Cullen

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

 

[ID:2608] From: Dr John Gilchrist (of Speddoch) / To: Dr William Cullen (Professor Cullen) / Regarding: Mr William McDowall (Macdowall, McDoual, McDowal, McDouall) (Patient), Miss Aitken (Patient), Mr Wellwood Johnstone Maxwell (of Barncleugh) (Patient) / 26 April 1785 / (Incoming)

Letter from John Gilchrist, concerning the case of Mr Maxwell of Barncleugh. He also reports on the progress of Mr McDowall. Also notes that the patient Miss Aitken, he spoke to Cullen about, had died a fortnight ago, "completely worn out".

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Metadata

FieldData
DOC ID 2608
RCPE Catalogue Number CUL/1/2/1654
Main Language English
Document Direction Incoming
Date26 April 1785
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 John Gilchrist, concerning the case of Mr Maxwell of Barncleugh. He also reports on the progress of Mr McDowall. Also notes that the patient Miss Aitken, he spoke to Cullen about, had died a fortnight ago, "completely worn out".
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1107]
Case of Mr William McDowal [McDowall, McDouall], who has a chest complaint and spits blood.
19
[Case ID:1410]
Case of Miss Aitken who has a long-standing, intermittent, painful chest complaint.
5


People linked to this document

Person IDRole in documentPerson
[PERS ID:115]AuthorDr John Gilchrist (of Speddoch)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:1080]PatientMr William McDowall (Macdowall, McDoual, McDowal, McDouall)
[PERS ID:2748]PatientMiss Aitken
[PERS ID:2808]PatientMr Wellwood Johnstone Maxwell (of Barncleugh)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:115]Patient's Physician / Surgeon / ApothecaryDr John Gilchrist (of Speddoch)
[PERS ID:1709]Other Physician / SurgeonMr John Harley

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Dumfries Borders Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe inferred
Mentioned / Other East Indies certain
Mentioned / Other India Asia certain
Mentioned / Other Bristol South-West England Europe certain
Mentioned / Other Barncleugh Dumfries Borders Scotland Europe certain

Normalized Text

[Page 1]
Dumfries April 26. 1785
Dear Sir


I duly received yours, dated in February, which it was needless to trou¬
ble you with acknowledging, on the Case of Mr McDowall, as to whom
I shall only say at present, that he has been in a tolerable way since
you saw him. -- As he may undertake a journey soon, he has desired
me to ask if you would think any mineral water adviseable. - He
once went to Bristol, but tho he got there, was prevented from
staying to drink the water. -- When I formerly spoke of a trial of
some very mild mercurial preparation in this Case (with a view to its
being so managed, or so combined, as to act as a diaphoretic),
it was just proposed in the way of holding out something to a
desponding patient that might at least please himself, when noth¬
ing else, seemingly of any consequence, could be talked of -- In
proper consumptive Cases, I have repeatedly and carefully tried
Mercury, in the first stage, without perceiving the least advantage
from it, tho' this is what I need not say to say to you. -- Miss
Aitken about whom I lately consulted you died a fortnight
ago, completely worne out. -- To the usual œdematous swellings
of the extremities, generally or always occurring more or less to¬
wards the termination of such cases, there was added in this Case
what I do not recollect to have seen before, - a considerable de¬
gree of real Ascites, which subsisted for several weeks, and cau¬
sed great distress at the last.


I am just waiting for Mr Harley Surgeon here, in order that
we may give you an account of the Case of a Gentleman of this quar¬
ter, his Brother in law, which, tho' it may not appear very formi¬
dable in any of its particular symptoms, yet when a general
view of all its circumstances is taken, gives I fear too good
cause of apprehension to his family and friends. --- I shall be
very happy if you can put us upon any thing that may give
a favourable turn to it.


The Patient is Mr Maxwell of Barncleugh, who is at pre¬
sent about the age of 38 and of a very unhealthy family. His
Mother died consumptive, and his two elder, and only, Brothers, were
carried off in what have been vulgarly termed deep consumptions.




[Page 2]


This gentleman himself, tho always reckoned to be of a delicate
constitution, has had no great threatenings of any pulmonary
disorder
. He passed two or three years, I believe, -- in the East In¬
dies when about the age ↑of 25↑ and bore that climate well, tho he suf¬
fered a good deal from the inflammatory affection of the Liver
occurring frequently in India; but it was attended with no bad
consequences. --- About ten years ago, soon after his marriage
I remember he spoke to me about a cough, or some other Com¬
plaints of his breast, which however were but slight and transi¬
ent; and, upon the whole he has been liable to no complaints of
that kind but what any body, from cold, might be liable to. Mr Max¬
well, tho not like a strong man, has by no means an unhealthy
appearance; -- and, for these ten years past he has been of a full
enough
habit, that is no way thin at any time. -- Two of his
children who are alive, are for their time of life, sufficiently
hale & thriving. --- With all this however, circumstances denoting
considerable delicacy, and relaxation, have at times occurred wi[th]
him. -- When about sixteen he became subject to a degree of th[e]
Prolapsus ani, which has never left him; and, when connected
with present circumstances, distresses him a good deal, - He has been
liable to the Piles, or at least to a considerable discharge of
blood from some parts of the rectum, for several years past; and
particularly last year. -- Another circumstance to be mentioned is
that, above two years ago, he was seized with a Sore throat, which
in two or three days, became very evidently a putrid one, by which
a good part of the velum pendulum palate was destroyed, (tho'
in a little time the deficiency was pretty well supplied) and the
uvula had almost dropt of. Since that time till now he has
enjoyed very good health, and has lived very regularly. He
always eats heartily; &, before the attack of the Angina, sometimes
exceeded in drinking; tho he never failed to suffer a good deal
in his stomach, two or three days after, for so doing.


Now to come to his present state, he was seized five or six weeks



[Page 3]

ago with what was called a bilious disorder, attended with more or less
vomiting and purging, which readily gave way to some Antimonials or
other emetics; and the state of his pulse was such that a small quan¬
tity of blood was drawn
. After this he seemed to be quite well again.
But, about a fortnight ago, he was seized anew with the uneasiness
in his stomach and bowels, producing frequent retchings, sometimes
very severe, a degree of diarrhœa at times, tho' the stools were seldom
copious, or very frequent; -- and sometimes a very disagreeable ten¬
esmus
, with a sense of tenderness or soreness in the rectum. At
first these complaints were attended with a very considerable
and oppressive headach; tho for several days past, that symptom
has been in a great measure removed; and his tongue, which
was moderately white and furred, is now much cleaner and
moister. --- For these ten days past, during which I have visited
him, his pulse has never risen above 95. It is commonly
about 85, or between that and 90, quite regular; & tolerably
firm or full for the most part, tho somewhat weak at times
.


--- The sickness at stomach, and retchings, for some days past
have been frequently recurring, and distress him greatly. - At
present too the diarrhœa too is often returning, that is 4 or 5
times in the night - or in the day, tho' the stools ↑in general↑ are far from
being very copious -- Five or six days ago his s↑t↑ools began
to be bloody
. -- At first the quantity of blood, (and that not
very considerable,) seemed equally mixed with the stool. - For
three or four days past the blood has been so plainly separ¬
ate from the fæces, as to leave no doubt that it comes after
them; and from the rectum. -- Sometimes one ounce perhaps; &
sometimes perhaps two or ↑even↑ three ounces of blood will be dis¬
charged. --- The Prolapsus ani constantly takes place to a
certain degree when he is at stool. --- Tho' a good deal of
Blood must have been discharged, yet his pulse remains as I
mentioned & his general strength is not much impaired;
but



[Page 4]

his spirits are exceedingly sunk so that he can scarcely
speak
to us; -- and he expresses the strongest apprehension
of his own danger. --- I must conclude, as the post
is just going, with adding hastily --- that he has
no kind of appetite - & is sensible of getting no sleep,
but, by opiates. --- We have used according to cir¬
cumstances -- gentle emetics & laxatives of different
kinds -- Columbo root - Saline draughts in the state
of Effervescence & other usual things - general or
local - I must only add that I am as always

Dear Sir Truly Yours
John Gilchrist


On reading over the above with Mr Harley
the only circumstance I have to add is that
when I was called to him there was a con¬
siderable pain in the right side - with some
fulness which gave apprehension - of something
wrong about the liver -- but since a large
Blister was applied on the part he has
complained of nothing there --


Dr. Gilchrist
Concerning Mr Maxwell
April 1785
V. XVII P. 45

Diplomatic Text

[Page 1]
Dumfries Apr: 26. 1785
Dear Sir


I duly received yours, dated in Febry, which it was needless to trou¬
ble you with acknowledging, on the Case of Mr McDowall, as to whom
I shall only say at present, that he has been in a tolerable way since
you saw him. -- As he may undertake a journey soon, he has desired
me to ask if you would think any mineral water adviseable. - He
once went to Bristol, but tho he got there, was prevented from
staying to drink the water. -- When I formerly spoke of a trial of
some very mild mercurial preparation in this Case (with a view to its
being so managed, or so combined, as to act as a diaphoretic),
it was just proposed in the way of holding out something to a
desponding patient that might at least please himself, when noth¬
ing else, seemingly of any consequence, could be talked of -- In
proper consumptive Cases, I have repeatedly and carefully tried
Mercury, in the first stage, without perceiving the least advantage
from it, tho' this is what I need not say to say to you. -- Miss
Aitken about whom I lately consulted you died a fortnight
ago, completely worne out. -- To the usual œdematous swellings
of the extremities, generally or always occurring more or less to¬
wards the termination of such cases, there was added in this Case
what I do not recollect to have seen before, - a considerable de¬
gree of real Ascites, which subsisted for several weeks, and cau¬
sed great distress at the last.


I am just waiting for Mr Harley Surgeon here, in order that
we may give you an account of the Case of a Gentleman of this quar¬
ter, his Brother in law, which, tho' it may not appear very formi¬
dable in any of its particular symptoms, yet when a general
view of all its circumstances is taken, gives I fear too good
cause of apprehension to his family and friends. --- I shall be
very happy if you can put us upon any thing that may give
a favourable turn to it.


The Patient is Mr Maxwell of Barncleugh, who is at pre¬
sent about the age of 38 and of a very unhealthy family. His
Mother died consumptive, and his two elder, and only, Brothers, were
carried off in what have been vulgarly termed deep consumptions.




[Page 2]


This gentleman himself, tho always reckoned to be of a delicate
constitution, has had no great threatenings of any pulmonary
disorder
. He passed two or three years, I believe, -- in the East In¬
dies when about the age ↑of 25↑ and bore that climate well, tho he suf¬
fered a good deal from the inflammatory affection of the Liver
occurring frequently in India; but it was attended with no bad
consequences. --- About ten years ago, soon after his marriage
I remember he spoke to me about a cough, or some other Com¬
plaints of his breast, which however were but slight and transi¬
ent; and, upon the whole he has been liable to no complaints of
that kind but what any body, from cold, might be liable to. Mr Max¬
well, tho not like a strong man, has by no means an unhealthy
appearance; -- and, for these ten years past he has been of a full
enough
habit, that is no way thin at any time. -- Two of his
children who are alive, are for their time of life, sufficiently
hale & thriving. --- With all this however, circumstances denoting
considerable delicacy, and relaxation, have at times occurred wi[th]
him. -- When about sixteen he became subject to a degree of th[e]
Prolapsus ani, which has never left him; and, when connected
with present circumstances, distresses him a good deal, - He has been
liable to the Piles, or at least to a considerable discharge of
blood from some parts of the rectum, for several years past; and
particularly last year. -- Another circumstance to be mentioned is
that, above two years ago, he was seized with a Sore throat, which
in two or three days, became very evidently a putrid one, by which
a good part of the velum pendulum palate was destroyed, (tho'
in a little time the deficiency was pretty well supplied) and the
uvula had almost dropt of. Since that time till now he has
enjoyed very good health, and has lived very regularly. He
always eats heartily; &, before the attack of the Angina, sometimes
exceeded in drinking; tho he never failed to suffer a good deal
in his stomach, two or three days after, for so doing.


Now to come to his present state, he was seized five or six weeks



[Page 3]

ago with what was called a bilious disorder, attended with more or less
vomiting and purging, which readily gave way to some Antimonials or
other emetics; and the state of his pulse was such that a small quan¬
tity of blood was drawn
. After this he seemed to be quite well again.
But, about a fortnight ago, he was seized anew with the uneasiness
in his stomach and bowels, producing frequent retchings, sometimes
very severe, a degree of diarrhœa at times, tho' the stools were seldom
copious, or very frequent; -- and sometimes a very disagreeable ten¬
esmus
, with a sense of tenderness or soreness in the rectum. At
first these complaints were attended with a very considerable
and oppressive headach; tho for several days past, that symptom
has been in a great measure removed; and his tongue, which
was moderately white and furred, is now much cleaner and
moister. --- For these ten days past, during which I have visited
him, his pulse has never risen above 95. It is commonly
about 85, or between that and 90, quite regular; & tolerably
firm or full for the most part, tho somewhat weak at times
.


--- The sickness at stomach, and retchings, for some days past
have been frequently recurring, and distress him greatly. - At
present too the diarrhœa too is often returning, that is 4 or 5
times in the night - or in the day, tho' the stools ↑in general↑ are far from
being very copious -- Five or six days ago his s↑t↑ools began
to be bloody
. -- At first the quantity of blood, (and that not
very considerable,) seemed equally mixed with the stool. - For
three or four days past the blood has been so plainly separ¬
ate from the fæces, as to leave no doubt that it comes after
them; and from the rectum. -- Sometimes one ounce perhaps; &
sometimes perhaps two or ↑even↑ three ounces of blood will be dis¬
charged. --- The Prolapsus ani constantly takes place to a
certain degree when he is at stool. --- Tho' a good deal of
Blood must have been discharged, yet his pulse remains as I
mentioned & his general strength is not much impaired;
but



[Page 4]

his spirits are exceedingly sunk so that he can scarcely
speak
to us; -- and he expresses the strongest apprehension
of his own danger. --- I must conclude, as the post
is just going, with adding hastily --- that he has
no kind of appetite - & is sensible of getting no sleep,
but, by opiates. --- We have used according to cir¬
cumstances -- gentle emetics & laxatives of different
kinds -- Columbo root - Saline draughts in the state
of Effervescence & other usual things - general or
local - I must only add that I am as always

Dear Sir Truly Yours
John Gilchrist


On reading over the above with Mr Harley
the only circumstance I have to add is that
when I was called to him there was a con¬
siderable pain in the right side - with some
fulness which gave apprehension - of something
wrong about the liver -- but since a large
Blister was applied on the part he has
complained of nothing there --


Dr. Gilchrist
C. Mr Maxwell
April 1785
V. XVII P. 45

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