Cullen

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

 

[ID:1241] From: Dr Thomas Gillespie / To: Dr William Cullen (Professor Cullen) / Regarding: Earl Thomas Kennedy (Lord Cassillis, 9th Earl of Cassillis, 4th Baronet of Culzean, 11th Lord Kennedy) (Patient) / 1 February 1776 / (Incoming)

Letter from Thomas Gillespie, giving Cullen a post mortem report on the autopsy of Lord Cassillis.

Facsimile

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Metadata

FieldData
DOC ID 1241
RCPE Catalogue Number CUL/1/2/341
Main Language English
Document Direction Incoming
Date1 February 1776
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy Yes
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from Thomas Gillespie, giving Cullen a post mortem report on the autopsy of Lord Cassillis.
Manuscript Incomplete? No
Evidence of Commercial Posting Yes

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 IDRole in documentPerson
[PERS ID:552]AuthorDr Thomas Gillespie
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:549]PatientEarl Thomas Kennedy (Lord Cassillis, 9th Earl of Cassillis, 4th Baronet of Culzean, 11th Lord Kennedy)
[PERS ID:552]Patient's Physician / Surgeon / ApothecaryDr Thomas Gillespie
[PERS ID:545]OtherDr Archibald Cullen (Ar or Arch)
[PERS ID:652]OtherMr Craigengillan (Graigengillan)
[PERS ID:544]OtherDr Henry Cullen (Harry, Dr Henry, "the young doctor" )

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Ayr (Air) Glasgow and West Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain
Place of Handstamp Ayr (Air) Glasgow and West Scotland Europe certain

Normalized Text

[Page 1]
Dear Doctor


I should have wrote you long 'ere now relative to the
appearances on opening the Body of the late Lord Cassillis
who died the day after my last to you; but that I have been
afflicted with a violent Inflammation in my Eyes and
Migrim on one of my Temples, and since I recovered have
been much from home. By mistake my last to you
was dated the day his Lordship died, which ought to have been
the day before. – His Cough and breathlessness became more
troublesome and uneasie to him that evening which contin¬
ued & encreased thro' the night. – The next morning, a Rattling
in his breast came on; he became speechless, and about three
o'Clock in the afternoon he expired easily. Eight & forty hours
after his Lordships death I opened the thorax & abdomen. In
the Thorax the Bronchial Glands both before & behind were Schirrous
to a very considerable degree. – Those before were as large as a Goose
Egg, and those behind, that of a Hen. – They were very little advanc'd
in the ulcerous state. The Lungs in the Right cavity of
the Thorax, were in a pretty sound state and did not adher any
where to the Pleura. Those in the Left Cavity, adhered not
in points; but universally where ever they could come in
contact, and that so firmly as that they could not be separated
without the knife or tearing. In the under part where they
adhered to the diaphragm there was a considerable Schir¬
rous
induration,and about two Inches from that, and more
in their substance another, of smaller bulk, both of which



[Page 2]

were tending to suppuration and further advanced than the
Bronchial Glands. The Heart was large & flaccid, and
neither it nor the large vessells were stuffed with any Poly¬
pous concretions and contained very little Blood.


In the abdomen, the lower Intestines were extremely loaded
with hard, large formed fæces, down to about six or seven inches
from the anus, where there was a schirrus & constriction in
the Rectum, which was pretty much in a suppurated state, in
so much that when it was taken hold of to examine, it readily
separated and presented at each end a small orifice that would
hardly transmit ones smallest finger. Betwixt this
narrow part of the Gut and the anus were some of these small
part formed excrements often mentioned in the course of
my correspondence with you, plainly shaped from passing
thro' this neck. The great sack of the colon was extremely
loaded with hard excrements and adhered very firmly to the
Peritoneum along the course of the Psoas muscle. Both
kidneys were large, and full of schirrous indurations; but
none of them tending to suppuration. On cutting into these,
and the bump on his Lordships forehead, the very same
appearance took place. The stomach, Liver &c were all
in a pretty sound state. I was fatigued & time would not
well admit of opening his Lordships head. – Perhaps some
such appearance as were external & in the Contents of the
Thorax & abdomen, might have been within the Cranium.
I apprehend it would be difficult to account for the violent



[Page 3]

and long continued headachs his Lordship was afflicted
with, from what was discovered and above narrated. Dis¬
coveries in the head, perhaps would have left us as much in the
dark. I dare not hazard any observations or remarks
on this obscure & perplexing case, particularly to you
whose Ingenuity & penetration would very probably detect
my ignorance & want of discernment.


By the by my Lord Cassillis is to be in your City in
a few days, and if you have an opportunity of paying
your Compliments to him I beg you may not
take any notice of your being so late of hearing
from me on the above subject, as perhaps he
would think it odd I had not wrote you before.


Our mutual friend Graigengillan is to be in the
East country in less than a month, I have desired him
to consult you when he gets to Town. He has been threat¬
ened with a kind of dysury of late. If I see him again
before he goes in, perhaps I will write you.


I beg my Compliments to Mrs. Cullen and your young
Gentlemen, 1 I hope you will keep your word and
alow them to make this place a part of their Rout 2 next
summer, when I shall endeavour to administer to
their Conveniency & pleasure as much as in my power.


Believe me always to be Dr. Dr. your most affectionate friend
and obedient humble servant
Thos. Gillespie
Air Feb 1st 1776



[Page 4]


To
Doctor William Cullen
Physician
Edinburgh


Dissection of Lord Cassillis
from Dr Gillespie
1st Febry 1776
Vol IV. p44.

Notes:

1: Dating implies this probably refers to Cullen's sons Archibald (born 1755) and Henry (born 1758).

2: Variant spelling of 'route', the implication being that Cullen's sons undertake some sort of seasonal social tour.

Diplomatic Text

[Page 1]
Dear Doctor


I should have wrote you long 'ere now relative to the
appearances on opening the Body of the late Lord Cassillis
who died the day after my last to you; but that I have been
afflicted with a violent Inflammation in my Eyes and
Migrim on one of my Temples, and since I recovered have
been much from home. By mistake my last to you
was dated the day his Lordship died, which ought to have been
the day before. – His Cough and breathlessness became more
troublesome and uneasie to him that evening which contin¬
ued & encreased thro' the night. – The next morning, a Rattling
in his breast came on; he became speechless, and about three
o'Clock in the afternoon he expired easily. Eight & forty hours
after his Lordships death I opened the thorax & abdomen. In
the Thorax the Bronchial Glands both before & behind were Schirrous
to a very considerable degree. – Those before were as large as a Goose
Egg, and those behind, that of a Hen. – They were very little advanc'd
in the ulcerous state. The Lungs in the Right cavity of
the Thorax, were in a pretty sound state and did not adher any
where to the Pleura. Those in the Left Cavity, adhered not
in points; but universally where ever they could come in
contact, and that so firmly as that they could not be separated
without the knife or tearing. In the under part where they
adhered to the diaphragm there was a considerable Schir¬
rous
induration,and about two Inches from that, and more
in their substance another, of smaller bulk, both of which



[Page 2]

were tending to suppuration and further advanced than the
Bronchial Glands. The Heart was large & flaccid, and
neither it nor the large vessells were stuffed with any Poly¬
pous concretions and contained very little Blood.


In the abdomen, the lower Intestines were extremely loaded
with hard, large formed fæces, down to about six or seven inches
from the anus, where there was a schirrus & constriction in
the Rectum, which was pretty much in a suppurated state, in
so much that when it was taken hold of to examine, it readily
separated and presented at each end a small orifice that wd.
hardly transmit ones smallest finger. Betwixt this
narrow part of the Gut and the anus were some of these small
part formed excrements often mentioned in the course of
my correspondence with you, plainly shaped from passing
thro' this neck. The great sack of the colon was extremely
loaded with hard excrements and adhered very firmly to the
Peritoneum along the course of the Psoas muscle. Both
kidneys were large, and full of schirrous indurations; but
none of them tending to suppuration. On cutting into these,
and the bump on his Lordships forehead, the very same
appearance took place. The stomach, Liver &c were all
in a pretty sound state. I was fatigued & time would not
well admit of opening his Lordships head. – Perhaps some
such appearance as were external & in the Contents of the
Thorax & abdomen, might have been within the Cranium.
I apprehend it wd. be difficult to account for the violent



[Page 3]

and long continued headachs his Lordship was afflicted
with, from what was discovered and above narrated. Dis¬
coveries in the head, perhaps wd. have left us as much in the
dark. I dare not hazard any observations or remarks
on this obscure & perplexing case, particularly to you
whose Ingenuity & penetration wd. very probably detect
my ignorance & want of discernment.


By the by my Lord Cassillis is to be in your City in
a few days, and if you have an opportunity of paying
your Compliments to him I beg you may not
take any notice of your being so late of hearing
from me on the above subject, as perhaps he
wd. think it odd I had not wrote you before.


Our mutual friend Graigengillan is to be in the
East country in less than a month, I have desired him
to consult you when he gets to Town. He has been threat¬
ened with a kind of dysury of late. If I see him again
before he goes in, perhaps I will write you.


I beg my Compts to Mrs. Cullen and your young
Gentlemen, 1 I hope you will keep your word and
alow them to make this place a part of their Rout 2 next
summer, when I shall endeavour to administer to
their Conveniency & pleasure as much as in my power.


Believe me always to be Dr. Dr. your most afft. friend
and obt. huble. servt.
Thos. Gillespie
Air Feb 1st 1776



[Page 4]


To
Doctor William Cullen
Physician
Edinburgh


Dissection of Ld Cassillis
from Dr Gillespie
1st Febry 1776
Vol IV. p44.

Notes:

1: Dating implies this probably refers to Cullen's sons Archibald (born 1755) and Henry (born 1758).

2: Variant spelling of 'route', the implication being that Cullen's sons undertake some sort of seasonal social tour.

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