Cullen

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

 

[ID:1207] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Anonymous (Patient) / 1775? / (Outgoing)

Directions by Cullen for an unnamed male patient who has suffered from various complaints after a fall. An undated, heavily contracted loose draft. The annotation at the bottom of the verso was probably added in the nineteenth century. The details remain unaccountable. Dating entirely based upon current placing in archive. Of all letters concerning persons ill after a fall the 'representation' mentioned in document ID:892 is the most likely match. If so, then this reply dates from 1774, but in either case the patient remains anonymous.

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Metadata

FieldData
DOC ID 1207
RCPE Catalogue Number CUL/1/2/307
Main Language English
Document Direction Outgoing
Date1775?
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen Yes
Letter of Introduction No
Case Note No
Summary Directions by Cullen for an unnamed male patient who has suffered from various complaints after a fall. An undated, heavily contracted loose draft. The annotation at the bottom of the verso was probably added in the nineteenth century. The details remain unaccountable. Dating entirely based upon current placing in archive. Of all letters concerning persons ill after a fall the 'representation' mentioned in document ID:892 is the most likely match. If so, then this reply dates from 1774, but in either case the patient remains anonymous.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:620]
Case of an unnamed patient whose symptoms are attributed to concussion to their kidneys and other parts after a fall.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1464]Patient
[PERS ID:1463]Patient's Physician / Surgeon / ApothecaryDr Mead
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)

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

Normalized Text

[Page 1]
Dear Sir


an anxiety to consider the subject fully & an uncommon degree
of occupation has made me later in writing to you than I wish. I own
after much consideration your ailments are a little difficult to account for. It is
possible that the concussion from the fall you had [which?] hurt your kidneys but by the
[{illeg}alre?] of the problems which followed after. I believe the effects of the fall were chiefly
on the muscles & that your kidneys were only hurt by the immoderate quantity of [soap?]
you took in a very short space. I must doubt if you have set down
{illeg} numbers exactly. for I have known severals who toyed with
soap than could bear & I have never known one who could bear ℥iv in
one day without being very sick & being purged very briskly whereas ypur
account says you took above 1/2lb per day for a month. If it was so
I am not surprised that [yr?] going by urine overstretched the vessels
of the kidneys & [on ye least check?] of perspiration made you liable
to Diabetes & tho' it had ceased for some time I shall not
wonder if upon certain occasions you shall have some return of it.
When it does happen in any degree you may expect a suppression at least some
interruption of {illeg} secretions & in this way I account for not only your costiveness
{illeg} for a suppression of the secretion of Bile & in consequence of the colour of your stools
A Jaundice is only the consequence of an obstruction of the Bile se¬
creted & will not be produced by a suppression of the sectretion itself. You say
you have no doubt of the excretories of the Liver being obstructed but I think
you should have said the secretories which makes some difference. I have
not time to tell you how much Dr Mead is mistaken with respect to
the influence of the Liver in Diabetes. without disrupting the state of
either your Liver or kidneys I must give my view of the matter. I
think the tone of your abdominal viscera is much weakened & this will pro¬
duce relaxation in one part & obstruct in another & particularly in the alimentary
canal
will produce indigestion & flatulency. To restore the tone
in general, Bark, Chalybeates, & cold bathing may be employed &
among the rest the alum whey which as a saline matter will be applied
to the kidneys more than to any [Other?] part among the strengtheners I
must not ommitt being much on horseback which not only strengthens
the system in general but also relieves the viscera by promoting perspiration
& if you must otherwise keep in view by [usn?] belt & flannel. It may ↓be↓



[Page 2]

very proper also to promote the secretion of Bile & the only means
I certainly know of for the purpose is vomiting butdo not push it too
far for frequent vomiting weakens the stomach. [when ye?] secretion of bile is
restored the intestines may (↑will↑) be sluggish & may require a free
stimulus but I think a warmer purgative than the soluable Tartar
would be proper & I believe the Pil stomatic London Pharmacopoeia would answer
I believe the flatulency of your Intestines will be relieved by the
Thebaic Tincture & you may not be able to disperse with it
but it will not strengthen & it may increase costiveness & I would
wish to avoid it as much as possible. & CC

W.C.

?
Who What Where
When

Diplomatic Text

[Page 1]
Dr Sir


an anxiety to consider ye subject fully & an uncommon degree
of occupation has made me later in writing to you yn I wish. I own
aftr much considn yr ailmts are a little difficult to account for. It is
possible yt ye concussion from ye fall you had [wh?] hurt yr kidneys bt by y
[{illeg}alre?] of ye pms wch followd aftr. I believe ye effts of ye fall were chiefly
on ye muscles & yt yr kidneys were only hurt by ye immoderate qty of [soap?]
you took in a very short space. I must doubt if you have set down
{illeg} numbers exactly. for I have known severals who toyed w.t
soap yn could bear & I have never known one who could bear ℥iv in
one day wth being very sick & being purged very briskly whereas yr
acct says you took above 1/2lb per day for a month. If it was so
I am not surprised that [yr?] going by urine overstretched ye vessels
of ye kidneys & [on ye least check?] of perspiratn made you liable
to Diabetes & tho' it had ceased for some time I shall not
wonder if upon certain occasions you shall have some return of it.
Wn it does happen in any degree you may expect a suppressn at least some
interruptn of {illeg} secrets & in ys way I acct for not only yr costiveness
{illeg} for a suppressn of ye secretn of Bile & in conseqnce of ye colour of yr stools
A Jaundice is only ye consequence of an obstructn of the Bile se¬
creted & will not be produced by a suppressn of the secretn itself. You say
you have no doubt of ye excretories of ye Liver being obstructed bt I think
you should have said ye secretories wch makes some difference. I have
not time to tell you how much Dr Mead is mistaken wth respect to
ye influence of ye Liver in Diabetes. Wth.t disrupting ye state of
either yr Liver or kidneys I must give my view of ye matter. I
think ye tone of yr abdominl viscer. is much weakened & ys will pro¬
duce relaxatn in one pt & obstruct in anothr & particy in ye alimen.
canal
will produce indigestion & flatulency. To restore ye tone
in general, Bark, Chalybeates, & cold bathing may be employed &
among ye rest ye alum whey wch as a saline mattr will be appld
to ye kidneys more yn to any [Other?] pt among ye strengtheners I
must not ommitt being much on horseback wch not only strengthens
ye systm in generl bt also relieves ye viscera by promoting perspirn
& if you must otherwise keep in view by [usn?] belt & flannel. It may ↓be↓



[Page 2]

very proper also to promote ye secretn of Bile & ye only means
I certainly know of for ye purpose is vomg btdo not push it too
far for freqt vomg weakens ye stom.. [when ye?] secretn of bile is
restored ye intestines may (↑will↑) be sluggish & may require a free
stimulus bt I think a warmer purgative yn ye soluble Tartr
would be propr & I believe ye Pil stomatic Ph. L. would answer
I believe ye flatulency of yr Intestines will be relieved by ye
Tinct. Thebaica & you may not be able to disperse wt it
bt it will not strengthen & it may increase costiveness & I would
wish to avoid it as much as possible. & CC

W.C.

?
Who What Where
When

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