Cullen

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

 

[ID:1242] From: Mr Andrew Liddell (Liddle) / To: [ADDRESSEE UNKNOWN] / Regarding: Alexander Dunbar (Patient) / 21? February 1776 / (Incoming)

Letter from Andrew Liddell - who usually writes from Thurso - describing the case of Mr Alexander Dunbar, the 13-year-old son of Captain Dunbar of Westfield. He has been 'subject to irregular & wandering Pains of his Belly' since infancy.

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Metadata

FieldData
DOC ID 1242
RCPE Catalogue Number CUL/1/2/342
Main Language English
Document Direction Incoming
Date21? February 1776
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from Andrew Liddell - who usually writes from Thurso - describing the case of Mr Alexander Dunbar, the 13-year-old son of Captain Dunbar of Westfield. He has been 'subject to irregular & wandering Pains of his Belly' since infancy.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:438]
Case of Mr Alexander Dunbar, adolescent son of Captain Dunbar of Westfield who has been 'subject to irregular & wandering Pains of his Belly' since infancy and who develops severe back pain, dizziness and an inability to stand.
5


People linked to this document

Person IDRole in documentPerson
[PERS ID:339]AuthorMr Andrew Liddell (Liddle)
[PERS ID:557]Patient Alexander Dunbar
[PERS ID:339]Patient's Physician / Surgeon / ApothecaryMr Andrew Liddell (Liddle)
[PERS ID:558]Patient's Relative / Spouse / FriendCaptain G Dunbar

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Thurso North Highlands Scotland Europe inferred
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain

Normalized Text

[Page 1]
Feb. 1776


Mr. Alexander Dunbar, son to Captain Dunbar of Westfield
aged 13 years, is of a tall slender make, growing fast, with
a delicate appearance. Much given to reading & study
but very little inclined to take exercise.


From his infancy He was subject to irregular & wandering
Pains of his Belly.


About 6 years ago He discharged several Long Round Worms.
For many years past He has been affected with violent
startings in his sleep
.


Sometimes there are intervals of many months, during
which the Patient is in good Health & spirits, & looks well.
These continue longest when He uses much Exercise, &
his Belly is kept regular. –– But often his complaints return
in a week or Fortnight, which happens principally in winter,
or when he is confind by bad weather.


At present the disorder proceeds in the following manner.
At first He begins to complain of the pains of his belly, which
are not fixd in one place, nor regular in their returns, some¬
times very acute, sometimes rather dull & heavy: His appe¬
tite fails
: He looks pale: He is quite low spirited: He
becomes costive, & if He continues so for 2 or 3 days is
sure to have the starting in his sleep: This, He observes, is
preceded the evening before by a sensation of heat, & some confu¬
sion of mind
; also if he slumbers for a few minutes thro' the day



[Page 2]

time, He is very ready to have the starting that night:
When seized with it He starts up in his sleep, either to his
seat or feet, stares amazed with his eyes open, utters frightened
cries, is insensible of surrounding objects, & when the fit is
over is not conscious of what ↑hath↑ pass'd, but feels some remains
of terror & affright without knowing the cause of it. ––


All this is sometimes momentary, but it frequently lasts
one, two or three minutes. ––


These two last months the returns of the pain are attended
with a degree of swelling over the whole belly, which tho'
sometimes pretty considerable, comes on & goes off
suddenly, seldom continuing above a quarter of an hour.
Sometimes theres a discharge of Flatus, which gives relief.
This distention takes place whether the Patient be costive
or has passage of his belly, & sometimes comes on immedi¬
ately after a stool. When the swelling is away, there is
no hardness to be discovered in any part of his Belly.
I never observed him feverish in the smallest degree.
His pulse is regular, seldom about 70 in a minute.
When called to Mr Dunbar in September 1774, I gave him
P. Stanni & afterwards two smart doses of Physic; but he
discharged no worms then nor since.


I observed when the disorder came on that it's duration
was shortened by a gentle Laxative, & Vomit.


During the intervals of his complaints he sometimes used



[Page 3]

the Bark & vinous stomachic Tincture, & even directed
to exercise himself abroad as much as he could conveni¬
ently, to use a light Diet & such as might serve ↑to↑ keep off
costiveness, & when that was insufficient to take a gentle
Laxative.

Dear Sir


I have sent you the foregoing Case in order to
have your opinion & advice. – As I had great dubiety
bout the cause of this complaint, the directions I
gave were only with a view to palliate, in hope
that longer time & observation might
more plainly point out its nature.
But before any thing further be at¬
tempted I think it necessary to have your Judgment
& Direction, which I hope you will favour one with
as fully as you think necessary & as soon as shall be
convenient for you.


With best wishes & greatest regard I am
Dear Sir
your very faithfully & Obedient servant
Andrew Liddell

To Doctor Cullen




[Page 4]


Doctor William Cullen
Physician
Edinburgh


The Swelling in the Belly has been more
frequent since Doctor Liddell wrote this within
some days ago 1


Mr Liddell. q.
Mr Dunbar. Alexr.
Feb. 1776
& Mr G. Dunbar
Feb July 1775
Vol. IV. p. 120 & 135

Notes:

1: Added on outer page of the letter after sealing, possibly by the young patient's father.

Diplomatic Text

[Page 1]
Feb. 1776


Mr. Alexander Dunbar, son to Capt. Dunbar of Westfield
aged 13 years, is of a tall slender make, growing fast, with
a delicate appearance. Much given to reading & study
but very little inclined to take exercise.


From his infancy He was subject to irregular & wandering
Pains of his Belly.


About 6 years ago He discharged several Long Round Worms.
For many years past He has been affected with violent
startings in his sleep
.


Sometimes there are intervals of many months, during
which the Patient is in good Health & spirits, & looks well.
These continue longest when He uses much Exercise, &
his Belly is kept regular. –– But often his complaints return
in a week or Fortnight, which happens principally in winter,
or when he is confind by bad weather.


At present the disorder proceeds in the following manner.
At first He begins to complain of the pains of his belly, which
are not fixd in one place, nor regular in their returns, some¬
times very acute, sometimes rather dull & heavy: His appe¬
tite fails
: He looks pale: He is quite low spirited: He
becomes costive, & if He continues so for 2 or 3 days is
sure to have the starting in his sleep: This, He observes, is
preceded the evening before by a sensation of heat, & some confu¬
sion of mind
; also if he slumbers for a few minutes thro' the day



[Page 2]

time, He is very ready to have the starting that night:
When seized with it He starts up in his sleep, either to his
seat or feet, stares amazed with his eyes open, utters frightened
cries, is insensible of surrounding objects, & when the fit is
over is not conscious of what ↑hath↑ pass'd, but feels some remains
of terror & affright without knowing the cause of it. ––


All this is sometimes momentary, but it frequently lasts
one, two or three minutes. ––


These two last months the returns of the pain are attended
with a degree of swelling over the whole belly, which tho'
sometimes pretty considerable, comes on & goes off
suddenly, seldom continuing above a quarter of an hour.
Sometimes theres a discharge of Flatus, which gives relief.
This distention takes place whether the Patient be costive
or has passage of his belly, & sometimes comes on immedi¬
ately after a stool. When the swelling is away, there is
no hardness to be discovered in any part of his Belly.
I never observed him feverish in the smallest degree.
His pulse is regular, seldom about 70 in a minute.
When called to Mr Dunbar in September 1774, I gave him
P. Stanni & afterwards two smart doses of Physic; but he
discharged no worms then nor since.


I observed when the disorder came on that it's duration
was shortened by a gentle Laxative, & Vomit.


During the intervals of his complaints he sometimes used



[Page 3]

the Bark & vinous stomachic Tincture, & even directed
to exercise himself abroad as much as he could conveni¬
ently, to use a light Diet & such as might serve ↑to↑ keep off
costiveness, & when that was insufficient to take a gentle
Laxative.

Dr Sir


I have sent you the foregoing Case in order to
have your opinion & advice. – As I had great dubiety
bout the cause of this complaint, the directions I
gave were only with a view to palliate, in hope
that longer time & observation might
more plainly point out its nature.
But before any thing further be at¬
tempted I think it necessary to have your Judgment
& Direction, which I hope you will favour one with
as fully as you think necessary & as soon as shall be
convenient for you.


With best wishes & greatest regard I am
Dear Sir
your very faithfully & Obedt. servt.
Andrew Liddell

To Doctor Cullen




[Page 4]


Doctor William Cullen
Physician
Edinburgh


The Swelling in the Belly has been more
frequent since Doctor Liddell wrote this within
some days ago 1


Mr Liddell. q.
Mr Dunbar. Alexr.
Feb. 1776
& Mr G. Dunbar
Feb July 1775
Vol. IV. p. 120 & 135

Notes:

1: Added on outer page of the letter after sealing, possibly by the young patient's father.

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