The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:4777] From: Dr William Cullen (Professor Cullen) / To: Dr John Campbell (of Wellwood) / Regarding: Mr Alexander Montgomerie (Montgomery; of Coylesfield) (Patient), Lady Mary Lindsay (Lindsay Crawford; later, of Crawford Priory and Kilbirnie.) (Patient) / 24 January 1784 / (Outgoing)
Reply, for 'Dr Campbell'. This letter, addressed to Dr John Campbell, concerns his as-yet unnamed female patient (Lady Mary Lindsay), whose kidney ailment Cullen regards as 'partly spasmodic, partly inflammatory'. Cullen advises on diet, medicine, and the restriction of exercise, particularly advising against dancing. He also thanks Campbell for his account of Montgomerie of Coilsfield's dissection. The enclosed prescription for a diuretic decoction is in Cullen's own hand.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 6 images for this document.
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Metadata
| Field | Data |
|---|---|
| DOC ID | 4777 |
| RCPE Catalogue Number | CUL/1/1/16/181 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 24 January 1784 |
| Annotation | None |
| Type | Machine scribal copy |
| Enclosure(s) | Enclosure(s) present |
| Autopsy | No |
| Recipe | Yes |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply, for 'Dr Campbell'. This letter, addressed to Dr John Campbell, concerns his as-yet unnamed female patient (Lady Mary Lindsay), whose kidney ailment Cullen regards as 'partly spasmodic, partly inflammatory'. Cullen advises on diet, medicine, and the restriction of exercise, particularly advising against dancing. He also thanks Campbell for his account of Montgomerie of Coilsfield's dissection. The enclosed prescription for a diuretic decoction is in Cullen's own hand. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1624] |
Case of Mr Alexander Montgomery of Coylesfield who Cullen believes has passed some gallstones and is jaundiced; upon his death in 1784 there is a postmortem examination. |
5 |
| [Case ID:1746] |
Case of Lady Mary Lindsay, who has a kidney and urinary disorder, as reported by Dr John Campbell. |
4 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:1586] | Addressee | Dr John Campbell (of Wellwood) |
| [PERS ID:5090] | Patient | Lady Mary Lindsay (Lindsay Crawford; later, of Crawford Priory and Kilbirnie.) |
| [PERS ID:3155] | Patient | Mr Alexander Montgomerie (Montgomery; of Coylesfield) |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:1586] | Patient's Physician / Surgeon / Apothecary | Dr John Campbell (of Wellwood) |
| [PERS ID:5089] | Patient's Relative / Spouse / Friend | Countess Jean Lindsay (of Crawford; Lady Craufurd) |
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 | Ayr (Air) | Glasgow and West | Scotland | Europe | inferred | |
| Mentioned / Other | Coilsfield House / Montgomerie House | Tarbolton | Glasgow and West | Scotland | Europe | certain |
Normalized Text
Dr Campbell
I am favoured with yours of the 20th. but
as it communicates a singular Case I have taken a
day to think on it. Now after thinking I still
find it singular and cannot very positively decide
with regard to the nature of it. The absence of
Vomiting and in the course of so many years no
appearance of Sand or Gravel makes me con¬
clude that it is not a Calculous case, and what
else it is difficult to say. I am entirely of your
opinion that there is no probability of the dose
of salts the Lady's mother speaks of bringing on
this disease but there must have been some
other circumstances not now to be discovered which
about that time brought on an affection of
the kidneys which has never since been entirely
[Page 2]
removed. This appears to me to be partly spasmodic,
partly inflammatory and neither purely the one nor
the other. I judge it Spasmodic because it comes in
fits at considerable intervals, because the most usual
time of these is at the approach of Menstruation
and because the disease consists in a strong constriction
of the Secretory vessels and has that also commu¬
nicated to the other parts of the Urinary passage
but at the same time, its being brought on by exercise,
its spreading upwards with severe pains, its being
relieved both by topical and general bleedings, the
blood appearing sizy and its being attended with
fever, and its being increased by the warmth of the
bed shews that a great deal of an inflammatory
state is present. You will please consider the
whole of these circumstances and give me your
doubts and remarks if you have any with regard
[Page 3]
to my conclusion. In the mean time I proceed upon
my own opinion and advise
1 That the young Lady takes for sometime
to a light diet chiefly of milk and farinacea.
2. That she avoids all violent exercise particularly
Dancing, that she takes none by walking or riding but
in the most gentle manner and during the week before
her period that she is particularly cautious in these
respects.
3d. That at all times she guards against any
degree of costiveness and when it comes on that it
be presently removed by a gentle laxative and that
unless in the week before her period her bowels
are very manifestly clear that she takes a dose of
such laxative.
4th. That every night at bedtime she takes
a dose of the Diuretic infusion (↑decoction↑). This is prescribed
[Page 4]
below. These are the remedies I would propose for
preventing any returns of the disease and how much¬
soever there may be of spasmodic in the Case
there is at the same time so much of the inflam¬
matory that I dare not advise any tonic remedies
but if you have spoken of any such and particularly
of the bark I think an infusion of it in water
can do no harm.
With respect to the management of fits when
they come on I can offer no amendment of your
practice. According to the degree of fever and pain
a bleeding may be necessary, laxative glysters
and fomentation will always be so and the only
addition I can think of is the trial of an opiate
and in the case of a little fever or when fever occurs
after bleeding I would think the trial of an opiate per¬
fectly safe and I can trust the dose and repetition of it with
great confidence to your discretion.
[Page 5]
I readily excuse your not mentioning the young
Lady's name. I am much obliged to you for your
account of Coylsfield's dissection but I have no
time for giving you any remarks upon it.
Dear Dr
Your most Obedient Servant
Edinburgh 24th. January
1784
[Page 6]
✍ For Miss
Take half an ounce of well-bruised Juniper Berries, and two drachms each of the best Frankincense and wild carrot Seed. Cook down from three to two pints of water, adding towards the end one ounce of grated liquorice Root. After removing from the fire, add an ounce of regenerated Tartar and two ounces of composite Juniper Water. Then, after it has settled, strain through paper. Label: Diuretic Decoction, about a gill of it to be taken every night at bedtime.
24th January
1784.
Diplomatic Text
Dr Campbell
I am favoured with yours of the 20th. but
as it communicates a singular Case I have taken a
day to think on it. Now after thinking I still
find it singular and cannot very positively decide
with regard to the nature of it. The absence of
Vomiting and in the course of so many years no
appearance of Sand or Gravel makes me con¬
clude that it is not a Calculous case, and what
else it is difficult to say. I am entirely of your
opinion that there is no probability of the dose
of salts the Lady's mother speaks of bringing on
this disease but there must have been some
other circumstances not now to be discovered which
about that time brought on an affection of
the kidneys which has never since been entirely
[Page 2]
removed. This appears to me to be partly spasmodic,
partly inflammatory and neither purely the one nor
the other. I judge it Spasmodic because it comes in
fits at considerable intervals, because the most usual
time of these is at the approach of Menstruation
and because the disease consists in a strong constriction
of the Secretory vessels and has that also commu¬
nicated to the other parts of the Urinary passage
but at the same time, its being brought on by exercise,
its spreading upwards with severe pains, its being
relieved both by topical and general bleedings, the
blood appearing sizy and its being attended with
fever, and its being increased by the warmth of the
bed shews that a great deal of an inflammatory
state is present. You will please consider the
whole of these circumstances and give me your
doubts and remarks if you have any with regard
[Page 3]
to my conclusion. In the mean time I proceed upon
my own opinion and advise
1 That the young Lady takes for sometime
to a light diet chiefly of milk and farinacea.
2. That she avoids all violent exercise particularly
Dancing, that she takes none by walking or riding but
in the most gentle manner and during the week before
her period that she is particularly cautious in these
respects.
3d. That at all times she guards against any
degree of costiveness and when it comes on that it
be presently removed by a gentle laxative and that
unless in the week before her period her bowels
are very manifestly clear that she takes a dose of
such laxative.
4th. That every night at bedtime she takes
a dose of the Diuretic infusion (↑decoction↑). This is prescribed
[Page 4]
below. These are the remedies I would propose for
preventing any returns of the disease and how much¬
soever there may be of spasmodic in the Case
there is at the same time so much of the inflam¬
matory that I dare not advise any tonic remedies
but if you have spoken of any such and particularly
of the bark I think an infusion of it in water
can do no harm.
With respect to the management of fits when
they come on I can offer no amendment of your
practice. According to the degree of fever and pain
a bleeding may be necessary, laxative glysters
and fomentation will always be so and the only
addition I can think of is the trial of an opiate
and in the case of a little fever or when fever occurs
after bleeding I would think the trial of an opiate per¬
fectly safe and I can trust the dose and repetition of it with
great confidence to your discretion.
[Page 5]
I readily excuse your not mentioning the young
Lady's name. I am much obliged to you for your
account of Coylsfield's dissection but I have no
time for giving you any remarks upon it.
Dear Dr
Your most Obedient Servant
Edinr. 24th. Jany.
1784
[Page 6]
✍ For Miss
℞ Baccar. Juniper. bene contus. ℥ſs
Summitt. abiatis
Sem. dauc. silv. @ ʒij
Coque ex aquæ lbiij ad lib. ij addens
sub finem Rad glycyrrh. ras. ℥j
Remotis ab igne adde
Tartar. regenerat. ℥j
Aq. Junip. comp. ℥ij
Denique post subsidentiam per chartam cola.
Signa Diuretic Decoction, about a gill of it to be taken
every night at bedtime
24th Janry.
1784.
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