Cullen

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

 

[ID:498] From: Dr William Cullen (Professor Cullen) / To: Anonymous / Regarding: Mr William Leslie (Leslye) (Patient) / 11 July 1774 / (Outgoing)

Reply 'For Mr Leslie'

Facsimile

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Metadata

FieldData
DOC ID 498
RCPE Catalogue Number CUL/1/1/3/76
Main Language English
Document Direction Outgoing
Date11 July 1774
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply 'For Mr Leslie'
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:466]
Case of Mr Leslie whose symptoms are considered rheumatic rather than gouty. He is travelling to Bath for treatment. Leslie consults Cullen again, over a locked, painful jaw, in 1781 (see Case:302).
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1343]Addressee
[PERS ID:177]PatientMr William Leslie (Leslye)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:1343]Patient's Relative / Spouse / Friend

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 Banff (Bamf) East Highlands Scotland Europe inferred
Mentioned / Other Norway Europe certain

Normalized Text

[Page 1]
For Mr Leslie
Dear Dr.


I have at length seen your friend Mr Leslie have
heard his story fully & considered it to all the attention &cc.
His symptoms have had all the appearance of Rheumatism
but I cannot be certain that they are not gouty. Their occupying
chiefly the knees & their suffering a translation to the hind¬
head
without taking any intermediate joint, the pain of his
knees relieving his spirits & clearing his head & his
sometimes having some qualms at the stomach are all
grounds of suspicion of the disease being gouty & if
there remains any doubt of this I say that Rheumatism
which suffers such translations & shews any connexion
to internal parts is to be treated as the Gout.


Upon this plan I think he must depend very much
upon his Regimen. I would not have him go to
Norway this winter but to pass it in a tolerably mild
& dry climate. While the season in this country
allows of it he should be very much on horseback or in
a carriage taking always great care to avoid Cold by warm
cloathing & other precuations. Application to business &
want of exercise seem to have hurt him & to avoid these
causes seems to be a strong reason for his being
absent from Norway for a long time to come.


In diet I would not enjoin a total abstinence
from meat and wine but I'm confident that the less he
takes of either he will be the better. He is of that consti¬
tution & time of life at which I think one might prevent
very entirely either rheumatism or gout by abstinence &
I think at least he should practise great moderation till he



[Page 2]

is very free from this disease.


these are measures which if tolerably prosecuted will I hope
prevent any return of his ailments but if either the nature
of the ailment too obstinate for my regimen or accidents
shall occasion any relapse. I shall now give you my opinion
how it should be treated. If the pains appear only in the knees
I would have him cover the part well with soft flannel &
wait with some patience for the pains going off of itself. If the
pain be exquisite with much fever I would consent to a bleeding,
which even the Gout in young persons will bear & if with the
fever the pains attack other points with more appearance of
Rheumatism there will be little or no doubt of the propriety
of bleeding. If the pain affecting only the knees be severe
with little or very moderate fever he may get relief by
leeches applied to the part & the more readily of there be any
swelling upon it. If when the pain has been in the knees it
be suddenly translated to the hind head & be there severe
it may be relieved by leeches & better still by a cup¬
ping glass
if he be in a place where it can be execu¬
ted. However severe the pain may be in the knees I would
never apply blisters to that part but when the pain is in the hind¬
head
& does not yield to other remedies. I would have
little hesitation in applying a blister there.


Whenever there is any attack of pain with any degree
of fever it will be very proper to keep his belly regular
& even open but I think purging is not proper unless
the rheumatic nature of the disease should be better ascer¬
tained.




[Page 3]


If this disease shall return & also keep lingering
about him the medicine I would depend upon is Dover's
Powder
the most certain cure of Rheumatism & not impro¬
per in the gout unless too frequently used. Wherever it is
proper much depends upon the administration. I give it in
the morning laying the person entirely in woollen & endeavour
to continue the sweating till night even then taking great care to
avoid cold. The effects depend upon the sweating being
brought out & carried on with little heat, on its being
universal, long continued, & on guarding against cold by
keeping in bed for a day or 2 after.

W. C.

Edinburgh 11 July
1774

Diplomatic Text

[Page 1]
For Mr Leslie
Dr Dr.


I have at length seen yr friend Mr Leslie have
heard his story fully & considered it to all ye attention &cc.
His sympts have had all ye appearance of Rheumatism
bt I cannot be certain yt yy are not gouty. Yr occupying
chiefly ye knees & yr suffering a translation to ye hind¬
head
wout taking any intermediate joint, ye pn of his
knees relieving his spirits & clearing his head & his
sometimes having some qualms at the stom. are all
grounds of suspicion of ye disease being gouty & if
yre remains any doubt of ys I say that Rheumatism
wc suffers such translations & shews any connexion
to internal parts is to be treated as the Gout.


Upon ys plan I think he must depend very mc
upon his Regimen. I would not have him go to
Norway ys winter bt to pass it in a tolerably mild
& dry climate. While ye season in this country
allows of it he should be very mc on horseback or in
a carriage taking always gt care to avoid Cold by warm
cloathing & other precuations. Applicn. to business &
want of exercise seem to have hurt him & to avoid yse
causes seems to be a strong reason for his being
absent from Norway for a long time to come.


In diet I would not enjoin a total abstinence
from meat and wine bt I'm confident yt ye less he
takes of either he will be ye better. He is of yt consti¬
tution & time of life at wc I think one mt prevent
very entirely either rheumatism or gout by abstinence &
I think at least he should practise gt moderation till he



[Page 2]

is very free fm ys disease.


Yse are measures wc if tolerably prosecuted will I hope
prevent any return of his ailments bt if either ye nature
of the ailment too obstinate for my regimen or accidents
shall occasn any relapse. I shall now give you my opinn
how it should be treated. If ye pns appear only in ye knees
I would have him cover ye pt well w soft flannel &
wait w some patience for ye pns going off of itself. If ye
pn be exquisite w mc fever I would consent to a bleedg.,
wc even ye Gout in young persons will bear & if w ye
fever ye pns attack other points w more appearance of
Rheumatism yre will be little or no doubt of ye propriety
of bleeding. If ye pn affecting only ye knees be severe
w little or very moderate fever he may get relief by
leeches applied to ye pt & ye more readily of yre be any
swelling upon it. If wn ye pn has bn in ye knees it
be suddenly translated to ye hind head & be yre severe
it may be relieved by leeches & better still by a cup¬
ping glass
if he be in a place where it can be execu¬
ted. However severe ye pn may be in ye knees I would
never apply blisters to yt pt bt wn ye pn is in ye hind¬
head
& does not yield to other remedies. I would have
little hesitation in applying a blister yre.


Whenever yre is any attack of pn w any degree
of fever it will be very proper to keep his belly regular
& even open bt I think purging is not proper unless
ye rheumatic nature of ye disease should be better ascer¬
tained.




[Page 3]


If ys disease shall return & also keep lingering
about him ye medicine I would depend upon is Dover's
Powder
ye most certain cure of Rheumatism & not impro¬
per in ye gout unless too frequently used. Wherever it is
proper mc depends upon ye administration. I give it in
ye morn. laying ye person entirely in woollen & endeavour
to cont ye sweating till nt. even yn taking gt care to
avoid cold. Ye effects depend upon ye sweating being
brought out & carried on w little heat, on its being
universal, long continued, & on guarding agst cold by
keeping in bed for a d. or 2 after.

W. C.

Edr 11 July
1774

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