Cullen

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

 

[ID:3195] From: Mr Henry Lochhead (Harry, 'Mr Logan') / To: Dr William Cullen (Professor Cullen) / Regarding: Mr Henry Lochhead (Harry, 'Mr Logan') (Patient) / July 1787 / (Incoming)

A letter from Henry Lochhead, concerning his own case. He gives details of his previous treatments and states he was badly treated by his previous physicians, Drs Hall, Black and Currie. He takes pains to recommend Dr Bland to Cullen, as Bland afforded him the greatest relief and he has heard Cullen does not have a high opinion of Bland. Lochead has been reading the work of Le Dran 'on surgery'.

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Metadata

FieldData
DOC ID 3195
RCPE Catalogue Number CUL/1/2/2096
Main Language English
Document Direction Incoming
DateJuly 1787
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary A letter from Henry Lochhead, concerning his own case. He gives details of his previous treatments and states he was badly treated by his previous physicians, Drs Hall, Black and Currie. He takes pains to recommend Dr Bland to Cullen, as Bland afforded him the greatest relief and he has heard Cullen does not have a high opinion of Bland. Lochead has been reading the work of Le Dran 'on surgery'.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:443]
Case of Mr Henry Lochead who regularly travels between Virginia and Glasgow who has a genito-urinary complaint which may be venereal.
12


People linked to this document

Person IDRole in documentPerson
[PERS ID:44]AuthorMr Henry Lochhead (Harry, 'Mr Logan')
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:44]PatientMr Henry Lochhead (Harry, 'Mr Logan')
[PERS ID:3310]Patient's Physician / Surgeon / ApothecaryDr Black
[PERS ID:468]Patient's Physician / Surgeon / ApothecaryDr James Currie
[PERS ID:2237]Patient's Physician / Surgeon / ApothecaryDr Bland
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:3309]Patient's Physician / Surgeon / ApothecaryDr Hall
[PERS ID:3312]Other Physician / SurgeonDr Henri François Le Dran
[PERS ID:3314]Other Physician / SurgeonDr Hard
[PERS ID:3318]Other Physician / SurgeonMr Bauldy Carcior
[PERS ID:468]Patient's Relative / Spouse / FriendDr James Currie
[PERS ID:3318]Patient's Relative / Spouse / FriendMr Bauldy Carcior
[PERS ID:2276]Patient's Relative / Spouse / FriendMr Spence
[PERS ID:3311]OtherMr Jameson
[PERS ID:3318]OtherMr Bauldy Carcior
[PERS ID:5896]Other

Places linked to this document

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

Normalized Text

[Page 1]

Dear Sir


I received your very agreeable favour of the 26 July last
which I have most carefully perused - In a good measure
already it has been of much service to me, but I am daily gain¬
ing more & more as experience is every day confirming the
truths it inculcates - It remains for me to apply them as my
present & future situation may require - And now to give
you as Concise a detail as I can of what has occurred since
I last wrote & of my now situation.


I observe your observation that tho you had many
remarks to make on the treatment I had from your Fra¬
ternity here, yet as they woud not be of any service to me
you declined giving them - This was very Just delicate & prece¬
dent, nor did I expect any other Opinion from you except
what directly tended to my benefite - Never the less I can
now with the Assistance of your letter & my own ex¬
perience Confidently assert I have been most shockingly
treated - Chiefly by not having my habit properly attended
to which at the time of the 2d injection much from the
degree of Rheumetism Either had must have been greatly



[Page 2]

inflamatory - Therefore instead of these a---d Saline clysters
I was eternally ply'd with which tore my poor rectum
& at last brought on the blind piles internally which produced
the Suppression - Abscess &ca - I aught when I was found
not be wrought on with the plaguy Electuary - either
had Clysters ↑given me↑ of a more emollient nature, or ↑been↑ tryed with
such purgatives as you mention - the simplest of which
viz. the Sulphur, has a most happy influence on me
- Then when suppression came on - of which I gave suffici¬
ent notice - I was plyed one of the days I was under it
with nitre a good many dozes - & had 4 glasses of wine
given me -- -- Its unnecessary to go farther on this matter
& I dare say you'll think I might have spared you the
trouble of so much of it. But I hope you'll excuse
me when I say it gives me relief for you ↑to↑ know my
sentiments --


I come now to where I left off in my last letter to
you - as near as I can - I did not keep a copy of what I
wrote you but I think I must have mentioned that the Clap



[Page 3]

which had quite sunk away while in my low state & during
the suppression & Abscess - As soon as I got out of bed &
began to pick up a little flesh - it again revived with
the chordee - (Its of this I intend chiefly to write you -
Dr Hall on its appearance made light of it & ordered
me to injecting again - and for the remains of the Rheu¬
metism
, & the remains of any Complaint about the Anus
derected me to go 200 miles to a sulphureous warm
spring we have here - "during my Stay at the Springs the"
"infection woud effectually cure the remaining - & poultices"
"applied at same time woud remove the Chordee" - This
turned out a most fatal advice - but you will recollect
his Thesis was of Baths -- To make as short of a long
disagreeable story as I can - I returned after 3 months ab¬
sence, relapsed in the Rheumatism, (the Climate there
being cold & wet, in which I was often caught, besides
the too great exposure of one in my then weak state
while at Bath - ) The Clap also & Chordee worse
than when I set off after using all the injection I


[Page 4]

carried with me - Well I must again resume the injection
& down with the system to get quit of the Chordee, tho
God knows I believe you woud have thought me suffic¬
ently low - your letter came to hand by this, & as it was
so delicately managed I found I coud show it with
propriety - It was read - it was returned to me again - &
no remark made - but with a sameness of pipe & tone
" 'tis well, very well - did you take a full purge today - aye do "
" take a full purge the chordee is a troublesome symptom
" I wish you a good afternoon Sir" Well, I went on in this
manner (but purged with manna) for 20 days - & I may
thank God you directed the manner of purge proper or
I suppose I might have had the same Gantlet tosses 1 : over
again - You mentioned I possibly might have a Gleet &
Stricture remaining - & directed how to proceed in either
of these Cases. No notice was taken of this tho, and I
was treated in the same manner as if it had be ↑en↑ recent
& virulent - indeed from the colour seeming bad - my not
having been above half cured when it sunk away by my


[Page 5]

weakness, & the Chordee still continuing I readily enough gave
into the belief that I was not at all in the situation
you supposed I might be in, & so kept as Ive said purg¬
ing
& injecting for 20 days more - during this time I used
to endeavour to extract from Hall his Opinion of mercury
in my case for as you may remember he had (along with
a certain Dr. Black here) just begun a course of pills
but a few days before the suppression came on last spring
his Opinion was never deciseve or satisfactory "indeed he"
"did not know - I have not much confidence in it, & it"
"wont do any harm, - you may try it - but I woud"
"rather defer it - its so dangerous as to catching cold"
"in your present situation" - However Black happening
to call on me as an acquaintance not having at this
time employed any more of them as I naturally imagined
Hall the most proper to finish the cure of the Clap
which he had begun" ↑&↑ As to Rheumatism I know more
of it than any of them - He (Black) happening to ex¬


[Page 6]

press himself positively that nothing but mercury woud
conquer it - it was very naturall for me to try it - es¬
pecially as I conceived my self to be in ↑a↑ different situation
from that you supposed, and as Hall would not be sa¬
tisfactory for or against it, & I found his purging & in¬
jecting
& poulticing woud not do -- Accordingly I took
me some five or six twenty pills of a grain each, made up
with Opium & Camphor which were to do for the Chordee
this took up near a month, as I was obliged to disuse
them now & then - for before I had taken a dozen I was set a
spitting at the rate of a quart a day & even a good
deal in the night - this was kept up for 16 days -
While on the height of the spitting, the matter seemed
to look better, & be of a better consistence ↑& the Chordee nearly gone, but on
leaving off the mercury & my mouth getting restored
again, the running & Chordee return'd with the same
if not increased violence - Upon this I grew quite
melancholy, I neither coud ↑get↑ rid of the disorder nor


[Page 7]

at all satisfied that any of them understood it - for Hall
woud now & then see me even when I had put myself
under Blacks course, ↑&↑ did not seem to condemn it
He saw me after I had done with it, when surely my
system was sufficiently low & yet the chordee at¬
tended me - & therefore ↑he↑ could not again desire me to
resume the former method - It was at this time I
catch'd at the idea of going home to see you as
the last Twigg -- & had absolutely made some
preparation for it - & wrote Mr. Jameson of my
intention - However from the time I had resolved
on this I coud perceive the difficulty of making
water
encrease so as prodigiously to alarm me
As I imputed this to the Mercury I had taken inwardly & had
even injected, mix'd with oil, I thought Black coud
not relieve me of it - Hall he called on me while
I was in the horrors expecting every other day to
have a totall suppression - he had not


[Page 8]

seen me for 10 days before, & on my representing my fears &
situation to him - (now my situation at this time was truly de¬
plorable - having come across Le Dran on surgery who paints
the consequences of a deseased bladder & difficulty of making
water
in terrible colours - I was clear my complaints were
such & arose from such causes he there described in his Chapter
on Fistulæ in Perineæ) - Hall however rather aggravated my
fears - After I described what I felt & & what I thought - "I am"
"apprehensive Sir, there is a Caruncle - I think it would be"
"adviseable to send for Bougies - I wish ye a good after¬"
"noon Sir" After such treatment as I had had, & such a
cold undecisive manner in the situation I was now in I
did not think of resting there, but sent for Dr. Bland who
lives within some few miles - He was gone to [Worts?] 2 - I
then sent to Dr. Currie A Young lad who lived with
Dr. Hardie in Glasgow - & who from his readiness & appli¬
cation has made a figure in his way here - He came
- He consulted with Dr. Hall - & to be sure they were
polite enough to agree cordially both as to what re¬
mained to be done & what had been done -


[Page 9]

Currie however condemned positively the use of the Mer¬
cury
& imputed my present situation to what I had tak¬
en of it - He & Hall prescribed - a regimen - an injection
- fomenting with lead water - & if in a few days
no Appearance to the better - to use the Bougies
- As to the regimen it varyed from what I had been
strictly observing before, only in allowing some White
meats & for Drink Claret & Port wine diluted - the
injection I suppose might have been the same with
Halls only that ↑it↑ was differently made up having Oil
& yolk of Egg in the Composition - But Currie hurry'd
every thing down he proposed & Halls genius seemed
to shrink before him - However Dr. Bland re¬
turning home came & saw me the very day I was
beginning on their plan - He heard my Story ab
initio 3 (for he had never been called in before) - He saw
the prescriptions - He condemned the variation they
had recommended on my manner of living - chiefly
the Claret & port for drink - my System wanted mend¬


[Page 10]

ing but it woud mend fast enough on milk & what
else I had been living on - but any stimulating food
or such drink was improper - directed me not to
meddle with the Bougies & substituted in room
of Curries Oil & Eggs &c (which even the oil woud
only serve to irritate) a dram of Sal Saturni
& 2 of Gum Arabic dissolved in water, which I was
to use two or three times a day - & now ↑&↑ then might
throw up milk & water -- Spoke positively &
satisfactorily on the symptom I had & their cause
as being chiefly owing to the tenderness of the whole
Urethra, owing to the [irration?] being kept up for
such a length of time, for want of proper manage¬
ment & attention to that object - that what supp¬
ng there was, was not virulent - but affect - not
withstanding the Appearances to the Country from the
colon being ↑of a↑ yellowish green sometimes - & the continue¬
ance of Chordee - apprehended no Stricture - nor


[Page 11]

that the bladder was any how Affected, except from
sympathy, notwithstanding the difficulty in making
urine
, & of my Observing even at the last of making
water
, small flakes or portions of whitish water
pass along with it - I also was ord (↑directed↑) for the pain
I felt at the root of perineo, (as well on making
water a burning heat - & stiffish pain or gripping
with the Anus at the last drops - As that it
remained even sore on being pressed with the
finger at all times -) For this I was to bath with
lead water & use a paultice made of same
for some few nights -- In short I got some
idea of my disorder & the cause of it, which
I never coud get before with my utmost pains
& I have the satisfaction even now after having
followed his derection & attended to the effects
to find it turn out right - The pain in perineo
& Ano are gone - the Chordee is less - My Apprehen¬


[Page 12]

sions & doubts & horrors of an approaching suppression
are removed which has had such a happy effect on
my body that tho I have eat nothing but bread &
milk, & Tea - Apples &ca I have within this last
40 days, almost got to my usual Strength & ap¬
pearance - The running still continues else but is
something diminished, is more glutinous - & not quite
so yellow - Lastly I make water much better - with
less difficultie - & with little or no heat - especially
if I take my usual quantity of Barley water with
the Gum Arabic - About a quart of this a day -
Currie had added to this Attending drink - magnesia
white vitriol &ca but Bland preferring the
more simple one of Gum Arabic alone, I have always
stuck to it - He prescribed ↑also↑ Flowers of sulphur
occasionally - which I had before chosen out of your
list - & found it have a very happy effect -


Dr. Bland saw me yesterday & from the whole
recommends a perseverance in the manner I am



[Page 13]

going on - that I need nothing more from him or any one
as a Physician - If this shoud be the case I must
think Dr Bland has much merit with me for his
Candour & Skill - it had been happy if I had ap¬
plied to him first - happy had I spoke to him be¬
fore I went to the Springs - & still much ↑so↑ if on my
return from them I had laid my case before him - I
am certain of this, because before he knew any¬
thing of your Opinion from what I had wrote you
His doctrine corresponded with yours to a
title -- But some Cursed fatality seems
to have attended me - For from what to other
people are very simple causes have to me
arisen the most vexatious painfull tedious
disorders, & it has always been my fate to
be improperly managed in them -- I remember
Bauldy Carcior from Hamilton a colleague & friend
of mine mention'd to me in Confidence about


[Page 14]

3 year ago that you had but a superficial Opinion
of Bland - perhaps when at home he may have been
but superficial - but it really seems to all who
know him now, that he is at least equall if not
Superior to any of his Profession in the Colony -
However the impression this had on me & prejudice
in favoure of any one Coming fresh from 4 years
Study under you determined me fatally to de¬
pend on Hall - Who on Account of his Genius &
Theoricall abilities is a melancholy proof to
me that experience is as much necessary as
study & reading -- I hope youll pardon me putting
you to the trouble of reading so much foreign
stuff -- but on Account of my situation & the occur¬
rencies that have happened to me, are so intertwined
in my mind with what else Ive wrote {illeg} I coud not
well seperate them -- Besides from the experience
I have had of Your Candour & humanity (all


[Page 15]

the world Confess your Abilities) I find my self relieved
in writing you all I know & think without cere¬
mony or reserve -- And now there seems to remain
that I lay before you briefly, the situation I am
in at present - which my freind Mr. Spence who
will deliver you this can supply where any
doubt about me may remain with you - And
begg you'll be kind enough to give me your
Opinion of my disorder if you think it can be done
from what Ive wrote - & the advice how I shall manage
myself futurely in any thing in this respect other
than what I have already had of you should occur
I have at present a prospect of doing conquering
all my Complaints - & a freedom from pain
seems now to be ↑my↑ utmost or greatest wish -


My Rheumetism is now entirely conquered - owing
I believe to the care in avoiding cold - Flannell Shirt
- Milk regimen - which ↑with↑ the Sulphur I take occasionally



[Page 16]

now agrees with me if possible better than when under that re¬
gimen at home - & possibly the Mercury I took which hurt
me so much otherways, helped to discuss it - or put it
in a disposition for the better - A little heat As I've
said yet remains in making water, when not diluted
a little running & a little Chordee - but both
these seem in a progress to the better - the Colour
of running Mr Spence if necessary will describe
- it seems now & then yet of a yellow hue - but
is less in quantity & more glutinous -- I yet pass always
with my urine these ↑small↑ Flakes of white glutinous
matter
, & I see them go along plainly towards the
last of making it -- In about 7 or 8 days after
disusing every thing by Blands direction -- except injecting the lead water now & then & milk & water occasionally↑
- fomenting with lead water the perineum and ap¬
plying a poultice or two, - the pains there & other
symp gave way & I made water for two or three
days as well & in as large a Stream as I almost


[Page 17]

ever did - but from that again the difficulty again gr[a]¬
dually returned - & again grew better - but not quite
so well as before - By attending narrowly and Anxi¬
ously to these Changes - I found first that I had no
reason to apprehend a Caruncle in the urethra
as the Stream had now flowed as large as usual
in health - in the next place I imputed the cause
of the return of the difficulty & smallness of
Stream - to the very extreme tenderness & irri¬
tability of the whole parts - as this had suc¬
ceeded twice, to some business I had been
doing in my Sleep which seemed to exert the
parts as much as If ↑I↑ had had reall inter¬
course - & still farther satisfied me as to
Blands Opinion - All now that remains of
my fears is on this Account I do not make water yet
to my mind - & I observe I seldom can retain it


[Page 18]

{illeg} two hours even tho these be but little to make
& The Chordee yet attends me -- In every other respect
I am well my body cool & free from feverishness
& I find no difficultie in my milk regimen &
drinking occasionally the barley water & Gum Ar¬
abic
-- I woud fain hope that by the Spring
I may be releived of all by going on with this
& now & then using the injection - At all events
I may hope not ↑to↑ be any worse by observing
these, till I can hear from you - I have just
one Observation more to mention - that when
free from any urinary Complaint the water seems
to be one large Stream - at other times its apt
to get into two small ones issuing from each
end of the mouth of ↑the↑ urethra, & when the difficulty
is great, only one of these Streams issue, & some
times it has come drop by drop, this it did the


[Page 19]

very morning of that Even day on the Evening
of which the difficultie first gave way to a
most pleasing change, which for the first time
set me at rest & satisfied me there coud not
be ↑a↑ Caruncle where the Stream flowed So
well -- Ive now done Sir & begg
your pardon for so tedious a detail ↑to↑ you
whose time I know well to be of much
importance every hour of it --


Mr Spence will likeways accompany
this with a small acknowledgement & if I can
be of any use to you here in any manner of
way it woud give me great pleasure to
have your Commands -- and I always am
with much esteem & respect

Dear Sir
your Obedient humble Servant

Henry Lochhead



[Page 20]


PS It was clearly the piles which from my imperfect des¬
cription you imagined might be a falling down of the
Gut - There were severall of them very discernible at
the time I last wrote you, which had arrived after
the Operation, & which tho not painfull yet as the
wound was not then heal, & Le Dran mentions them
incurable but by ligature or incesion I was much
frightned -- You saw the severall recipes I had from
the Faculty here, but an Old woman gave me
an Ointment made of a weed we have here called
Jamston weed stewed with Cream which as I
thought the most simple made use of & it had
the effect in two or three days - There are still
rugæ remaining, and the lips of the Anus pro¬
trude greatly if I strain - but acBut your strict
injunctions as to the trim of my belly, which I
have as strictly attended to, seems to keep all the
parts in good order


yrs above

HyL



[Page 21]


Doctor Cullen
Physician
Edinburg


Mr. Lochead

Notes:

1: 'Gantlet' is a variant spelling of 'Gauntlet', a type of glove associated with medieval Knights. Lochead is alluding to the proverbial expression "throw down the gauntlet" (i.e. issue a challenge), to imply that, without Cullen's intervention, he would have had to face another confrontation with Dr. Hall.

2: Possibly an abbreviation for 'Worcester'.

3: 'From the beginning'.

Diplomatic Text

[Page 1]

Dear Sir


I received your very agreeable favour of the 26 July last
which I have most carefully perused - In a good measure
already it has been of much service to me, but I am daily gain¬
ing more & more as experience is every day confirming the
truths it inculcates - It remains for me to apply them as my
present & future situation may require - And now to give
you as Concise a detail as I can of what has occurred since
I last wrote & of my now situation.


I observe your observation that tho you had many
remarks to make on the treatment I had from your Fra¬
ternity here, yet as they woud not be of any service to me
you declined giving them - This was very Just delicate & prece¬
dent, nor did I expect any other Opinion from you except
what directly tended to my benefite - Never the less I can
now with the Assistance of your letter & my own ex¬
perience Confidently assert I have been most shockingly
treated - Chiefly by not having my habit properly attended
to which at the time of the 2d injection much from the
degree of Rheumetism Either had must have been greatly



[Page 2]

inflamatory - Therefore instead of these a---d Saline clysters
I was eternally ply'd with which tore my poor rectum
& at last brot. on the blind piles internally which produced
the Suppression - Abscess &ca - I aught when I was found
not be wrought on with the plaguy Electuary - either
had Clysters ↑given me↑ of a more emollient nature, or ↑been↑ tryed with
such purgatives as you mention - the simplest of wh
viz. the Sulphur, has a most happy influence on me
- Then when suppression came on - of which I gave suffici¬
ent notice - I was plyed one of the days I was under it
with nitre a good many dozes - & had 4 glasses of wine
given me -- -- Its unnecessary to go farther on this matter
& I dare say you'll think I might have spared you the
trouble of so much of it. But I hope you'll excuse
me when I say it gives me relief for you ↑to↑ know my
sentiments --


I come now to where I left off in my last letter to
you - as near as I can - I did not keep a copy of what I
wrote you but I think I must have mentioned that the Clap



[Page 3]

which had quite sunk away while in my low state & during
the suppression & Abscess - As soon as I got out of bed &
began to pick up a little flesh - it again revived with
the chordee - (Its of this I intend chiefly to write you -
Dr Hall on its appearance made light of it & ordered
me to injecting again - and for the remains of the Rheu¬
metism
, & the remains of any Complaint about the Anus
derected me to go 200 miles to a sulphureous warm
spring we have here - "during my Stay at the Springs the"
"infection woud effectually cure the remaining - & poultices"
"applied at same time woud remove the Chordee" - This
turned out a most fatal advice - but you will recollect
his Thesis was of Baths -- To make as short of a long
disagreeable story as I can - I returned after 3 months ab¬
sence, relapsed in the Rheumatism, (the Climate there
being cold & wet, in which I was often caught, besides
the too great exposure of one in my then weak state
while at Bath - ) The Clap also & Chordee worse
than when I set off after using all the injection I


[Page 4]

carried with me - Well I must again resume the injection
& down with the system to get quit of the Chordee, tho
God knows I believe you woud have thought me suffic¬
ently low - your letter came to hand by this, & as it was
so delicately managed I found I coud show it with
propriety - It was read - it was returned to me again - &
no remark made - but with a sameness of pipe & tone
" 'tis well, very well - did you take a full purge today - aye do "
" take a full purge the chordee is a troublesome symptom
" I wish you a good afternoon Sir" Well, I went on in this
manner (but purged with manna) for 20 days - & I may
thank God you directed the manner of purge proper or
I suppose I might have had the same Gantlet tosses 1 : over
again - You mentioned I possibly might have a Gleet &
Stricture remaining - & directed how to proceed in either
of these Cases. No notice was taken of this tho, and I
was treated in the same manner as if it had be ↑en↑ recent
& virulent - indeed from the colour seeming bad - my not
having been above half cured when it sunk away by my


[Page 5]

weakness, & the Chordee still continuing I readily enough gave
into the belief that I was not at all in the situation
you supposed I might be in, & so kept as Ive said purg¬
ing
& injecting for 20 days more - during this time I used
to endeavour to extract from Hall his Opinion of mercury
in my case for as you may remember he had (along with
a certain Dr. Black here) just begun a course of pills
but a few days before the suppression came on last spring
his Opinion was never deciseve or satisfactory "indeed he"
"did not know - I have not much confidence in it, & it"
"wont do any harm, - you may try it - but I woud"
"rather defer it - its so dangerous as to catching cold"
"in your present situation" - However Black happening
to call on me as an acquaintance not having at this
time employed any more of them as I naturally imagined
Hall the most proper to finish the cure of the Clap
which he had begun" ↑&↑ As to Rheumatism I know more
of it than any of them - He (Black) happening to ex¬


[Page 6]

press himself positively that nothing but mercury woud
conquer it - it was very naturall for me to try it - es¬
pecially as I conceived my self to be in ↑a↑ different situation
from that you supposed, and as Hall would not be sa¬
tisfactory for or against it, & I found his purging & in¬
jecting
& poulticing woud not do -- Accordingly I took
me some five or six twenty pills of a grain each, made up
with Opium & Camphor which were to do for the Chordee
this took up near a month, as I was obliged to disuse
them now & then - for before I had taken a dz I was set a
spitting at the rate of a quart a day & even a good
deal in the night - this was kept up for 16 days -
While on the height of the spitting, the matter seemed
to look better, & be of a better consistence ↑& the Chordee nearly gone, but on
leaving off the mercury & my mouth getting restored
again, the running & Chordee return'd with the same
if not increased violence - Upon this I grew quite
melancholy, I neither coud ↑get↑ rid of the disorder nor


[Page 7]

at all satisfied that any of them understood it - for Hall
woud now & then see me even when I had put myself
under Blacks course, ↑&↑ did not seem to condemn it
He saw me after I had done with it, when surely my
system was sufficiently low & yet the chordee at¬
tended me - & therefore ↑he↑ could not again desire me to
resume the former method - It was at this time I
catch'd at the idea of going home to see you as
the last Twigg -- & had absolutely made some
preparation for it - & wrote Mr. Jameson of my
intention - However from the time I had resolved
on this I coud perceive the difficulty of making
water
encrease so as prodigiously to alarm me
As I imputed this to the Mercury I had taken inwardly & had
even injected, mix'd with oil, I thought Black coud
not relieve me of it - Hall he called on me while
I was in the horrors expecting every other day to
have a totall suppression - he had not


[Page 8]

seen me for 10 days before, & on my representing my fears &
situation to him - (now my situation at this time was truly de¬
plorable - having come across Le Dran on surgery who paints
the consequences of a deseased bladder & difficulty of making
water
in terrible colours - I was clear my complaints were
such & arose from such causes he there described in his Chapr.
on Fistulæ in Perineæ) - Hall however rather aggravated my
fears - After I described what I felt & & what I thought - "I am"
"apprehensive Sir, there is a Caruncle - I think it would be"
"adviseable to send for Bougies - I wish ye a good after¬"
"noon Sir" After such treatment as I had had, & such a
cold undecisive manner in the situation I was now in I
did not think of resting there, but sent for Dr. Bland who
lives within some few miles - He was gone to [Worts?] 2 - I
then sent to Dr. Currie A Young lad who lived with
Dr. Hardie in Glasgow - & who from his readiness & appli¬
cation has made a figure in his way here - He came
- He consulted with Dr. Hall - & to be sure they were
polite enough to agree cordially both as to what re¬
mained to be done & what had been done -


[Page 9]

Currie however condemned positively the use of the Mer¬
cury
& imputed my present situation to what I had tak¬
en of it - He & Hall prescribed - a regimen - an injection
- fomenting with lead water - & if in a few days
no Appearance to the better - to use the Bougies
- As to the regimen it varyed from what I had been
strictly observing before, only in allowing some White
meats & for Drink Claret & Port wine diluted - the
injection I suppose might have been the same with
Halls only that ↑it↑ was differently made up having Oil
& yolk of Egg in the Composition - But Currie hurry'd
every thing down he proposed & Halls genius seemed
to shrink before him - However Dr. Bland re¬
turning home came & saw me the very day I was
beginning on their plan - He heard my Story ab
initio 3 (for he had never been called in before) - He saw
the prescriptions - He condemned the variation they
had recommended on my manner of living - chiefly
the Claret & port for drink - my System wanted mend¬


[Page 10]

ing but it woud mend fast enough on milk & what
else I had been living on - but any stimulating food
or such drink was improper - directed me not to
meddle with the Bougies & substituted in room
of Curries Oil & Eggs &c (wh even the oil woud
only serve to irritate) a dram of Sal Saturni
& 2 of Gum Arabic disoled in water, which I was
to use two or three times a day - & now ↑&↑ then might
throw up milk & water -- Spoke positively &
satisfactorily on the symptom I had & their cause
as being chiefly owing to the tenderness of the whole
Urethra, owing to the [irration?] being kept up for
such a length of time, for want of proper manage¬
ment & attention to that object - that what supp¬
ng there was, was not virulent - but affect - not
withstanding the Appearances to the Country from the
colon being ↑of a↑ yellowish green sometimes - & the continue¬
ance of Chordee - apprehended no Stricture - nor


[Page 11]

that the bladder was any how Affected, except from
sympathy, notwithstanding the difficulty in making
urine
, & of my Observing even at the last of making
water
, small flakes or portions of whitish water
pass along with it - I also was ord (↑directed↑) for the pain
I felt at the root of perineo, (as well on making
water a burning heat - & stiffish pain or gripping
with the Anus at the last drops - As that it
remained even sore on being pressed with the
finger at all times -) For this I was to bath with
lead water & use a paultice made of same
for some few nights -- In short I got some
idea of my disorder & the cause of it, which
I never coud get before with my utmost pains
& I have the satisfaction even now after having
followed his derection & attended to the effects
to find it turn out right - The pain in perineo
& Ano are gone - the Chordee is less - My Apprehen¬


[Page 12]

sions & doubts & horrors of an approaching suppression
are removed which has had such a happy effect on
my body that tho I have eat nothing but bread &
milk, & Tea - Apples &ca I have within this last
40 days, almost got to my usual Strength & ap¬
pearance - The running still continues else but is
something diminished, is more glutinous - & not quite
so yellow - Lastly I make water much better - with
less difficultie - & with little or no heat - especially
if I take my usual qty of Barley water with
the Gum Arabic - About a quart of this a day -
Currie had added to this Attending drink - magnesia
white vitriol &ca but Bland preferring the
more simple one of Gum Arabic alone, I have always
stuck to it - He prescribed ↑also↑ Flowers of sulphur
occasionally - which I had before chosen out of your
list - & found it have a very happy effect -


Dr. Bland saw me yesterday & from the whole
recommends a perseverance in the manner I am



[Page 13]

going on - that I need nothing more from him or any one
as a Physician - If this shoud be the case I must
think Dr Bland has much merit with me for his
Candour & Skill - it had been happy if I had ap¬
plied to him first - happy had I spoke to him be¬
fore I went to the Springs - & still much ↑so↑ if on my
return from them I had laid my case before him - I
am certain of this, because before he knew any¬
thing of your Opinion from what I had wrote you
His doctrine corresponded with yours to a
title -- But some Cursed fatality seems
to have attended me - For from what to other
people are very simple causes have to me
arisen the most vexatious painfull tedious
disorders, & it has always been my fate to
be improperly managed in them -- I remember
Bauldy Carcior from Hamilton a colleague & friend
of mine mention'd to me in Confidence about


[Page 14]

3 year ago that you had but a superficial Opinion
of Bland - perhaps when at home he may have been
but superficial - but it really seems to all who
know him now, that he is at least equall if not
Superior to any of his Profession in the Colony -
However the impression this had on me & prejudice
in favoure of any one Coming fresh from 4 years
Study under you determined me fatally to de¬
pend on Hall - Who on Acct. of his Genius &
Theoricall abilities is a melancholy proof to
me that experience is as much necessary as
study & reading -- I hope youll pardon me putting
you to the trouble of reading so much foreign
stuff -- but on Acct. of my situation & the occur¬
rencies that have happened to me, are so intertwined
in my mind with what else Ive wrote {illeg} I coud not
well seperate them -- Besides from the experience
I have had of Your Candour & humanity (all


[Page 15]

the world Confess your Abilities) I find my self relieved
in writing you all I know & think without cere¬
mony or reserve -- And now there seems to remain
that I lay before you briefly, the situation I am
in at present - which my freind Mr. Spence who
will deliver you this can supply where any
doubt about me may remain with you - And
begg you'll be kind enough to give me your
Opinion of my disorder if you think it can be done
from what Ive wrote - & ye. advice how I shall manage
myself futurely in any thing in this respect other
than what I have already had of you should occur
I have at present a prospect of doing conquering
all my Complaints - & a freedom from pain
seems now to be ↑my↑ utmost or greatest wish -


My Rheumetism is now entirely conquered - owing
I believe to the care in avoiding cold - Flannell Shirt
- Milk regimen - which ↑with↑ the Sulphur I take occasionally



[Page 16]

now agrees with me if possible better than when under that re¬
gimen at home - & possibly the Mercury I took wh hurt
me so much otherways, helped to discuss it - or put it
in a disposition for the better - A little heat As I've
said yet remains in making water, when not diluted
a little running & a little Chordee - but both
these seem in a progress to the better - the Colour
of running Mr Spence if necessary will describe
- it seems now & then yet of a yellow hue - but
is less in qty & more glutinous -- I yet pass always
with my urine these ↑small↑ Flakes of white glutinous
matter
, & I see them go along plainly towards the
last of making it -- In about 7 or 8 days after
disusing every thing by Blands direction -- except injecting the lead water now & then & milk & water occasionally↑
- fomenting wt. lead water the perineum and ap¬
plying a poultice or two, - the pains there & other
symp gave way & I made water for two or three
days as well & in as large a Stream as I almost


[Page 17]

ever did - but from that again the difficulty again gr[a]¬
dually returned - & again grew better - but not quite
so well as before - By attending narrowly and Anxi¬
ously to these Changes - I found first that I had no
reason to apprehend a Caruncle in the urethra
as the Stream had now flowed as large as usual
in health - in the next place I imputed the cause
of the return of the difficulty & smallness of
Stream - to the very extreme tenderness & irri¬
tability of the whole parts - as this had suc¬
ceeded twice, to some business I had been
doing in my Sleep which seemed to exert the
parts as much as If ↑I↑ had had reall inter¬
course - & still farther satisfied me as to
Blands Opinion - All now that remains of
my fears is on this Accot. I do not make water yet
to my mind - & I observe I seldom can retain it


[Page 18]

{illeg} two hours even tho these be but little to make
& The Chordee yet attends me -- In every other respect
I am well my body cool & free from feverishness
& I find no difficultie in my milk regimen &
drinking occasionally the barley water & Gum Ar¬
abic
-- I woud fain hope that by the Spring
I may be releived of all by going on with this
& now & then using the injection - At all events
I may hope not ↑to↑ be any worse by observing
these, till I can hear from you - I have just
one Observation more to mention - that when
free from any urinary Complaint the water seems
to be one large Stream - at other times its apt
to get into two small ones issuing from each
end of the mouth of ↑ye↑ urethra, & when the difficulty
is great, only one of these Streams issue, & some
times it has come drop by drop, this it did the


[Page 19]

very morning of that Even day on the Evening
of which the difficultie first gave way to a
most pleasing change, which for the first time
set me at rest & satisfied me there coud not
be ↑a↑ Caruncle where the Stream flowed So
well -- Ive now done Sir & begg
your pardon for so tedious a detail ↑to↑ you
whose time I know well to be of much
importance every hour of it --


Mr Spence will likeways accompany
this with a small acknowledgement & if I can
be of any use to you here in any manner of
way it woud give me great pleasure to
have your Commands -- and I always am
with much esteem & respect

Dear Sir
yr. Obed hble Servt

Henry Lochhead



[Page 20]


PS It was clearly the piles which from my imperfect des¬
cription you imagined might be a falling down of the
Gut - There were severall of them very discernible at
the time I last wrote you, which had arrived after
the Operation, & which tho not painfull yet as the
wound was not then heal, & Le Dran mentions them
incurable but by ligature or incesion I was much
frightned -- You saw the severall recipes I had from
the Faculty here, but an Old woman gave me
an Ointment made of a weed we have here called
Jamston weed stewed with Cream which as I
thought the most simple made use of & it had
the effect in two or three days - There are still
rugæ remaining, and the lips of the Anus pro¬
trude greatly if I strain - but acBut your strict
injunctions as to the trim of my belly, which I
have as strictly attended to, seems to keep all the
parts in good order


yrs above

HyL



[Page 21]


Doctor Cullen
Physician
Edinr.


Mr. Lochead

Notes:

1: 'Gantlet' is a variant spelling of 'Gauntlet', a type of glove associated with medieval Knights. Lochead is alluding to the proverbial expression "throw down the gauntlet" (i.e. issue a challenge), to imply that, without Cullen's intervention, he would have had to face another confrontation with Dr. Hall.

2: Possibly an abbreviation for 'Worcester'.

3: 'From the beginning'.

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