Cullen

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

 

[ID:1844] Case Note / Regarding: Mr Thomas French (Patient) / April? 1780? / (Incoming)

Case note describing the case of Thomas French. Unsigned and undated, but probably from April 1780.

Facsimile

There are 4 images for this document.

[Page 1]


 

[Page 2]


 

[Page 3]


 

[Page 4]


 
 

Metadata

FieldData
DOC ID 1844
RCPE Catalogue Number CUL/1/2/923
Main Language English
Document Direction Incoming
DateApril? 1780?
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Case note describing the case of Thomas French. Unsigned and undated, but probably from April 1780.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1225]
Case of Thomas French who has a stomach complaint.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:1514]Author
[PERS ID:4023]PatientMr Thomas French
[PERS ID:1514]Patient's Physician / Surgeon / Apothecary
[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 Glasgow Glasgow and West Scotland Europe inferred

Normalized Text

[Page 1]


Mr: Thomas French aged 47. Complains of a dullness & heaviness,
Sickness at the stomach, accompanied with very great distension,
Belching of Wind
& total want of appetite. Frequently a Vomi¬
ting
of Insipid phlegm or Bile, but sometimes without this Symp¬
tom. The patient is generally seized early in the morning after
his first sleep, from which time till he gets up, he is Oppressed with
frequent short disturbed sleeps
, with a little sweating & sleight shi¬
vering
upon the acession of cold air. These Complaints general¬
ly continue for two or at most three days, when the Patient gets
well & enjoys a pretty good state of health & spirits for eight
or ten days, sometimes a longer, sometimes a shorter Interval
tho of late they recur more frequently than formerly. This Course
hath been observed ever since May last tho the Patient hath
always had what is called a Weak Stomach.


No Hardness nor swelling of either the Hypochondriæ can be felt,
/ except a general distension of the whole abdomen, evidently from
air during the paroxysm / Belly regular, rather inclining to
be lax than otherwise. Stools of a natural appearance -
urine in proper quantity, at the beginning pale Coloured
towards the End is higher Coloured, & deposits a lateritious
Sediment. No Swelling of the Legs. Pulse variable,
while the disorder continues is generally feeble & from 80 to 90 -
Eyes dull & heavy - face higher coloured than ordinary –
He hath at times complained of cramp pains in the Achilles Ten¬
don
& muscles of the Feet, & he hath also sometimes felt a
High pain in the Ball of his great Toe, but these Symptoms
are by no means constant Attendants. –––



[Page 2]

He never had a fit of the Gout, nor is he of a family where that
disease can be traced. He never was subject to any hæmorrhoidal
discharge ––. For these 20 years he hath lived without
much Exercise, an easy kind of Life; tho' by no means addicted
to Intemperance. His common diet had been Tea twice a day
Spirits & Water at Dinner & Supper & every day he Smokes
three or four Pipes of Tobacco. The skin is generally lax -
with Black Hair & blackish Eyes. ––


Queritus 1st. Are we to consider this disease as a true Dyspepsia
Idiopathica
of which it hath the greatest part of the Pathogno¬
monic Symptoms? or


2d. Are we to consider it as Symptomatic of an Obstruction in
any of the Glandular Abdominal Viscera? or


3d. Are we to consider it as any way connected with the Atonic Gout.
This last Supposition, tho' at least probable, yet the pains about
the feet have always been very slight & so often absent en¬
tirely, that joined to other Considerations it never hath been more
attended to, than just to make me on the Look out, in case it
should Appear that Nature was attempting a Critical deposition
on the Extremities.


As to Obstructions in any of the Glandular Viscera, The absence
of pain & hardness, joined to a regular Belly, with stools of a
Yellow Colour, & Legs in good order have always made me
reject that Supposition –– My Patient had some how or other
got it into his head that his Liver was unsound.


I have therefore always considered & treated it as a Dyspepsia
brought on by an easy full Living, with little Exercise, & probably
encreased by his Smoaking Tobacco. –




[Page 3]


In the Cure Vomits were Employed at the beginning with some
advantage, but on this Patient Vomiting is particularly severe
they therefore have not been much used of late.


Purgatives had also been used at first, but as his Belly is al¬
ways so regular they did not seem to be much indicated, &
their repetition might weaken still more the tone of the
stomach, they have been therefore laid aside.


Of the Class of Tonics several have been tried, or to speak
more properly have been attempted to be tried, for from a
particular Idiosyncrasy this Patients stomach rejects almost
every thing that hath the name & appearance of a Medicine.
Bark in Substance & Cold Infusion, is immediately thrown
up
, in Tincture however is retained.


He hath been tried with pills of Asafœtida & Extract of Gentian
but are hardly swallowed when they are thrown back again
& various preparations have been met with the same fate.
Infusions of Aromatics & Bitters in Spirits, both seperately
& Conjoined are used, & indeed the only Medicines I have ever
got his stomach to retain. Neither the Columba nor
Fava Sancti Ignatii have yet been tried.


I got him a few bottles of Harrogate Water, but its disa¬
greeable taste prevents him from taking any quantity
perhaps Pyrmont Water might answer better.


As to regimen he is to exchange his tea for a trial of Cocoa.
He eats few Vegetables especially such as contain much fixed
air. His Drink is Porter, Spirits & Water, or a Glass of Wine
ocassionally ––––––– & he rides out every good Day



[Page 4]

I have repeatedly urged him to give over Smoking. He once
indeed refrained it for eight or ten days, but as he found no
sensible benefit in that time he just began to it again –


Mr French
April. 1780
V. XI p.3 –

Diplomatic Text

[Page 1]


Mr: Thomas French aged 47. Complains of a dullness & heaviness,
Sickness at the stomach, accompanied with very great distension,
Belching of Wind
& total want of appetite. Frequently a Vomi¬
ting
of Insipid phlegm or Bile, but sometimes without this Symp¬
tom. The patient is generally seized early in the morning after
his first sleep, from which time till he gets up, he is Oppressed with
frequent short disturbed sleeps
, with a little sweating & sleight shi¬
vering
upon the acession of cold air. These Complaints general¬
ly continue for two or at most three days, when the Patient gets
well & enjoys a pretty good state of health & spirits for eight
or ten days, sometimes a longer, sometimes a shorter Interval
tho of late they recur more frequently than formerly. This Course
hath been observed ever since May last tho the Patient hath
always had what is called a Weak Stomach.


No Hardness nor swelling of either the Hypochondriæ can be felt,
/ except a general distension of the whole abdomen, evidently from
air during the paroxysm / Belly regular, rather inclining to
be lax than otherwise. Stools of a natural appearance -
urine in proper quantity, at the beginning pale Coloured
towards the End is higher Coloured, & deposits a lateritious
Sediment. No Swelling of the Legs. Pulse variable,
while the disorder continues is generally feeble & from 80 to 90 -
Eyes dull & heavy - face higher coloured than ordinary –
He hath at times complained of cramp pains in the Achilles Ten¬
don
& muscles of the Feet, & he hath also sometimes felt a
High pain in the Ball of his great Toe, but these Symptoms
are by no means constant Attendants. –––



[Page 2]

He never had a fit of the Gout, nor is he of a family where that
disease can be traced. He never was subject to any hæmorrhoidal
discharge ––. For these 20 years he hath lived without
much Exercise, an easy kind of Life; tho' by no means addicted
to Intemperance. His common diet had been Tea twice a day
Spirits & Water at Dinner & Supper & every day he Smokes
three or four Pipes of Tobacco. The skin is generally lax -
with Black Hair & blackish Eyes. ––


Queritus 1st. Are we to consider this disease as a true Dyspepsia
Idiopathica
of which it hath the greatest part of the Pathogno¬
monic Symptoms? or


2d. Are we to consider it as Symptomatic of an Obstruction in
any of the Glandular Abdominal Viscera? or


3d. Are we to consider it as any way connected with the Atonic Gout.
This last Supposition, tho' at least probable, yet the pains about
the feet have always been very slight & so often absent en¬
tirely, that joined to other Considerations it never hath been more
attended to, than just to make me on the Look out, in case it
should Appear that Nature was attempting a Critical deposition
on the Extremities.


As to Obstructions in any of the Glandular Viscera, The absence
of pain & hardness, joined to a regular Belly, with stools of a
Yellow Colour, & Legs in good order have always made me
reject that Supposition –– My Patient had some how or other
got it into his head that his Liver was unsound.


I have therefore always considered & treated it as a Dyspepsia
brought on by an easy full Living, with little Exercise, & probably
encreased by his Smoaking Tobacco. –




[Page 3]


In the Cure Vomits were Employed at the beginning with some
advantage, but on this Patient Vomiting is particularly severe
they therefore have not been much used of late.


Purgatives had also been used at first, but as his Belly is al¬
ways so regular they did not seem to be much indicated, &
their repetition might weaken still more the tone of the
stomach, they have been therefore laid aside.


Of the Class of Tonics several have been tried, or to speak
more properly have been attempted to be tried, for from a
particular Idiosyncrasy this Patients stomach rejects almost
every thing that hath the name & appearance of a Medicine.
Bark in Substance & Cold Infusion, is immediately thrown
up
, in Tincture however is retained.


He hath been tried with pills of Asafœtida & Extract of Gentian
but are hardly swallowed when they are thrown back again
& various preparations have been met with the same fate.
Infusions of Aromatics & Bitters in Spirits, both seperately
& Conjoined are used, & indeed the only Medicines I have ever
got his stomach to retain. Neither the Columba nor
Fava Sancti Ignatii have yet been tried.


I got him a few bottles of Harrogate Water, but its disa¬
greeable taste prevents him from taking any quantity
perhaps Pyrmont Water might answer better.


As to regimen he is to exchange his tea for a trial of Cocoa.
He eats few Vegetables especially such as contain much fixed
air. His Drink is Porter, Spirits & Water, or a Glass of Wine
ocassionally ––––––– & he rides out every good Day



[Page 4]

I have repeatedly urged him to give over Smoking. He once
indeed refrained it for eight or ten days, but as he found no
sensible benefit in that time he just began to it again –


Mr French
April. 1780
V. XI p.3 –

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