The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:4717] From: Dr William Cullen (Professor Cullen) / To: Mr William Clapham / Regarding: Mr Holt (Patient) / October? 1783? / (Outgoing)
Letter concerning the case of Mr Holt.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 5 images for this document.
[Page 1]
[Page 2]
[Page 3]
[Page 4]
[Page 5]
Metadata
| Field | Data |
|---|---|
| DOC ID | 4717 |
| RCPE Catalogue Number | CUL/1/1/16/121 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | October? 1783? |
| Annotation | None |
| Type | Machine copy |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | Yes |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Letter concerning the case of Mr Holt. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1593] |
Case of Mr Holt with a history of nephritis and swollen feet which may have been gout, but who is now suffering from a severe asthma. |
2 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:3453] | Addressee | Mr William Clapham |
| [PERS ID:3452] | Patient | Mr Holt |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:3453] | Patient's Physician / Surgeon / Apothecary | Mr William Clapham |
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 | Yorkshire | North-East | England | Europe | inferred | |
| Mentioned / Other | Newcastle upon Tyne | North-East | England | Europe | certain |
Normalized Text
Mr. Holt.
Dear Sir
I am favoured with yours of the 20th. and both
your Patient and I are much obliged to you for the full
accurate and judicious account you have given of the Case.
I have no sort of doubt with respect to the nature
of the disease and you have very clearly perceived it to
be founded entirely in a Gouty Diathesis, for I hold the
Nephritic and podagric disposition to be one and
the same; and the effect of your blistering and the
fit of Gout brought on by it in relieving the Asthma
shows clearly enough, that this last is entirely owing
to the Gout and Nephralgia not taking the proper
course. And I expect that this notion will be confir¬
med by some relief of the Asthma from the Nephral¬
gic fit that happened in the night before your letter.
This is enough with respect to my opinion
of the Case and with respect to the Cure of it I hope
[Page 2]
I may be also useful to you. But in the first place I
must say that your good judgement has anticipated some
part of my advice. Your attempting to restore the tone
of the stomach by Bark and Chalybeates was very
judicious, but on many occasions I have found this
measure to be slow and therefore I do not consider
that you perhaps have not ↑yet↑ seen the effects of it,
your Blistering equally judicious promised and
obtained more immediate relief, and, I think
you must endeavour to render the benefit of it
more permanent, by putting in a pea issue on
the inside of the knee a little below the joint.
I would for the present give up the use of the
Tonics strictly so called, and I would try to support
the tone of the stomach and some determination
to the surface of the body by the use of Gum
[Page 3]
Guaiac. I offer you a formula below but have
you to vary it at your discretion; and particularly
instead of the Solution I have given to give draughts
for single doses every night at bed time. The Doses
in my opinion should be just, such as to keep the
belly regular. This will be more necessary if you
shall attempt, as I think you may try to relieve
his Asthma by Opiates, which I have often found
both safe and effectual, but leave you to determine
in this more clearly by trials. Besides what I
have advised, I must say; that in all such mixed
cases of Gout and Gravel, I always employ some
Alkaline remedies, and of all others I think
the Caustic Lixivium the most effectual & for
the particular use of this I need not offer you any
directions.
I add no more advice at present but if
[Page 4]
hereafter you think I can be of any further service you
may depend upon my punctual attention. With respect
to the Fee I have no objection to it, but the trouble of
negotiating so small a Draught at such a distance.
If you shall ever have occasion to send me a Fee your
best way would be to Send it to Newcastle where they
always have Scotch notes every day at hand.
Your Fee does not give me half so much pleasure
as knowing that you are alive and well and as I
hope in a thriving way. Believe me to be most sin¬
cerely
Your affectionate and most obedient
humble Servant
Edinburgh 26th. September
1783
I have said nothing above of Diet or Exercise because
these can be directed more properly by a person on the spot.
[Page 5]
For Mr. Holt.
Take two drachms of Gum Guaiacum and three drachms of the purest white sugar. Crush them in a fine powder, to which you will add one ounce of raw mucilage of gum Arabicum. Crush them diligently again, and add, little by little, half an ounce of Volatile Elixir Guaiacum, once ounce of nutmeg water, three ounces of simple peppermint water and three ounces of simple cinnamon water. Mix and Label: Diaphoretic Solution. A tablespoon more or less to be taken every night at bedtime shaking the phial always very well before pouring out.
26th. September 1783
Diplomatic Text
Mr. Holt.
Dear Sir
I am favoured with yours of the 20th. and both
your Patient and I are much obliged to you for the full
accurate and judicious account you have given of the Case.
I have no sort of doubt with respect to the nature
of the disease and you have very clearly perceived it to
be founded entirely in a Gouty Diathesis, for I hold the
Nephritic and podagric disposition to be one and
the same; and the effect of your blistering and the
fit of Gout brought on by it in relieving the Asthma
shows clearly enough, that this last is entirely owing
to the Gout and Nephralgia not taking the proper
course. And I expect that this notion will be confir¬
med by some relief of the Asthma from the Nephral¬
gic fit that happened in the night before your letter.
This is enough with respect to my opinion
of the Case and with respect to the Cure of it I hope
[Page 2]
I may be also useful to you. But in the first place I
must say that your good judgement has anticipated some
part of my advice. Your attempting to restore the tone
of the stomach by Bark and Chalybeates was very
judicious, but on many occasions I have found this
measure to be slow and therefore I do not consider
that you perhaps have not ↑yet↑ seen the effects of it,
your Blistering equally judicious promised and
obtained more immediate relief, and, I think
you must endeavour to render the benefit of it
more permanent, by putting in a pea issue on
the inside of the knee a little below the joint.
I would for the present give up the use of the
Tonics strictly so called, and I would try to support
the tone of the stomach and some determination
to the surface of the body by the use of Gum
[Page 3]
Guaiac. I offer you a formula below but have
you to vary it at your discretion; and particularly
instead of the Solution I have given to give draughts
for single doses every night at bed time. The Doses
in my opinion should be just, such as to keep the
belly regular. This will be more necessary if you
shall attempt, as I think you may try to relieve
his Asthma by Opiates, which I have often found
both safe and effectual, but leave you to determine
in this more clearly by trials. Besides what I
have advised, I must say; that in all such mixed
cases of Gout and Gravel, I always employ some
Alkaline remedies, and of all others I think
the Caustic Lixivium the most effectual & for
the particular use of this I need not offer you any
directions.
I add no more advice at present but if
[Page 4]
hereafter you think I can be of any further service you
may depend upon my punctual attention. With respect
to the Fee I have no objection to it, but the trouble of
negotiating so small a Draught at such a distance.
If you shall ever have occasion to send me a Fee your
best way would be to Send it to Newcastle where they
always have Scotch notes every day at hand.
Your Fee does not give me half so much pleasure
as knowing that you are alive and well and as I
hope in a thriving way. Believe me to be most sin¬
cerely
Your affectionate and most obedient
humble Servant
Edinr. 26th. Septr.
1783
I have said nothing above of Diet or Exercise because
these can be directed more properly by a person on the spot.
[Page 5]
For Mr. Holt.
℞ Gum Guaiac
Sacchar. alb. purifs. @ ʒij
Terito simul in pulverem tenuem cui adde
Mucilag. gum. Arab. crafs. ℥j
Terito iterum diligenter et paulatim adde
Elixir. Guaiacum Volat. ℥fs
Aq. nuc. muschat. ℥j
--- menth. piper. simpl.
--- cinnamom. simpl. @ ℥iij
ℳ. Sig. Diaphoretic Solution
A Table Spoonful more or less to be taken every
night at bed time shaking the Phial always
very well before pouring out
26th. Septr. 1783
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