Cullen

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

 

[ID:254] From: Dr William Cullen (Professor Cullen) / To: Mr Robert Wallace / Regarding: Mr James Fleming (Patient) / 18 January 1782 / (Outgoing)

Reply concerning 'my very old acquaintance' Mr Fleming who has an incurable blockage of his oesophagus. Cullen recommends Cicuta (Hemlock) as a desperate, last resort.

Facsimile

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Metadata

FieldData
DOC ID 254
RCPE Catalogue Number CUL/1/1/14/140
Main Language English
Document Direction Outgoing
Date18 January 1782
Annotation None
TypeMachine copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply concerning 'my very old acquaintance' Mr Fleming who has an incurable blockage of his oesophagus. Cullen recommends Cicuta (Hemlock) as a desperate, last resort.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:863]
Case of Cullen's 'old aquaintance' Mr James Fleming who has an obstructed oesophagus which proves fatal. May be same person as Case 276.
10


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:216]AddresseeMr Robert Wallace
[PERS ID:2820]PatientMr James Fleming
[PERS ID:216]Patient's Physician / Surgeon / ApothecaryMr Robert Wallace
[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 Cullen's House / Mint Close Edinburgh Edinburgh and East Scotland Europe certain
Destination of Letter Glasgow Glasgow and West Scotland Europe inferred

Normalized Text

[Page 1]

Dear Sir


I have conversed with my very old aquain¬
tance Mr Fleming and find that he labours under a very
disagreeable ailment commonly of very difficult cure.
It is commonly owing to a schirrous angustation of the Oeso¬
phagus
a little above the cardia and when that is confirmed
I take it to be incurable but the disease I have sometimes
found to depend entirely upon spasm and whether with some
degree of constant angustatio yet from its being occasionally
better and worse I judge that something spasmodic occurs.
Upon this Supposition before he is going to swallow let him
try half a tea spoonfull or a whole tea spoonfull of Æther
in an ounce of water. Let the æther and water be previous¬
ly mixed in a vial to be kept till the time of use inverted
upon the cork. If this answers you will use it occasionally
as you shall find proper observing that a frequent use is
ready to render it less effectual. If you shall distinctly
perceive it ↑to↑ be Spasmodic you may think of trying Camphire



[Page 2]

dissolved in a large proportion of Sweet oil, as 3 or 5 grains to
an ounce. It will even be worth while to try sometimes a spoon¬
full of Oil by itself for whatever opens the passage without
renewing the spasm will be of service and perhaps you may
find that the most powerfull of all Antispasmodics [Opium?]
may be of use. But to attempt a radical cure of the dis¬
ease the only very probable remedy I can think of is Mercury
and I would prefer the Mercurial Pill given to taint his
breath or give a little of the copper taste but no farther. On
this you may bestow more or less time as he bears it and
his business allows for at this season he must be confined.
If the Mercury cannot be admitted for any length of time
or at intervals only I would in the meantime give him Cicuta
with a valeat quantum valere potest 1 and because I think he
should not be without a medicine. With respect to diet he
must take what he can swallow most easily for every new irri¬
tation
will aggravate the disease which seems to have been
first brought on ↑by↑ a strain. In diet therefore Egg, Blanc mange
Jelly & every thing that can be brought into a gelatinous


[Page 3]

form as [Neatsfeet?] veal Head, an old Cock &c: His warm punch
at night may be very properly continued and the effect of it makes
me the above antispasmodics may be usefull. Mr Fleming is
old Comrad I have a regard for and therefore your writing as often
as you shall think there is any use for it will never be troublesome
to me. I am with very sincere regard


Dear Robert Yours &c.

William Cullen

Edinburgh 18th. January
1782. ---

Notes:

1: Translates literally as 'let it be what it is worth', but as a common legal phrase used with respect of wills, it more usually translated as 'stands..for what it is worth'. Cicuta (Hemlock) is a poison in all but small doses, and Cullen only recommends it as a last resort when treating cancerous tumours.

Diplomatic Text

[Page 1]

Dear Sir


I have conversed with my very old aquain¬
tance Mr Fleming and find that he labours under a very
disagreeable ailment commonly of very difficult cure.
It is commonly owing to a schirrous angustation of the Oeso¬
phagus
a little above the cardia and when that is confirmed
I take it to be incurable but the disease I have sometimes
found to depend entirely upon spasm and whether with some
degree of constant angustatio yet from its being occasionally
better and worse I judge that something spasmodic occurs.
Upon this Supposition before he is going to swallow let him
try half a tea spoonfull or a whole tea spoonfull of Æther
in an ounce of water. Let the æther and water be previous¬
ly mixed in a vial to be kept till the time of use inverted
upon the cork. If this answers you will use it occasionally
as you shall find proper observing that a frequent use is
ready to render it less effectual. If you shall distinctly
perceive it ↑to↑ be Spasmodic you may think of trying Camphire



[Page 2]

dissolved in a large proportion of Sweet oil, as 3 or 5 grains to
an ounce. It will even be worth while to try sometimes a spoon¬
full of Oil by itself for whatever opens the passage without
renewing the spasm will be of service and perhaps you may
find that the most powerfull of all Antispasmodics [Opium?]
may be of use. But to attempt a radical cure of the dis¬
ease the only very probable remedy I can think of is Mercury
and I would prefer the Mercurial Pill given to taint his
breath or give a little of the copper taste but no farther. On
this you may bestow more or less time as he bears it and
his business allows for at this season he must be confined.
If the Mercury cannot be admitted for any length of time
or at intervals only I would in the meantime give him Cicuta
with a valeat quantum valere potest 1 and because I think he
should not be without a medicine. With respect to diet he
must take what he can swallow most easily for every new irri¬
tation
will aggravate the disease which seems to have been
first brought on ↑by↑ a strain. In diet therefore Egg, Blanc mange
Jelly & every thing that can be brought into a gelatinous


[Page 3]

form as [Neatsfeet?] veal Head, an old Cock &c: His warm punch
at night may be very properly continued and the effect of it makes
me the above antispasmodics may be usefull. Mr Fleming is
old Comrad I have a regard for and therefore your writing as often
as you shall think there is any use for it will never be troublesome
to me. I am with very sincere regard


Dear Robert Yours &c.

William Cullen

Edinr. 18th. Janry.
1782. ---

Notes:

1: Translates literally as 'let it be what it is worth', but as a common legal phrase used with respect of wills, it more usually translated as 'stands..for what it is worth'. Cicuta (Hemlock) is a poison in all but small doses, and Cullen only recommends it as a last resort when treating cancerous tumours.

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