DEP/DUA/1/47/23 (Transcript version)

Robert Gib

(1789)

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No16 Robt Gib at 38

When formerly spoke of this case expressd doubt with regard to it.

But although inclind to view it as somewhat of compl. nature, yet consid chief affect to which he was subj as an ex of Cephalea or headach

Was disposed to view it as being what in this country commonly known by name of nerv headachs.

A disease which notwith such affect pointed out by nosol, has not in my opin a place in any of their writing.

But which I am inclind to think by no means an uncommon occur in this country.

And which may I think with suff. prop be disting by title of Ceph. Nerv.

Whethr however disease of pres patient an ex of it or not cannot pos. pretend to say.

Since came under our care, nothing can be said to have occured partic conf conj.

But on other hand as little reason to alter opin.

And whether effect of med or not, under med pract empl. compl of patient have at least been consid allev.

On idea formd of affect had here recourse to two med, the Pil. Hyosc & Powder of Valer.

First of these formulae has for active basis the extr of Hyosciam or Henb.

The Hyosciam seems to have been a good deal empl in pract of med even in earliest periods of healing art.

And partic recomm by Dioscord, Celsus & others as a means of allev severe pain.

But same intent found to be still more effect answ by opium.

Hence fell very much into disuse.

Of late however empl revivd in pract with very high reput by Dr Stork of Vin.

And I must own look upon it one of most powerful & useful artic which has introd.

For although infer to Opium both as means of allev pain & procur sleep yet in partic cases possess many adv. over opium.

And espec often prod of these effects without any inconven. while opium under every form that can be thought of, & with every corrig that can be tried, prod of great uneas.

Partic as giving sickness at stom, confus of head & even delir.

Has farther adv. of alm never binding belly.

A circum from use of Opium often prod of great distress.

From these circum then in many cases disp to try it where opium found inconv.

Or even to have recourse to it prior to empl. of opium.

This in former pract have often been led to do in cases of nerv headach in partic.

For though with some of these opium prod of best effect, yet with many others disagr very much.

And from Hyos have freq I think seen best conseq.

Was then on these grounds that had here recourse to it.

Directed it you will obs. under form of Pil ex Hyos. as we stile them.

These formd of [extr] of Hyos & crumb of bread in such prop. that gr of the [extr] enters every five gr of mass.

And this quant with those not habit to it, reckon at commen, a suff. dose.

But like other artic of narcot tribe from habit influ very soon dimin

While here however directed Hyos; had recourse also to anoth artic the Valer.

This likewise I empl on idea that headach of pat, was of nerv kind.

For is I think unquest, one of those artic, the inf of which on nerv syst, very consid.

And from this also, if be not much deceivd, have seen good conseq, both in cases of headach & other affect imm depend on nerv influ.

Valer here taken to extent of ℥i twice a day.

This indeed much infer to doses in which sometimes empl.

But at same time, as far as my obs goes, is as much as most stom will easily bear

Nay in many cases have seen even sickness & even vom from smaller doses.

Here however both one & other med taken regul without any inconv.

And for some days thought all his compl a little easier.

But then became affected with a set of sympt in some degree diff from former.

Was much distressed with [palpr.] at his heart.

And these accomp with involut contract resemb cramps both in hands and feet.

These sympt if throwing any light on nature of his disease were at least in fav of suppos of nerv affec

For one evid depend on morbid state of action, other of sensat.

Perhaps may also consid as a nerv. sympt. anoth affect to which at this time subj.

Cold sweats viz on infer extrem.

For presumpt that these affect of sudden relax or loss of tone.

In same manner as occurr in more general manner from sickness [threatn] deliq animi.

From these circum then not led to any change in pract.

But while contin former med encr. encr. dose of Hyosciam to two gr. daily.

On this course contin as you will obs. for sev weeks without any import alter.

That is though at times subj to returns of pains both in head & other parts, yet not highly distress.

And upon whole thought himself consid easier.

But upon twentieth of last month had very severe attack of headach.

And accomp as on former simil occas. with affection both of sight & hearin.

Still however did not despair of success from persist in med already begun.

But wishd to push the use of the Hyosciam somewhat farther.

This however chose natur to do by more freq repet of dose than by augm quant at once.

And as imagind that use of Valer might interfere with operat resolvd on omitting it.

Directed therefore use of Hyos alone to extent of two grains thrice a day.

To this quant also taken without any inconv.

A circum not indeed surpr. [illegible] formr habit.

During use headach upon whole very consid easier.

In so much indeed that at last report he compl. only of pain of back.

Was himself [conv.] that his diseas very much dimin from med here empl.

And although am far from imag. that will not at times be subj, even to severe returns, yet look upon his case as an prob. ex of benef from Hyosciam in cases of Nerv. headach

At same time so doubtful in many partic that cannot speak of it with great confid.