The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:176] From: Dr William Cullen (Professor Cullen) / To: Dr John Alves / Regarding: Captain Ross (Patient) / 4 August 1781 / (Outgoing)
Reply 'For Captn Ross'
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 4 images for this document.
[Page 1]
[Page 2]
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[Page 4]
Metadata
| Field | Data |
|---|---|
| DOC ID | 176 |
| RCPE Catalogue Number | CUL/1/1/14/62 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 4 August 1781 |
| Annotation | None |
| Type | Machine copy |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | No |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply 'For Captn Ross' |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1352] |
Case of Captain Ross, a young soldier, who caught a venereal infection when in America - which was treated - but who after recently attending a recent review at Ford George has started to display signs of a severe mental disorder. |
5 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:148] | Addressee | Dr John Alves |
| [PERS ID:147] | Patient | Captain Ross |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:148] | Patient's Physician / Surgeon / Apothecary | Dr John Alves |
Places linked to this document
| Role in document | Specific Place | Settlements / Areas | Region | Country | Global Region | Confidence |
|---|---|---|---|---|---|---|
| Place of Writing | Cullen's House / Mint Close | Edinburgh | Edinburgh and East | Scotland | Europe | certain |
| Destination of Letter | Inverness | North Highlands | Scotland | Europe | inferred | |
| Mentioned / Other | Fort George | Ardersier | North Highlands | Scotland | Europe | certain |
Normalized Text
For Captn. Ross
I have attentively considered the very full account
of this Gentlemans case communicated by Dr Alves
and hope it may be considered as an incidental disorder.
It is true that some degree of previous melancholy is
alleged to have appeared but possibly this would not have
↑been↑ taken notice of if the latter disorder had not appeared
and tho there had been some foundation for the observa¬
tion it is possible that it might never ↑have↑ proceeded to any
great degree unless the violent and repeated intemperance
at Fort George had occurred. But however this maybe
I am glad to find that after some fits of violent Phrensy
he is become more tractable, has some lucid intervals
of reason and that his ailment consists more in false
imaginations than in any violent delirium.
But taking every view of the case I must observe
that hitherto he seems to have been very properly treated
[Page 2]
The bleeding at first employed was certainly very proper
but both as that was large and that a good deal more was
lost by the breaking out of the vein I hope no more bleeding
will now be necessary and in my present view of the case
I would wish to avoid more bleeding. But let it be obser¬
ved that I say this in my present view of the case and if
contrary to my expectation there should be any return of
phrensy with frequent pulse, flushed face and inflamed
Eyes bleeding may still be necessary. In a case not very
violent, Leeches may be applied to the temples and if
more considerable bleeding seems necessary I would prefer
opening the temporal Artery to any other manner of bleeding
While his delirium is moderate and he has so much
reflexion to be much disturbed by the cutting out of his
hair I should not insist upon it but if he shall become
so incoherent as to have little suite of reflexion I should
think the cutting out of his hair absolutely necessary
and that for the sake of blistering his head from which
[Page 3]
I would expect more benefit than from blistering any where else
Tho I hope that in his present state much evacuation will
not be necessary I shall think some constant derivation from
head very proper and therefore that his belly be kept open -
without much purging. I would chuse to employ the Soluble
Tartar and he may have a small dose of that in a large -
draught of new drawn Cow milk whey every morning. But if
much delirium or frensy should prevail some stronger me¬
dicines must be employed and none more proper than the
Tartar emetic already employed.
The only medicine I can recommend for composing his
Spirits is Camphire. If he can be brought to take medicines
easily let ten grains of this be rubbed with as much Nitre
and made into a bolus to be swallowed in a wafer. But
if he cannot be brought to take it in this way let the Cam¬
phire be rubbed with Sugar and this put into a little Syrup
he may be made ↑to↑ swallow ↑it↑ by holding his nose. Such a
dose he may have for three nights together but afterwards
only every second ↑or↑ third night and if it appears to give
[Page 4]
sleep he may after some repetition have the dose increased
by two or three grains at a time to fifteen or even to twenty
grains.
I have now mentioned the only remedies I think necessary
but much will depend on his regimen. Let his body be
kept as cool as the weather will allow. Let his diet be
entirely vegetable with some but not much milk. Much
depends on the management of his mind. While address
and artifice will answer let no force be employed but if
he proves at any time impetuous violent and willfull he
must be restrained and a strait wastecoat is the only secure
measure and the most gentle that can be employed and if
he proves quite maniacal an authority must be acquired
and even by blows if necessary for there is nothing in
such cases more hurtfull than indulging fits of impetuo¬
sity and passions.
These are ↑the↑advices which I can offer at present but
if the disease draws out into a chronic state there will be
room for further advice which I shall give most willingly
Diplomatic Text
For Captn. Ross
I have attentively considered the very full account
of this Gentlemans case communicated by Dr Alves
and hope it may be considered as an incidental disorder.
It is true that some degree of previous melancholy is
alleged to have appeared but possibly this would not have
↑been↑ taken notice of if the latter disorder had not appeared
and tho there had been some foundation for the observa¬
tion it is possible that it might never ↑have↑ proceeded to any
great degree unless the violent and repeated intemperance
at Fort George had occurred. But however this maybe
I am glad to find that after some fits of violent Phrensy
he is become more tractable, has some lucid intervals
of reason and that his ailment consists more in false
imaginations than in any violent delirium.
But taking every view of the case I must observe
that hitherto he seems to have been very properly treated
[Page 2]
The bleeding at first employed was certainly very proper
but both as that was large and that a good deal more was
lost by the breaking out of the vein I hope no more bleeding
will now be necessary and in my present view of the case
I would wish to avoid more bleeding. But let it be obser¬
ved that I say this in my present view of the case and if
contrary to my expectation there should be any return of
phrensy with frequent pulse, flushed face and inflamed
Eyes bleeding may still be necessary. In a case not very
violent, Leeches may be applied to the temples and if
more considerable bleeding seems necessary I would prefer
opening the temporal Artery to any other manner of bleeding
While his delirium is moderate and he has so much
reflexion to be much disturbed by the cutting out of his
hair I should not insist upon it but if he shall become
so incoherent as to have little suite of reflexion I should
think the cutting out of his hair absolutely necessary
and that for the sake of blistering his head from which
[Page 3]
I would expect more benefit than from blistering any where else
Tho I hope that in his present state much evacuation will
not be necessary I shall think some constant derivation from
head very proper and therefore that his belly be kept open -
without much purging. I would chuse to employ the Soluble
Tartar and he may have a small dose of that in a large -
draught of new drawn Cow milk whey every morning. But if
much delirium or frensy should prevail some stronger me¬
dicines must be employed and none more proper than the
Tartar emetic already employed.
The only medicine I can recommend for composing his
Spirits is Camphire. If he can be brought to take medicines
easily let ten grains of this be rubbed with as much Nitre
and made into a bolus to be swallowed in a wafer. But
if he cannot be brought to take it in this way let the Cam¬
phire be rubbed with Sugar and this put into a little Syrup
he may be made ↑to↑ swallow ↑it↑ by holding his nose. Such a
dose he may have for three nights together but afterwards
only every second ↑or↑ third night and if it appears to give
[Page 4]
sleep he may after some repetition have the dose increased
by two or three grains at a time to fifteen or even to twenty
grains.
I have now mentioned the only remedies I think necessary
but much will depend on his regimen. Let his body be
kept as cool as the weather will allow. Let his diet be
entirely vegetable with some but not much milk. Much
depends on the management of his mind. While address
and artifice will answer let no force be employed but if
he proves at any time impetuous violent and willfull he
must be restrained and a strait wastecoat is the only secure
measure and the most gentle that can be employed and if
he proves quite maniacal an authority must be acquired
and even by blows if necessary for there is nothing in
such cases more hurtfull than indulging fits of impetuo¬
sity and passions.
These are ↑the↑advices which I can offer at present but
if the disease draws out into a chronic state there will be
room for further advice which I shall give most willingly
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