Cullen

The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh

 

[ID:579] From: Dr William Cullen (Professor Cullen) / To: Mr J. Spens / Regarding: Mr J. Spens (Patient) / 19 June 1782 / (Outgoing)

Reply to Mr Spens who has venereal disease. Cullen diagnoses a urethra in 'an indifferent State', further hurt by 'the accidents you mention'. He suggests a mild mercurial injection, and adds that 'you might put this question in my name to John Hunter and I wish to have his opinion'.

Facsimile

There are 4 images for this document.

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Metadata

FieldData
DOC ID 579
RCPE Catalogue Number CUL/1/1/15/63
Main Language English
Document Direction Outgoing
Date19 June 1782
Annotation None
TypeMachine copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply to Mr Spens who has venereal disease. Cullen diagnoses a urethra in 'an indifferent State', further hurt by 'the accidents you mention'. He suggests a mild mercurial injection, and adds that 'you might put this question in my name to John Hunter and I wish to have his opinion'.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1468]
Case of Mr J. Spens who is thought to have gout, but his primary problem is a urinary stricture associated with a venereal infection which he has discussed with the surgeon John Hunter.
6


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:2782]AddresseeMr J. Spens
[PERS ID:2782]PatientMr J. Spens
[PERS ID:2783]Patient's Physician / Surgeon / ApothecaryMr Potts
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:526]Patient's Physician / Surgeon / ApothecaryMr John Hunter

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 London London and South-East England Europe inferred

Normalized Text

[Page 1]

Mr J. Spens

My dear Sir


I have long taken an earnes con¬
cern in your health I shall always be ready to take
care of it as well as I can but I am sorry to find at present
more difficulty than I could wish. Your urethra has
been long in an indifferent State and by the accidents you
mention it must have been further hurt and I think your
present Symptoms of a Stricture returning almost every day
Shows the parts a good deal hurt. I am sorry to find it
Mr Potts opinion that you cannot expect ever to be free
of Some gleet and I am afraid he has some reason for
thinking so but at the same time I am of your opi¬
nion that this would keep you always in a very ticklish
State and that nothing is more desireable for you than
to get entirely free from every kind of running. This I
have been endeavouring to do and Shall endeavour it
Still but it will require time and the present time is not



[Page 2]

at all favourable to it. You must first get quit of your
gonorrhea and all the Symptoms which have any connexion
↑with it↑ Such as the pain of your testicles and as I suspect the
daily Strictures. Your Surgeons one or other must judge
of all this and when they Shall be of opinion that you
are free of the gonorrhea I shall then advise what I
think may be proper to obviate gleet & all its consequences.
In the mean time I wish you would consult your Sur¬
geons whether a mild mercurial injection that is the
mercury very well, exceedingly well triturated with either
Mucilage or unguent and further diffused either in water
or oil might not be of Service to the gonorrhea in particular
and to the urethra in general. I think you might ↑put↑ this
question in my name to John Hunter and I wish to
have his opinion, which I expect he will give with Some
attention as coming from me who recommended you to him.


If I remember right I think the accounts you gave
me of the bougies formerly employed made me judge that
they were not well Suited to your Urethra but I can --



[Page 3]

perceive that at present they may be absolutely necessary
and how far they may be necessary is only to be judged of
partly by your Self but especially by a Surgeon on the Spot.
Your Stricture cannot be Said to be absolutely permanent
but the disposition to it is certainly very permanent and
I cannot allow it to be of a Such a temporary kind as could
be relieved by such a blister as you mention. I don't un¬
derstand Mr Hunters caustic, have no experience of any
Such practice and therefore can give no opinion about it.


There can be no objection to Mr Potts advice of a warm
bath, it can do no harm and may be of Service but I don't
think you can use it So often or So much as to make it of
great Service.


I believe you must at present, if you do not use the
injection I mentioned, allow time for the gentleman to go off
and hardly to use any medicine at all. I think you are
too fond of them, fly to them too Soon and generally use them
too much. I think none of my medicines are very proper
at present but if you are to employ any of them I think



[Page 4]

the balsamic mixture the Safest. Your report of it on the
11th 1 is very favorable and if you have found the like good
effects of it continue I consent to your continuing the medi¬
cine now and then but I must join with yourself in obser¬
ving that you do not give it fair play when you take it at
a time when any other cause of a feverish State is present.


I am sorry that you are at present deprived of exercise
which might keep your body in better plight but I am of
opinion that no kind of exercise is Suited to your present
State. Your fullness is not either favorable to your pre¬
sent ailments but it would not be mended by any purgatives
and I do not advise any because I think it (↑they↑) might be other¬
wise hurtfull. A Spare diet is the only Sure and Safe means
of keeping down your fullness. I don't believe you are
intemperate but at Same time I doubt if your temperance
goes far. Expecting to hear from you often I am with
great regard and Sincere concern Dear Sir


Your most obedient Servant

William Cullen

Edinburgh 18th June 1782.


The influenza on mySelf & many others has made this letter a two days work

Notes:

1: No letter traced, but possibly a verbal report through a third party.

Diplomatic Text

[Page 1]

Mr J. Spens

My dear Sir


I have long taken an earnes con¬
cern in your health I shall always be ready to take
care of it as well as I can but I am sorry to find at present
more difficulty than I could wish. Your urethra has
been long in an indifferent State and by the accidents you
mention it must have been further hurt and I think your
present Symptoms of a Stricture returning almost every day
Shows the parts a good deal hurt. I am sorry to find it
Mr Potts opinion that you cannot expect ever to be free
of Some gleet and I am afraid he has some reason for
thinking so but at the same time I am of your opi¬
nion that this would keep you always in a very ticklish
State and that nothing is more desireable for you than
to get entirely free from every kind of running. This I
have been endeavouring to do and Shall endeavour it
Still but it will require time and the present time is not



[Page 2]

at all favourable to it. You must first get quit of your
gonorrhea and all the Symptoms which have any connexion
↑with it↑ Such as the pain of your testicles and as I suspect the
daily Strictures. Your Surgeons one or other must judge
of all this and when they Shall be of opinion that you
are free of the gonorrhea I shall then advise what I
think may be proper to obviate gleet & all its consequences.
In the mean time I wish you would consult your Sur¬
geons whether a mild mercurial injection that is the
mercury very well, exceedingly well triturated with either
Mucilage or unguent and further diffused either in water
or oil might not be of Service to the gonorrhea in particular
and to the urethra in general. I think you might ↑put↑ this
question in my name to John Hunter and I wish to
have his opinion, which I expect he will give with Some
attention as coming from me who recommended you to him.


If I remember right I think the accounts you gave
me of the bougies formerly employed made me judge that
they were not well Suited to your Urethra but I can --



[Page 3]

perceive that at present they may be absolutely necessary
and how far they may be necessary is only to be judged of
partly by your Self but especially by a Surgeon on the Spot.
Your Stricture cannot be Said to be absolutely permanent
but the disposition to it is certainly very permanent and
I cannot allow it to be of a Such a temporary kind as could
be relieved by such a blister as you mention. I don't un¬
derstand Mr Hunters caustic, have no experience of any
Such practice and therefore can give no opinion about it.


There can be no objection to Mr Potts advice of a warm
bath, it can do no harm and may be of Service but I don't
think you can use it So often or So much as to make it of
great Service.


I believe you must at present, if you do not use the
injection I mentioned, allow time for the gentleman to go off
and hardly to use any medicine at all. I think you are
too fond of them, fly to them too Soon and generally use them
too much. I think none of my medicines are very proper
at present but if you are to employ any of them I think



[Page 4]

the balsamic mixture the Safest. Your report of it on the
11th 1 is very favorable and if you have found the like good
effects of it continue I consent to your continuing the medi¬
cine now and then but I must join with yourself in obser¬
ving that you do not give it fair play when you take it at
a time when any other cause of a feverish State is present.


I am sorry that you are at present deprived of exercise
which might keep your body in better plight but I am of
opinion that no kind of exercise is Suited to your present
State. Your fullness is not either favorable to your pre¬
sent ailments but it would not be mended by any purgatives
and I do not advise any because I think it (↑they↑) might be other¬
wise hurtfull. A Spare diet is the only Sure and Safe means
of keeping down your fullness. I don't believe you are
intemperate but at Same time I doubt if your temperance
goes far. Expecting to hear from you often I am with
great regard and Sincere concern Dear Sir


Your most obedient Servant

William Cullen

Edin.r 18th June 1782.


The influenza on mySelf & many others has made this letter a two days work

Notes:

1: No letter traced, but possibly a verbal report through a third party.

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