The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:336] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Earl Thomas Kennedy (Lord Cassillis, 9th Earl of Cassillis, 4th Baronet of Culzean, 11th Lord Kennedy) (Patient) / 19 September 1775 / (Outgoing)
Reply 'To Dr Gillespie about the Earl of Cassillis'.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 2 images for this document.
[Page 1]
[Page 2]
Metadata
| Field | Data |
|---|---|
| DOC ID | 336 |
| RCPE Catalogue Number | CUL/1/1/6/35 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 19 September 1775 |
| Annotation | None |
| Type | Scribal copy ( includes Casebook Entry) |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | No |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply 'To Dr Gillespie about the Earl of Cassillis'. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:3] |
Case of Earl Cassillis, who is fevered, weak and in a state of terminal decline; eventually includes a post-mortem report. |
7 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:549] | Patient | Earl Thomas Kennedy (Lord Cassillis, 9th Earl of Cassillis, 4th Baronet of Culzean, 11th Lord Kennedy) |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:552] | Patient's Physician / Surgeon / Apothecary | Dr Thomas Gillespie |
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 | Cullean Castle; Culzean Castle | Maybole | Glasgow and West | Scotland | Europe | inferred |
Normalized Text
To Dr Gilespie about the Earl of Cassills
From my Lord constitution sufficiently suited
to the gout & his once having had an appearance of it, I have
no doubt of a gouty disposition subsisting & having some
share in the present complaints but at the same time I am
convinced that much of them is of the rheumatic kind. -
In this view I think all the evaluations you have provided
have been very proper but I believe also that it is right that
they have been topical rather than general. You have very
properly endeavoured to excite some determination to the
lower extremities but I have seldom had any success in
that way & if more blistering is necessary I would certainly
apply it to the parts immediately affected. As matters seem
to stand at present the remedy I would depend upon is
Dovers powder which properly conducted is of great service
in all such cases & I can see no objections to it in this. I
don't perceive that you have put my Lord in flannel but I
think you should & his Lordship should not only be in
a flannel shirt but laid also in blankets when he takes
the medicine mentioned. I would begin with a dose of
twenty grains & give that in the morning when the usual
time of sleeping is quite over. It will be best taken made
into a bolus & swallowed in a wafer that any nausea
may be avoided & for the same purpose his Lordship
should not drink any for some time after or till there
is some appearance of sweat. X To favour this the body &
arms are to be covered close but with little or no addition
of blankets except on the feet & legs where they may
be laid on pretty thick & if the sweat does not come freely
to the feet & legs it should be encouraged by bottles of hot
water or boiled bricks laid to the feet. When the sweat
appears his Lordship should drink frequently by a
[Page 2]
little at a time of some warm weak liquor as weak bohea
tea, weak sage tea, water gruel or weak beef tea & the last
with a little dry toast may be given at any time as
nourishment. By this management the sweat is to be
continued in a moderate degree & with as little heat as
possible as long as his Lordship easily bears it. I would
wish it for at least twelve hours. However when it is
necessary to let it cease or that it ceases of itself, let him
be shifted into dry flannels & blankets & lay out his
Arms but it will be best for him to continue in bed
till next morning, & to keep his chamber all next day.
If my Lord bears it well & finds the relief I expect I
would after one day or two ↑at farthest↑ repeat the practise increas¬
ing the dose to twentyfive or thirty grains as your
discretion shall direct. Tho my Lord shall find much
relief from these measures he must be very cautious
in quitting his chamber or coming in to the air for some
time after for I suspect that the returns of ailment which
his Lordship has had have been owing to some want
of caution in this respect. I lay my stress on this measure
& therefore say little about Others. ------ Your dose of Emetic
tartar & laudanum on Sunday night was somewhat of
the same kind but I expect you will find the Dovers
powder more effectuall & your medicine & your medicine
may have its place afterwards. I observe that there has
been several threatings of feverish fits but I doubt if
these will be so regular or give such clear intermissions
as to admit of the bark. An attention to the state of the
belly is very necessary & I need not doubt of your bestowing
it. I have only to add that when ever pains are urgent
to special bleeding & blistering are not only allowable but
the most necessary & certain means of relief. ______
Diplomatic Text
To Dr Gilespie about the Earl of Cassills
From my Lord constitution sufficiently suited
to the gout & his once having had an appearance of it, I have
no doubt of a gouty disposition subsisting & having some
share in the present complaints but at the same time I am
convinced that much of them is of the rheumatic kind. -
In this view I think all the evaluations you have provided
have been very proper but I believe also that it is right that
they have been topical rather than general. You have very
properly endeavoured to excite some determination to the
lower extremities but I have seldom had any success in
that way & if more blistering is necessary I would certainly
apply it to the parts immediately affected. As matters seem
to stand at present the remedy I would depend upon is
Dovers powder which properly conducted is of great service
in all such cases & I can see no objections to it in this. I
don't perceive that you have put my Lord in flannel but I
think you should & his Lordship should not only be in
a flannel shirt but laid also in blankets when he takes
the medicine mentioned. I would begin with a dose of
twenty grains & give that in the morning when the usual
time of sleeping is quite over. It will be best taken made
into a bolus & swallowed in a wafer that any nausea
may be avoided & for the same purpose his Lordship
should not drink any for some time after or till there
is some appearance of sweat. X To favour this the body &
arms are to be covered close but with little or no addition
of blankets except on the feet & legs where they may
be laid on pretty thick & if the sweat does not come freely
to the feet & legs it should be encouraged by bottles of hot
water or boiled bricks laid to the feet. When the sweat
appears his Lordship should drink frequently by a
[Page 2]
little at a time of some warm weak liquor as weak bohea
tea, weak sage tea, water gruel or weak beef tea & the last
with a little dry toast may be given at any time as
nourishment. By this management the sweat is to be
continued in a moderate degree & with as little heat as
possible as long as his Lordship easily bears it. I would
wish it for at least twelve hours. However when it is
necessary to let it cease or that it ceases of itself, let him
be shifted into dry flannels & blankets & lay out his
Arms but it will be best for him to continue in bed
till next morning, & to keep his chamber all next day.
If my Lord bears it well & finds the relief I expect I
would after one day or two ↑at farthest↑ repeat the practise increas¬
ing the dose to twentyfive or thirty grains as your
discretion shall direct. Tho my Lord shall find much
relief from these measures he must be very cautious
in quitting his chamber or coming in to the air for some
time after for I suspect that the returns of ailment which
his Lordship has had have been owing to some want
of caution in this respect. I lay my stress on this measure
& therefore say little about Others. ------ Your dose of Emetic
tartar & laudanum on Sunday night was somewhat of
the same kind but I expect you will find the Dovers
powder more effectuall & your medicine & your medicine
may have its place afterwards. I observe that there has
been several threatings of feverish fits but I doubt if
these will be so regular or give such clear intermissions
as to admit of the bark. An attention to the state of the
belly is very necessary & I need not doubt of your bestowing
it. I have only to add that when ever pains are urgent
to special bleeding & blistering are not only allowable but
the most necessary & certain means of relief. ______
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