Cullen

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

 

[ID:2214] From: Mr John Goodsir / To: Dr William Cullen (Professor Cullen) / Regarding: Mr David Bethune (of Kilconquhar; of Balfour) (Patient) / 23 May 1782 / (Incoming)

Letter from John Goodsir concerning the case of Mr Bethune, who has since been seen by Dr Black. Although there are no new symptoms, those existing 'have gradually become more violent & continued', with pains in the colon, a tenesmus, retching, and nephritic symptoms. He needs laudanum to sleep, and purgatives and injections to pass stools. Goodsir writes to both William and, by inference, Henry Cullen who had attended Bethune. The address page was subsequently been used to make some sums which may have no connection with the case.

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Metadata

FieldData
DOC ID 2214
RCPE Catalogue Number CUL/1/2/1286
Main Language English
Document Direction Incoming
Date23 May 1782
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from John Goodsir concerning the case of Mr Bethune, who has since been seen by Dr Black. Although there are no new symptoms, those existing 'have gradually become more violent & continued', with pains in the colon, a tenesmus, retching, and nephritic symptoms. He needs laudanum to sleep, and purgatives and injections to pass stools. Goodsir writes to both William and, by inference, Henry Cullen who had attended Bethune. The address page was subsequently been used to make some sums which may have no connection with the case.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:260]
Case of Mr David Bethune of Balfour who consulted Cullen previously over stomach complaints (See Case 34). Now also has an eye problem, head-pains, abdominal pains and increasing weakness.
20


People linked to this document

Person IDRole in documentPerson
[PERS ID:1301]AuthorMr John Goodsir
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:11]PatientMr David Bethune (of Kilconquhar; of Balfour)
[PERS ID:1301]Patient's Physician / Surgeon / ApothecaryMr John Goodsir
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:1003]Patient's Physician / Surgeon / ApothecaryDr Joseph Black

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Largo Edinburgh and East Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain

Normalized Text

[Page 1]
Largo May 23d. 1782

Ge
Gentlemen


Since Doctor Black left Mr. Bethune
there has occur'd no new symptom that demands
attention, The symptoms at that time present however
have gradually become more violent & continued – viz
the pains in his stomach & that part of his back opposite
as also in his bowels, especially in his left side much about
the curvature of the Colon, in one or other of these parts
for the last three weeks he has had few intervals of ease


The next set of troublesom symptoms are those in the
Urinary passages
& Rectum Strangury & Tenesmus generally
urging him at the same time give much uneasiness &
when he would sleep by the use of Laudanum is prevent¬
ed by stranguary, Mr. Bethune has frequently had the
following Nephritic symptoms Pain in his Back, running
along the course of the Ureters to the bottom of his Belly
attended with sickness, flatulent Eructations, fruitless
attempts to vomit
– I must observe that the sickness &ca.
have at times come on without the seeming above sympt¬
oms of his Kidneys being affected – At times a disagreeable
smell has been felt
when Mr. Bethune had the reaching
For Six or Eight days past he has had no inclination to vomit



[Page 2]

He is generally releived after this kind of reaching
commonly falls asleep after it – When Mr. Bethune is
tolerably free of pain his pulse is generally from 75 to
80
but when the pains are encreas'd it becomes more
frequent even to 100 ↑then↑ intermits
– still very little appitite,
little Thirst, but frequently a dryness in his mouth,
for a long time past has had no motion in his Bowels
but what is procured by purgativesvery little natural
sleep
his strength flesh & spirits much exausted ––
So far as I have had it in my power to examine his
stools, they are generally scanty, small roundish, soft
portions of Fæces mix'd with slimmy stuff – I have not been
able to discover any scybala except some after he began
to use the Injection
. His urine is of a natural colour
but a thick lateritious sediment ––


The different purgatives proscribed him he has used, tho'
none of them with much effect as the Castor Oil [or?] Daffy's Elixir & the last physic of Senna Salts & Tincture as
much so, but the Rhubarb by the last two trials &
Aloetic Pills [or?] Asafœtida had no effect – shall be directed
in future to continue with such purgatives as may give
the least uneasiness & operate with certainty, till I hear
from you Gentlemen – he has been in use for some time



[Page 3]

past to Andersons pills, at present however from the
Tenesmus
I should suspect their use to be doubtful –


He has repeatedly used Injections, but except two or
three with the addition of the Solution of Asafœtida and
one of plain oil /as he would not comply with its use
any more/ they have all been of the same nature with
the one first proscribed – the addition of asafœtida made no
sensible change to the better on the former Injection,
The oil was long retaind & did not he says abate
the tenesmus nor procured much evacuation _ From
the [tenesmus?] I have begun to think of {illeg}ping o{illeg}
the salt & using Injections of the Emolient kind
He felt he says no releife from the Proprietary Elixir of Vitriol – he
used it repeatedly – He now begins to use the Laudanam
with more freedom, from his own account he has not sleept
at a medium two hours every night
for a forthnight past;
night before last he got 48 drops of Laudanum last night 46:
43 drops procured 4 hours sleep, 46 – 5 hours & this day
which he has not done for ten days he proposes to take
an airing, have still some other remarks to make but
a I propose to write soon, shall conclude with beging
pardon for my silence & offer an appology in my next
I am with very much respect Gentlemen

your very Humble & obedient Servant
John Goodsir



[Page 4]


Doctor Cullen, &ca.
Physician
Edinburgh

Diplomatic Text

[Page 1]
Largo May 23d. 1782

Ge
Gentlemen


Since Doctor Black left Mr. Bethune
there has occur'd no new symptom that demands
attention, The symptoms at that time present however
have gradually become more violent & continued – viz
the pains in his stomach & that part of his back opposite
as also in his bowels, especially in his left side much about
the curvature of the Colon, in one or other of these parts
for the last three weeks he has had few intervals of ease


The next set of troublesom symptoms are those in the
Urinary passages
& Rectum Strangury & Tenesmus generally
urging him at the same time give much uneasiness &
when he would sleep by the use of Laudanum is prevent¬
ed by stranguary, Mr. Bethune has frequently had the
following Nephritic symptoms Pain in his Back, running
along the course of the Ureters to the bottom of his Belly
attended with sickness, flatulent Eructations, fruitless
attempts to vomit
– I must observe that the sickness &ca.
have at times come on without the seeming above sympt¬
oms of his Kidneys being affected – At times a disagreeable
smell has been felt
when Mr. Bethune had the reaching
For Six or Eight days past he has had no inclination to vomit



[Page 2]

He is generally releived after this kind of reaching
commonly falls asleep after it – When Mr. Bethune is
tolerably free of pain his pulse is generally from 75 to
80
but when the pains are encreas'd it becomes more
frequent even to 100 ↑then↑ intermits
– still very little appitite,
little Thirst, but frequently a dryness in his mouth,
for a long time past has had no motion in his Bowels
but what is procured by purgativesvery little natural
sleep
his strength flesh & spirits much exausted ––
So far as I have had it in my power to examine his
stools, they are generally scanty, small roundish, soft
portions of Fæces mix'd with slimmy stuff – I have not been
able to discover any scybala except some after he began
to use the Injection
. His urine is of a natural colour
but a thick lateritious sediment ––


The different purgatives proscribed him he has used, tho'
none of them with much effect as the Ol: Ricini [vl?] Tinct
Senn: Com:
& the last physic of Senn. Salts & Tincture as
much so, but the Rhubarb by the last two trials &
Pil. Aloet. [vl?] Assafœt had no effect – shall be directed
in future to continue with such purgatives as may give
the least uneasiness & operate with certainty, till I hear
from you Gentlemen – he has been in use for some time



[Page 3]

past to Andersons pills, at present however from the
Tenesmus
I should suspect their use to be doubtful –


He has repeatedly used Injections, but except two or
three with the addition of the Solution of Assafœt: and
one of plain oil /as he would not comply with its use
any more/ they have all been of the same nature wt.
the one first proscribed – the addition of assafœt: made no
sensible change to the better on the former Injection,
The oil was long retaind & did not he says abate
the tenesmus nor procured much evacuation _ From
the [tenesmus?] I have begun to think of {illeg}ping o{illeg}
the salt & using Injections of the Emolient kind
He felt he says no releife from the Elxr. prop: vitriol – he
used it repeatedly – He now begins to use the Laudanam
with more freedom, from his own account he has not sleept
at a medium two hours every night
for a forthnight past;
night before last he got 48 drops of Laud: last night 46:
43 drops procured 4 hours sleep, 46 – 5 hours & this day
which he has not done for ten days he proposes to take
an airing, have still some other remarks to make but
a I propose to write soon, shall conclude with beging
pardon for my silence & offer an appology in my next
I am with very much respect Gentlemen

your very Huble & obt. Servt.
John Goodsir



[Page 4]


Doctor Cullen, &ca.
Physician
Edinburgh

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