Cullen

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

 

[ID:2684] From: Dr William Hamilton (in Glasgow) / To: Dr William Cullen (Professor Cullen) / Regarding: Mr John Hyndman (Patient) / 11 August 1785 / (Incoming)

Letter from William Hamilton, concerning the case of Mr Hyndman, a 'very fat' man, over 60, whose case he sends 'At the desire of Mr Hyndmans friends'. He has come up from London and been taken ill at his friend Mr King's house, near Port Glasgow. Hamilton sees signs of apoplexy and erysipelas in his condition, and an affection of the throat which is reminiscent of typhus. His ankles seem to be gangrenous where blistered. Hamilton is sending the letter by an express, with the fee enclosed.

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Metadata

FieldData
DOC ID 2684
RCPE Catalogue Number CUL/1/2/1726
Main Language English
Document Direction Incoming
Date11 August 1785
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 William Hamilton, concerning the case of Mr Hyndman, a 'very fat' man, over 60, whose case he sends 'At the desire of Mr Hyndmans friends'. He has come up from London and been taken ill at his friend Mr King's house, near Port Glasgow. Hamilton sees signs of apoplexy and erysipelas in his condition, and an affection of the throat which is reminiscent of typhus. His ankles seem to be gangrenous where blistered. Hamilton is sending the letter by an express, with the fee enclosed.
Manuscript Incomplete? No
Evidence of Commercial Posting Yes

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1790]
Case of Mr Hyndman who is diagnosed with erysipelas.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:175]AuthorDr William Hamilton (in Glasgow)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:3619]PatientMr John Hyndman
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:175]Patient's Physician / Surgeon / ApothecaryDr William Hamilton (in Glasgow)
[PERS ID:3620]Patient's Physician / Surgeon / ApothecaryMr Burns
[PERS ID:3621]Patient's Relative / Spouse / FriendMrs Hyndman
[PERS ID:3622]Patient's Relative / Spouse / FriendMr King

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Glasgow College Glasgow Glasgow and West Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain
Mentioned / Other London London and South-East England Europe certain
Mentioned / Other Port Glasgow Glasgow and West Scotland Europe certain

Normalized Text

[Page 1]
Dear Sir


At the desire of Mr Hyndmans
friends I send you the following state of his
case for your opinion which they are
anxious to have as soon as possible.
He is a man of upwards of sixty, he
was very fat short necked & his face
full & red. He was accustomed to live
as most of the London citizens do very
fully, tho he was temperate in drinking
he used little exercise & for several years
had been subject to regular fits of the
Gout
, On the 18th of July last he was
observed to look ill, he complained of
want of appetite
at dinner & in the evening
he was attacked with a severe cold fit
which was succeeded by heatDelirium
pain in his head. In this state he
continued thro the night. At one time he
complained of pain in his feet & knees
but these went off towards morning.
In the morning the delirium continued



[Page 2]

but was attended with great stupor, high
breathing
, & an almost compleat inability
of moving. Mr Burns surgeon in Portglasgow
was sent for, (Mr Kings house at which he
was taken ill being within a few miles
of that town) he bled him to the extent
of ten ounces
& gave him a spoonful of
Castor oil
which was the purgative he
was accustomed to take. I saw him
that evening. I found him relieved by the
bleeding
tho the blood that was taken so
far from being buffy was rather loose
in its texture, his pulse which before had
been 130 was now about 100
, the stupor
still continued
& he complained of pain
& weight in
his forehead. A Blister was
that night applied over
his whole head
& mustard poultices to his feet.


Next morning he was much better had
less stupor & was very distinct. Leeches
were applied to
his temples, & his belly
again opened by the oil. A redness ↑on↑ the
afternoon of this day (the 20th) was observed
on one cheek which by next morning
had spread over the whole of that side of
his face
& was evidently Erysipelas. Since
that time the inflammation has gone over



[Page 3]

his whole head, & after leaving that has
spread over his back, breast & has within
these two days appeared a little on his
legs
. The stupor has never gone compleatly
off & at times it has been considerable

his pulse has been from 80 to 100
during the first week of his illness the
affection of his headach
was the most
alarming symptom & particularly as
his state of body was such as would
favour an attack of Apoplexy & he had
had several near relations who had died
of it. For this fortnight past, the stupor
has rather abated
, & has been more like
that from fever, his strength is less
his tongue & mouth very foul & parchd
& in short he seems to have more the
appearance of Typhus
. On Thursday last
a hiccup came on which continued
incessantly for three day, but after try¬
ing musk Camphor &c in vain it seemed
to be relieved by the use of wine. It has
left him this morning, the weakness
was considerably increased
, he lay dosing
except when he was spoken to
, his
breathing which last night was often
stopped by a great quantity of mucus
that
he collected in his throat, was less inter¬
rupted, his pulse about 100, to which


[Page 4]

it had fallen from 112 after taking some
wine, his mouth very dry & covered
with a kind of white aphthous crust
& his thirst very considerable, his skin
dry tho not very hot. He is perfectly
distinct, but is unwilling to speak.
He complained yesterday of a very severe
shooting pain in
his head which soon
went off but left him very restless &
uneasy, but today he has had no
return of it. These are I think the
principal present symptoms.


The plan Dr Marshal & I have followed
was in the beginning of the Disease
to remove the affection of the head by
the antiphlogistic regimen, procuring
& keeping up a state of perspiration

& having the head as high when in bed
& making him frequently sit up.
Within these ten days, the degree of
weakness
, the sinking of the pulse
& a gangrenous appearance on the
ankles
where blisters had been applied
made us give him wine, by which he
seemed so much relieved & strengthened
that it has been continued, & for some
days past he has drunk a bottle of
Madiera in the twenty four hours.



[Page 5]

Whenever the wine was neglected to be
given his pulse became quicker &
often intermitted
the stupor increased
& every bad symptom was brought on
but then went off after its use.


During the first part of the Disease in
order to remove the affection of the
head
he was blistered repeatedly & always
with relief
. The Blistered parts have
for several days looked black & gangren¬
ous
which has made us give him
the bark, in about the quantity of 2 drachms
in the twenty four hours, this being
as much as he would take.


His belly has been kept regularly
open with the Castor oil, the use
of injections being impossible
from
his size & unwieldiness & his lying
constantly on his back.


We were prevented from having recourse
to the lancet after the first bleeding
from
its being an evacuation he was not at all
accustomed to
; from the state of the blood
from the appearance of Gout at the first
attack of the Disease & from the state
of his pulse
which we were affraid would



[Page 6]

not bear it.


We are at present giving him wine in
the quantity mentioned, the bark every
four hours & keeping his belly open
His ankles are dressed with poultace.
As the erysipelas has left his head &
face for several days & even the swelling
of it
came off, nothing is applied to it
but flour is dusted on the parts
where
the inflammation now is.


His food has been panada sago &
for two days an egg, his drink
balm tea (which is a nostrum of his
wifes) whey weak gruel &c ––


If any thing further occurs may I beg
you will let me know by the
express who will set off immediately
on getting your letter. I wished
much you had been called to see him
but certain circumstances prevented
it. I beg my respectful Compliments to Mrs
Cullen

I am Dear Sir
with the highest Esteem
your obliged humble servant
William Hamilto[n]
College Glasgow
August 11th 1785



[Page 7]


PS As this goes by an express who
may open the letter if he thinks there
is money ↑in↑ it, I have only to say
I have enclosed in it five pounds




[Page 8]

Mr. Wm. Hamilton
C. Mr. Hyndman
August 1785
V. XVII p. 216

Diplomatic Text

[Page 1]
Dear Sir


At the desire of Mr Hyndmans
friends I send you the following state of his
case for your opinion which they are
anxious to have as soon as possible.
He is a man of upwards of sixty, he
was very fat short necked & his face
full & red. He was accustomed to live
as most of the London citizens do very
fully, tho he was temperate in drinking
he used little exercise & for several years
had been subject to regular fits of the
Gout
, On the 18th of July last he was
observed to look ill, he complained of
want of appetite
at dinner & in the eveng.
he was attacked with a severe cold fit
which was succeeded by heatDelirium
pain in his head. In this state he
continued thro the night. At one time he
complained of pain in his feet & knees
but these went off towards morning.
In the morning the delirium continued



[Page 2]

but was attended with great stupor, high
breathing
, & an almost compleat inability
of moving. Mr Burns surgeon in Portglasgow
was sent for, (Mr Kings house at which he
was taken ill being within a few miles
of that town) he bled him to the extent
of ten ounces
& gave him a spoonful of
Castor oil
which was the purgative he
was accustomed to take. I saw him
that evening. I found him relieved by the
bleeding
tho the blood that was taken so
far from being buffy was rather loose
in its texture, his pulse which before had
been 130 was now about 100
, the stupor
still continued
& he complained of pain
& weight in
his forehead. A Blister was
that night applied over
his whole head
& mustard poultices to his feet.


Next morning he was much better had
less stupor & was very distinct. Leeches
were applied to
his temples, & his belly
again opened by the oil. A redness ↑on↑ the
afternoon of this day (the 20th) was observed
on one cheek which by next morning
had spread over the whole of that side of
his face
& was evidently Erysipelas. Since
that time the inflamn. has gone over



[Page 3]

his whole head, & after leaving that has
spread over his back, breast & has within
these two days appeared a little on his
legs
. The stupor has never gone compleatly
off & at times it has been considerable

his pulse has been from 80 to 100
during the first week of his illness the
affection of his headach
was the most
alarming symptom & particularly as
his state of body was such as would
favour an attack of Apoplexy & he had
had several near relations who had died
of it. For this fortnight past, the stupor
has rather abated
, & has been more like
that from fever, his strength is less
his tongue & mouth very foul & parchd
& in short he seems to have more the
appearance of Typhus
. On Thursday last
a hiccup came on which continued
incessantly for three day, but after try¬
ing musk Camphor &c in vain it seemed
to be relieved by the use of wine. It has
left him this morning, the weakness
was considerably increased
, he lay dosing
except when he was spoken to
, his
breathing which last night was often
stopped by a great quantity of mucus
that
he collected in his throat, was less inter¬
rupted, his pulse about 100, to which


[Page 4]

it had fallen from 112 after taking some
wine, his mouth very dry & covered
with a kind of white aphthous crust
& his thirst very considerable, his skin
dry tho not very hot. He is perfectly
distinct, but is unwilling to speak.
He complained yesterday of a very severe
shooting pain in
his head which soon
went off but left him very restless &
uneasy, but today he has had no
return of it. These are I think the
principal present symptoms.


The plan Dr Marshal & I have followed
was in the beginning of the Disease
to remove the affection of the head by
the antiphlogistic regimen, procuring
& keeping up a state of perspiration

& having the head as high when in bed
& making him frequently sit up.
Within these ten days, the degree of
weakness
, the sinking of the pulse
& a gangrenous appearance on the
ankles
where blisters had been applied
made us give him wine, by which he
seemed so much relieved & strengthened
that it has been continued, & for some
days past he has drunk a bottle of
Madiera in the twenty four hours.



[Page 5]

Whenever the wine was neglected to be
given his pulse became quicker &
often intermitted
the stupor increased
& every bad symptom was brought on
but then went off after its use.


During the first part of the Disease in
order to remove the affection of the
head
he was blistered repeatedly & always
with relief
. The Blistered parts have
for several days looked black & gangren¬
ous
which has made us give him
the bark, in about the quantity of ʒii
in the twenty four hours, this being
as much as he would take.


His belly has been kept regularly
open with the Castor oil, the use
of injections being impossible
from
his size & unwieldiness & his lying
constantly on his back.


We were prevented from having recourse
to the lancet after the first bleeding
from
its being an evacuation he was not at all
accustomed to
; from the state of the blood
from the appearance of Gout at the first
attack of the Disease & from the state
of his pulse
which we were affraid would



[Page 6]

not bear it.


We are at present giving him wine in
the quantity mentioned, the bark every
four hours & keeping his belly open
His ankles are dressed with poultace.
As the erysipelas has left his head &
face for several days & even the swelling
of it
came off, nothing is applied to it
but flour is dusted on the parts
where
the inflamn. now is.


His food has been panada sago &
for two days an egg, his drink
balm tea (which is a nostrum of his
wifes) whey weak gruel &c ––


If any thing further occurs may I beg
you will let me know by the
express who will set off immedy.
on getting your letter. I wished
much you had been called to see him
but certain circumstances prevented
it. I beg my respectful Complts to Mrs
Cullen

I am Dear Sir
with the highest Esteem
your obliged humble servt
William Hamilto[n]
College Glasgow
Augt 11th 1785



[Page 7]


PS As this goes by an express who
may open the letter if he thinks there
is money ↑in↑ it, I have only to say
I have enclosed in it five pounds




[Page 8]

Mr. Wm. Hamilton
C. Mr. Hyndman
Augt. 1785
V. XVII p. 216

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