Cullen

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

 

[ID:28] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mr Gordon (of Earlston) (Patient) / 20 April 1765? / (Outgoing)

Reply, 'For Mr Gordon', concerning the patient's gout and associated 'gravel and sand'. The change of handwriting is almost certainly merely a change of scribe and not an indication of any joint-consultation (see footnote).

Facsimile

There are 5 images for this document.

[Page 1]


 

[Page 2]


 

[Page 3]


 

[Page 4]


 

[Page 5]


 
 

Metadata

FieldData
DOC ID 28
RCPE Catalogue Number CUL/1/1/1/23
Main Language English
Document Direction Outgoing
Date20 April 1765?
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply, 'For Mr Gordon', concerning the patient's gout and associated 'gravel and sand'. The change of handwriting is almost certainly merely a change of scribe and not an indication of any joint-consultation (see footnote).
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:163]
Case of Mr Gordon of Earlston who suffers from gout [who may be same person as Case 162].
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1022]PatientMr Gordon (of Earlston)
[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 Earlston Borders Scotland Europe inferred

Normalized Text

[Page 1]
For Mr Gordon


With regard to Mr Gordons ailments {illeg} we 1 have
no doubt that it is a sandy gravel a common
consequence of the gout & the confinement it
occasions. It is not uncommon for the sandy
gravel
to occasion much wind in the bowels as
it seems to do in Mr Gordons case.


We do not propose to give any advice for Mr
Gordons gouty complaints & we wish he
would not [tamper?] with them himself. If
Tansy tea can cure or alleviate the gout we



[Page 2]

imagine it must increase the gravel or prod[use]
a worse disease. If he lets it alone we hope to
relieve his gravel.


For this purpose we think Lime water a very
probable Remedy. We are told that Mr Gordon
has been {illeg} using it & we have only to say
that no benifit is to be expected from it unless
properly prepared & taken in a pretty Large
quantity. We think a choping every day is the
proper dose & we wish to know if Mr Gordon has
taken it to that quantity or if there is any diffi¬
culty in his doing so.


If the Lime water makes Mr Gordon costive this must
be carefully prevented by his taking a proper laxative &
at any rate when the pains of his kidney are frequent
or severe such a laxative is very proper. What we think
best is an ounce of good Manna with half an ounce
of Glaubsters salt both disolved in a muchkin of
new drawn whey & this taken in morning at two
or three draughts. {illeg} (↑It↑) is to be repeated according
to the state of his belly & the returns of his gravel.
The Dose proposed may seem weak & may be incrased
if his Constitution requre it but unless only
to keep his belly open with much purging. When
any severe fits of pain come on while he is Costive
the most ready relief will be by Glysters.


By the use of the Lime water with frequent Laxatives
we expect the gravel will be easier but if at any



[Page 3]

time a severe fit comes on with vomiting we advise
him to be put into a warm bath above the waist
as one of the best means of bringing down whatever is
sticking in the kidneys.


Mr Gordons diet should be low but not too low. Every
day at dinner he should take a bit of meat but let
it be of the lighter kinds White fowl, Chicken, Lamb, or
a bit of tender Mutton, are the best. Beef & Veal are
more doubtfull, water fowl, wild fowl, Pige↑o↑ns, & small
are to hot. Pork & Bacon [ly?] much too heavey. The
lighter kinds of white fish as Haddock & Whiting
boiled & served with a light sauce he may take some
times. Salmon Herring & drest shell fish are very impro¬
per. If at any time his appetite shall become sharp he
must take care never to make a full meal meat of any
kind but must make up a great part of it with vege¬
table food. Of Greens & Roots he may take moderately but
must avoid the more windy kinds & {illeg} at any kind
of Pudding will be safer than the garden things. Salt
mean of all kinds ↑he↑ must ↑avoid↑ be avoided.


For drink the best is Water with a small proportion
of Rum, Brandy, Dutch Gin, or very good Farrintosh, &
with a small proportion any of these may be his ordina¬
ry drink & at Dinner he may take two or three Glasses
a little stronger. Malt liquor of all kinds we think
bad for him Even wine is doubtfull & particularly
the Red wines. He may take at times a little Madeira



[Page 4]

or good sherry with water. {illeg} Few other white wines are
to be trusted only when the fits of Gravel are on
him a good Rhemish or Hock will be must proper of all.


We forgot above to say that his supper should be very
light & if his stomach agree tolerably with milk we
would advise to take it constantly at supper with bread,
Rice, Barley or sago as he likes best.


Green Tea if taken moderately we think very proper.
Coffee we think not so safe.


In Exercise Mr Gordon must proceed very cautiously.
Every kind of Brisk exercise must be very hurtfull
to his gravel but his gout would be the better of a
great deal. Till his kidneys are very clear the only
kind he can try will be an easy machine on a smoth
road. If it can be convenient sailing will be both
usefull if due care is taken to avoid cold. We
suppose that Mr Gordon has long been acquanted (↑acquainted↑)
with the virtues of Flannel.


It appears that Mr Gordon is easiest abed & when
the gravel is uneasy a reclining posture is commonly
the easiest but when the gout is entirely gone we
would diswade him from soaking much in his
naked bed or from indulging much at any time
a soft one.


These are the advises that occur to us {illeg} upon the
informat{illeg}n (↑ion↑) we have at present but we wish to
know more particularly what [experience has?] (is exactly {illeg})



[Page 5]

is exactly the state of his appetite & digestion &
& what experience he has of Particular foods agreeing
or disagreeing with him. What is the ordinary state
of his belly & if he is easily moved by Laxatives. W


Whether he has much thirst & if possible what is the
state of his pulse? What trials he has made of Lime
water
& what soap he can bear or in what manner
did this disturb him? When these Querries are answered
we shall be ready to advise further & always with the
utmost attention we are capable of ---

April th 20

Notes:

1: Cullen's use of the first person plural implies an habitually formal mode of address lending gravitas to his response (there is no suggestion that this was a joint consultation).

Diplomatic Text

[Page 1]
For Mr Gordon


With regard to Mr Gordons ailments {illeg} we 1 have
no doubt that it is a sandy gravel a common
consequence of the gout & the confinement it
occasions. It is not uncommon for the sandy
gravel
to occasion much wind in the bowels as
it seems to do in Mr Gordons case.


We do not propose to give any advice for Mr
Gordons gouty complaints & we wish he
would not [tamper?] with them himself. If
Tansy tea can cure or alleviate the gout we



[Page 2]

imagine it must increase the gravel or prod[use]
a worse disease. If he lets it alone we hope to
relieve his gravel.


For this purpose we think Lime water a very
probable Remedy. We are told that Mr Gordon
has been {illeg} using it & we have only to say
that no benifit is to be expected from it unless
properly prepared & taken in a pretty Large
quantity. We think a choping every day is the
proper dose & we wish to know if Mr Gordon has
taken it to that quantity or if there is any diffi¬
culty in his doing so.


If the Lime water makes Mr Gordon costive this must
be carefully prevented by his taking a proper laxative &
at any rate when the pains of his kidney are frequent
or severe such a laxative is very proper. What we think
best is an ounce of good Manna with half an ounce
of Glaubsters salt both disolved in a muchkin of
new drawn whey & this taken in morning at two
or three draughts. {illeg} (↑It↑) is to be repeated according
to the state of his belly & the returns of his gravel.
The Dose proposed may seem weak & may be incrased
if his Constitution requre it but unless only
to keep his belly open with much purging. When
any severe fits of pain come on while he is Costive
the most ready relief will be by Glysters.


By the use of the Lime water with frequent Laxatives
we expect the gravel will be easier but if at any



[Page 3]

time a severe fit comes on with vomiting we advise
him to be put into a warm bath above the waist
as one of the best means of bringing down whatever is
sticking in the kidneys.


Mr Gordons diet should be low but not too low. Every
day at dinner he should take a bit of meat but let
it be of the lighter kinds White fowl, Chicken, Lamb, or
a bit of tender Mutton, are the best. Beef & Veal are
more doubtfull, water fowl, wild fowl, Pige↑o↑ns, & small
are to hot. Pork & Bacon [ly?] much too heavey. The
lighter kinds of white fish as Haddock & Whiting
boiled & served with a light sauce he may take some
times. Salmon Herring & drest shell fish are very impro¬
per. If at any time his appetite shall become sharp he
must take care never to make a full meal meat of any
kind but must make up a great part of it with vege¬
table food. Of Greens & Roots he may take moderately but
must avoid the more windy kinds & {illeg} at any kind
of Pudding will be safer than the garden things. Salt
mean of all kinds ↑he↑ must ↑avoid↑ be avoided.


For drink the best is Water with a small proportion
of Rum, Brandy, Dutch Gin, or very good Farrintosh, &
with a small proportion any of these may be his ordina¬
ry drink & at Dinner he may take two or three Glasses
a little stronger. Malt liquor of all kinds we think
bad for him Even wine is doubtfull & particularly
the Red wines. He may take at times a little Madeira



[Page 4]

or good sherry with water. {illeg} Few other white wines are
to be trusted only when the fits of Gravel are on
him a good Rhemish or Hock will be must proper of all.


We forgot above to say that his supper should be very
light & if his stomach agree tolerably with milk we
would advise to take it constantly at supper with bread,
Rice, Barley or sago as he likes best.


Green Tea if taken moderately we think very proper.
Coffee we think not so safe.


In Exercise Mr Gordon must proceed very cautiously.
Every kind of Brisk exercise must be very hurtfull
to his gravel but his gout would be the better of a
great deal. Till his kidneys are very clear the only
kind he can try will be an easy machine on a smoth
road. If it can be convenient sailing will be both
usefull if due care is taken to avoid cold. We
suppose that Mr Gordon has long been acquanted (↑acquainted↑)
with the virtues of Flannel.


It appears that Mr Gordon is easiest abed & when
the gravel is uneasy a reclining posture is commonly
the easiest but when the gout is entirely gone we
would diswade him from soaking much in his
naked bed or from indulging much at any time
a soft one.


These are the advises that occur to us {illeg} upon the
informat{illeg}n (↑ion↑) we have at present but we wish to
know more particularly what [experience has?] (is exactly {illeg})



[Page 5]

is exactly the state of his appetite & digestion &
& what experience he has of Particular foods agreeing
or disagreeing with him. What is the ordinary state
of his belly & if he is easily moved by Laxatives. W


Whether he has much thirst & if possible what is the
state of his pulse? What trials he has made of Lime
water
& what soap he can bear or in what manner
did this disturb him? When these Querries are answered
we shall be ready to advise further & always with the
utmost attention we are capable of ---

April th 20

Notes:

1: Cullen's use of the first person plural implies an habitually formal mode of address lending gravitas to his response (there is no suggestion that this was a joint consultation).

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