SD389.1. William Cother to George Ricketts Nuttall
Addendum to The Brownings’ Correspondence, vol. 1.
[Worcester]
[24 June 1821] [1]
Sir,
You will probably have been prepared by your friend Mr. Barrett to expect a letter from me, which in the hope of soothing a highly interested, and interesting family I gladly undertook to write to you. The subject on which I have to communicate upon, is not new to you—the case of Miss Barrett—that prodigy in intellectual powers and acquirements! I saw her in consequence of some of our mutual friends having known that I had been successful in removing some painful affections of the nerves which assume the intermittent shape. This case unfortunately differs materially from them and is one of essential importance, both to the lady herself and to her friends. Though you have a description of it from her own eloquent pen, I shall, as briefly as I can recapitulate it’s history and state its present symptoms. It began with pain in the head, which continued at intervals for seven weeks—the pain then attacked various parts of the body, for a considerable period, and for the last month it has permanently seated itself on the right side, that is about the center of the angle formed by the greatest projection of the ribs, the umbilicus, and the anterior superior spinous process of the os ilium. The pain commences here is carried to the corresponding region of the back, up the side to the point of the right shoulder, and down the arm. The suffering is agony, and the paroxysms continue from a quarter of an hour to an hour and upwards, accompanied by convulsive twitches of the muscles, in which the diaphragm is particularly concerned. The attack seems gradually to approach its acme, and then suddenly ceases—during its progress the mind is for the most part conscious of surrounding objects but towards its close, there is generally some, and occasionally, very considerable confusion produced by it. There are generally three attacks in the day and none during the night—very considerable debility and consequent nervous irritation, producing smallness and feebleness of the pulse, pain, and weakness in the back, which will not allow her sitting up, without support by pillows, and she is always rendered worse by exercise. The feet are generally cold—the pupil appeared much dilated, but contracted on the stimulus of light. She sometimes awakes in the night in great fright; and says that in the morning there is a sensation as though a cord were tied round the stomach (i.e. the part affected) “which seems to break”, to use her own expression. She is unable to rest on the right side—the tongue clean, and the stomach and bowels (aperient medicine is required) seemed to be so little affected, as to have excited my surprise, though she has only a relish for highly seasoned food. She has shrunk so much as to have produced in the minds of her friends great anxiety, though her countenance does not indicate to a stranger any cause for alarm. The mind has ceased in a great degree to engage in those investigations and pursuits which formerly constituted it’s greatest delight, and there appears to be a degree of listlessness perceptible to those around her, even where the affections are concerned.
I understand she has taken a variety of powerful medicines without any permanent benefit. Opium at one time relieved the spasms but it has ceased to have that effect. I examined the side, and spinal column as accurately as I could. In the side I should have remarked that she feels the sensation of its being swolen, which by no means appears to be the fact. There is too great irritability in the abdominal muscles to allow of much pressure being made upon them, but nothing like visceral accretion is to be inferred from the case itself or from the best examination I could make, nor could I detect any thing obviously wrong about the spine. I should state that two of the sisters of this young lady had some time since, the same kind of pain, or nearly so, which occupied the second stage of this malady. They were all suffering at the same time, which created a suspicion that they had taken something deleterious—they both, however, soon recovered, without much, if any, medical treatment. For what remains for me to add, I shall have to make some apology. I trust you will excuse my giving you the views I entertain of this case, and I hope you will with the same candour give me yours. I am greatly assisted in this subject, by having witnessed some years since in a young lady, strikingly similar, though much more aggravated case, which terminated at length in decided affection of the spine—from which she has recovered and is the mother of three children. When I first saw this lady in Hampshire, she was suffering from the same kind of spasms, as I observed in Miss Barrett (the left side being here affected) and they were most vividly recalled to my recollection on this occasion. She was at this time relieved by bleeding &c. though her debility was infinitely greater than Miss Barrett’s. I did not see any reason at this period to imagine there was disease of the spine, nor had it entered into the contemplation of the physician and surgeon who attended her. After some three or four weeks, she was enabled to travel home to Salisbury a distance of 40 miles, where I again saw her in consultation. I had no doubt the vertebral column was now affected—the surgeon who attended her concurred with me in opinion, and she ultimately recovered. You will agree that it is difficult to remove the effect which an impression of this kind, must make upon the mind of a medical man. Keeping therefore this case in view, and for reasons which shall be stated below, I should recommend, generally, the treating Miss Barretts case as for diseased spine, upon the plan recommended by Baynton—giving only such medicines as might assist the operations of nature or as its exigencies would require—bleeding might also be employed if necessary to mitigate the spasms, and the Unguentum Antimonii Tartarisati applied to the side, would prove some counter irritation—proper attention should be paid to the ingesta. Medicine seems to have, and to have had no effect, and the worst as it appears to me that can result from the adoption of this measure, will be the loss of time if it should even be proved to have been injudiciously recommended. The reasons I alluded to above, are the history of the case—no relief having been obtained from the variety of well directed attempts to remove it’s influence. The increasing debility—loss of locomotive power—pain in the back—it’s requiring support in the erect posture—no attack during the night—constant inconvenience from exercise, together with the state of the nervous and sanguiferous systems, indicating a high degree of sympathy, and most probably referable to derangement in some highly important organ. The uterine system is not materially affected. At the same time that I confess, the positive proofs are wanting of the existance of diseased spine, I must say that this is the best inference, I could draw of Miss Barretts from the opportunity I had of enquiring into it’s nature and of witnessing her sufferings. Being more anxious for the welfare of the sufferer, than for the fate of my own opinion, I shall again request you to use every freedom in commenting upon this communication, and beg to remain, Sir, Your most obedient servant
Wm Cother
Publication: BC, pp. 343–346.
Source: Copy at Pierpont Morgan Library.
1. Date provided by letter 82106241.
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