Cullen

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

 

[ID:4706] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Colonel Bayly (Bailie) (Patient) / 8 September 1783 / (Outgoing)

Reply 'For Colonel Bayly'

Facsimile

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Metadata

FieldData
DOC ID 4706
RCPE Catalogue Number CUL/1/1/16/110
Main Language English
Document Direction Outgoing
Date8 September 1783
Annotation None
TypeMachine scribal copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply 'For Colonel Bayly'
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1652]
Case of Colonel Bayly [Baillie] who is disposed to gout.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:3239]PatientColonel Bayly (Bailie)
[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]
For Colonel Bayly


After considering the whole circumstances
of the Colonels complaints I am persuaded that the
whole of them depend upon some disposition to the
Gout
in his constitution. The removal from his
side
to his stomach, the various circumstances of
the complaint there and particularly the relief he
has had from a fit of violent Cramps in his limbs
can all be explained upon no other supposition.


To determine the Gout to its proper course
in the extremities would be a very desireable and
certainly the most effectual means of relieving all
his complaints; but this is very little in our power
and all I can propose is to support nature in
any efforts we may suppose her to make and in the
mean time to remove the most troublesome symptom.


For the first of these purposes I have




[Page 2]


prescribed on the paper inclosed two medicines which the
Colonel will please to take as soon as he is settled at home
for a fortnight. I do no desire them to be taken for
longer than a fortnight at one time but after that when
they have been laid aside for two three weeks he may
then take a second course of them and that sooner or
later according to the effects of the first trial and accor¬
ding to any return of his Stomach complaints.


His most troublesome complaint and what
most immediately demands relief is his difficulty of
swallowing
. This I don't suppose to depend upon
any fixed obstruction but judge it to depend very
entirely upon a spasm towards the lower end of the
Gullet
. To obviate this he must never take any thing
cold and before he is to swallow any thing solid he
should endeavour to open the passage by swallowing
a mouthful or two of warm water or other mild liquid.
When he is to swallow any thing solid he must
take care that the first mouthful be extremely well




[Page 3]


chewed and rendered very soft and moist before it goes
into the Gullet. The taking down this will probably
make what goes down afterwards easier but at all
times he should take care that every Morsel that
he is to swallow be always very soft and moist and if
that can be taken care of his solid food may be of
what kind he likes best and some solid food will always
be better for him than much liquid.


By these means I should think a few glasses
of wine very proper for him but they must be always
taken diluted with a little warm water and only taken
immediately after he has swallowed something more
solid.


By these means I hope his swallowing
will be kept tolerably easy till a fit of the Gout shall
come to take off the fit of Spasm entirely but
if it shall happen that these spasms continue to
recur or become more violent I have prescribed on
the inclosed paper a medicine which I hope shall
give him relief. The manner of using it is that




[Page 4]


He is to take a small Phial that will hold about three
spoonfuls of water and he is to pour ↑into it↑ this quantity or
so much as will fill it nearly but not entirely to the
neck. Upon this water he is to pour a small tea
spoonful of the liquor prescribed and immediately
to cork the Phial very closs and immediately also
to invert the Phial and let it stand upon its cork.
In this situation the Phial may remain for any
length of time with the dose ready for use. When
it is to be used the still inverted Phial is to be put
into water somewhat warm but not very warm
and there to remain till the Phial and its contents
have become a little warm, then taking the Phial
from the warm water and keeping it still inverted
the cork is to be drawn out and the liquor allowed
to fall into a tea Cup previously a little warmed
and the dose falling into it instantly swallowed


This medicine will I hope take off any
considerable spasm of the Gullet, but I would




[Page 5]


not have recourse had to it without necessity nor
would I have it oftener employed than necessity
may require.


Beside these remedies if the spasm of the
Gullet
continue to be very troublesome I would
have a piece of Blister applied upon the lower
part of the breast bone
and reaching a little
further down upon the pit of the stomach. If this
give relief to the spasms a part of the blistered
place
may be kept open as a perpetual blister
for eight or ten days but if in that time the relief
that was obtained by the blister does not continue
the issue should be allowed to heal up that a
fresh blister may be again applied.

William Cullen

Edinburgh 8th. Septr.
1783



[Page 6]
For Coll. Bayly

Take one ounce each of the powdered root of Wild valerian and powdered Peruvian bark, two drachms each of powdered cinnamon and Iron Filings, an ounce and a half of Conserve and peel of orange and a sufficient quantity of Simple Syrup to make a soft Electuary. The bigness of a nutmeg to be swallowed in a wafer twice a day, and washed down with a little warm water.

Take half a drachm of Volatile elixir of guaiac, ten drops of Egg yolk and two drachms of Simple Syrup. Bring together and gradually add an ounce and a half of Rose water. Mix and Label: Diaphoretic Draught. To be taken at bedtime having before set the phial in a little warm water. N. B. This draught to be repeated every night for a fortnight.

Take one ounce of the best Liquid æther. Label: Antispasmodic Spirit. N. B. Let some water be put into the phial with this.

W. C.
8th September 1783.

Diplomatic Text

[Page 1]
For Colonel Bayly


After considering the whole circumstances
of the Colonels complaints I am persuaded that the
whole of them depend upon some disposition to the
Gout
in his constitution. The removal from his
side
to his stomach, the various circumstances of
the complaint there and particularly the relief he
has had from a fit of violent Cramps in his limbs
can all be explained upon no other supposition.


To determine the Gout to its proper course
in the extremities would be a very desireable and
certainly the most effectual means of relieving all
his complaints; but this is very little in our power
and all I can propose is to support nature in
any efforts we may suppose her to make and in the
mean time to remove the most troublesome symptom.


For the first of these purposes I have




[Page 2]


prescribed on the paper inclosed two medicines which the
Colonel will please to take as soon as he is settled at home
for a fortnight. I do no desire them to be taken for
longer than a fortnight at one time but after that when
they have been laid aside for two three weeks he may
then take a second course of them and that sooner or
later according to the effects of the first trial and accor¬
ding to any return of his Stomach complaints.


His most troublesome complaint and what
most immediately demands relief is his difficulty of
swallowing
. This I don't suppose to depend upon
any fixed obstruction but judge it to depend very
entirely upon a spasm towards the lower end of the
Gullet
. To obviate this he must never take any thing
cold and before he is to swallow any thing solid he
should endeavour to open the passage by swallowing
a mouthful or two of warm water or other mild liquid.
When he is to swallow any thing solid he must
take care that the first mouthful be extremely well




[Page 3]


chewed and rendered very soft and moist before it goes
into the Gullet. The taking down this will probably
make what goes down afterwards easier but at all
times he should take care that every Morsel that
he is to swallow be always very soft and moist and if
that can be taken care of his solid food may be of
what kind he likes best and some solid food will always
be better for him than much liquid.


By these means I should think a few glasses
of wine very proper for him but they must be always
taken diluted with a little warm water and only taken
immediately after he has swallowed something more
solid.


By these means I hope his swallowing
will be kept tolerably easy till a fit of the Gout shall
come to take off the fit of Spasm entirely but
if it shall happen that these spasms continue to
recur or become more violent I have prescribed on
the inclosed paper a medicine which I hope shall
give him relief. The manner of using it is that




[Page 4]


He is to take a small Phial that will hold about three
spoonfuls of water and he is to pour ↑into it↑ this quantity or
so much as will fill it nearly but not entirely to the
neck. Upon this water he is to pour a small tea
spoonful of the liquor prescribed and immediately
to cork the Phial very closs and immediately also
to invert the Phial and let it stand upon its cork.
In this situation the Phial may remain for any
length of time with the dose ready for use. When
it is to be used the still inverted Phial is to be put
into water somewhat warm but not very warm
and there to remain till the Phial and its contents
have become a little warm, then taking the Phial
from the warm water and keeping it still inverted
the cork is to be drawn out and the liquor allowed
to fall into a tea Cup previously a little warmed
and the dose falling into it instantly swallowed


This medicine will I hope take off any
considerable spasm of the Gullet, but I would




[Page 5]


not have recourse had to it without necessity nor
would I have it oftener employed than necessity
may require.


Beside these remedies if the spasm of the
Gullet
continue to be very troublesome I would
have a piece of Blister applied upon the lower
part of the breast bone
and reaching a little
further down upon the pit of the stomach. If this
give relief to the spasms a part of the blistered
place
may be kept open as a perpetual blister
for eight or ten days but if in that time the relief
that was obtained by the blister does not continue
the issue should be allowed to heal up that a
fresh blister may be again applied.

William Cullen

Edr. 8th. Septr.
1783



[Page 6]
For Coll. Bayly


pulv. rad. valerian. Silv.
-- cort. Peruvian. @ ℥j
-- cinnamon.
Limat. Mart. ppt. @ ʒij
Conserve. e cort. aurantior. ℥iſs
Syr. Simpl. q. s. ut f. Electarium molle
Sig. Stomachic Electuary the bigness of a nutmeg
to be swallowed in a wafer twice a day, and washed
down with a little warm water


Elix. guajacin. vol. ʒſs
Vitell. ovi. gtt. X.
Simple Syrup ʒij
Terito Simul et paulatim adde
Aq. rosar. ℥jſs
ℳ. Sig. Diaphoretic Draught to be taken at bedtime
having before, set the phial in a little warm water.
N. B. This draught to be repeated every night for a fortnight


Liquori æther opt. ℥j
Signa Antispasmodic Spirit
N. B. Let some water be put into the phial with this.

W. C.
8th Septr. 1783.

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