by aid of med dimin [pred] to disease, tend may be so far taken off that without this circum fits will not occurr.

Thus then see ground, on which certain med, without any pecul or specif affect, may have conseq. here alledged.

And if with pres. patient, tend to disease can be dimin, not imp, that may have this affect.

But besides this still anoth mode of conv. attacks of fits from day to night.

That is by means of anticip fits.

In some inst, partic of sympt epilep, attended with aura epilep, progr may be stopt by a [illegible] [illegible] [part.]

And where this suff. early appl, fit always effect anticip.

For propag of pecul [impress] to brain by which affect to be induced is thus prev.

But besides such pecul. causes, several othrs also in which anticp. of fits may take place.

Thus for inst, may sometimes be done by strong impress. either extern or internal.

As volat alk or aethr taken into stom, strokes on palm of hands, or like.

And often also by pecul [impress] such for ex. as forcing some subst into mouth, keep jaws wide [illegible].

Not long since, had undr my care, a young gentlem who empl. this mode, with great success.

In place of trust to piece of money diff retaind & apt to slip into mouth carried about with him an iron machine [contriv] for purp.

And by introd on any threatn of fit, never faild to prev. occur.

By this means was able to go into [comp] & amusem without dist. to himself or others.

At same time cannot repres it as having ultim proved of serv.

For when wanted opp of empl it as during night when asleep or slumb. fits occured took place with greatr sever than before.

This no uncomn occur. Nay has even been by some alledg that in conseq of freq. anticip, epilep has even proved fatal.

Yet no doubt that susp of fits gives remed better chance of success.

Hence not improb. that if necess. may with pres patient have recour to some exped of this kind.