Cullen

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

 

[ID:4189] From: Dr William Cullen (Professor Cullen) / To: Mr Walter Riddell / Regarding: Mr Robert or Walter Riddell (Patient), Mr (Patient) / 11 November 1777? / (Outgoing)

Reply, 'Walter Riddel Esqr. Dumfries'. Letter gives advice concerning one of Mr Riddell's sons, who is suffering from jaundice. Cullen suggests sieving Mr Riddell Jr's stools to search for traces of biliary stones, although he thinks the ailment is more a spasmodic one. he recommends 'a teaspoonfull of good æther' and keeping his bowels open. He also refers to a case of Mr Riddell's (unnamed) nephew: 'wish I could give as good hopes of your nephew but think that pains should still be taken for his relief', and to Dr Gilchrist and Mr Yorstoun, and a Mr Ferguson.

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Metadata

FieldData
DOC ID 4189
RCPE Catalogue Number CUL/1/1/10/46
Main Language English
Document Direction Outgoing
Date11 November 1777?
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, 'Walter Riddel Esqr. Dumfries'. Letter gives advice concerning one of Mr Riddell's sons, who is suffering from jaundice. Cullen suggests sieving Mr Riddell Jr's stools to search for traces of biliary stones, although he thinks the ailment is more a spasmodic one. he recommends 'a teaspoonfull of good æther' and keeping his bowels open. He also refers to a case of Mr Riddell's (unnamed) nephew: 'wish I could give as good hopes of your nephew but think that pains should still be taken for his relief', and to Dr Gilchrist and Mr Yorstoun, and a Mr Ferguson.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:923]
Case of the son of Walter Riddell, who has a biliary disorder, possibly a stone.
2
[Case ID:2512]
Case of the nephew of Walter Riddell, possibly Mr Kennedy.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1459]AddresseeMr Walter Riddell
[PERS ID:2150]PatientMr
[PERS ID:1683]PatientMr Robert or Walter Riddell
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:115]Patient's Physician / Surgeon / ApothecaryDr John Gilchrist (of Speddoch)
[PERS ID:929]Other Physician / SurgeonDr Thomas Yorstoun (Yerstoun, Yorstown, Yorkston)
[PERS ID:1459]Patient's Relative / Spouse / FriendMr Walter Riddell
[PERS ID:2149]OtherMr Ferguson

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 Dumfries Borders Scotland Europe certain

Normalized Text

[Page 1]
Walter Riddell Esqr. Dumfries. –
November 11th
Sir


I shall be very anxious to be of service to your son and
therefore have considered every part of the information concerning
him with great attention. The case is difficult but I must form
a judgement of it as well as I can.


From the state of his urine Urine & the yellowness of his
skin
at the end of his fits there is certainly an obstruction
and regurgitation of bile attends those fits, and I believe
the cause of this to be the cause of all the symptoms.


Let it therefore be examined whether he passes any biliary
stones
. From the coming on of his fits till four or five
days after them, let every thing he passes in stool be diffused
very perfectly in water, & passed through a hair sieve, so that
if there be any biliary concretions they may be retained upon
the sieve. This examination cannot be omitted but at the same time
I must own that I do not think biliary stone the cause of
the disorder, and from the time that the disease has lasted (Dr
Gilchrist says from an early age) from his having grown very
fast, from the pains & vomitings which attend the fits, and from the absence
of all inflamatory symptoms, particularly from the relief he lately
had from a belt
, I am persuaded that the disease is purely spasmodic
& I would accordingly propose the means of cure to be cold bathing
exercise, bark and Chalybeates, but I will not advise or insist
upon any of these till the examination proposed above is once
made. In the mean time if a fit should come on, let care



[Page 2]

be taken in the first place to have his belly sufficiently
opened, let him at same time have recourse to his belt.
For the rest I would trust to opiates for putting an end to the fit.
Dr Gilchrist observes that Mr Riddel bears opiates well
but that the seem to do little service towards shortening the fits.
It may be so & in that case I would not insist upon them, but
I suspect that they have not been given in such large doses as
are commonly necessary. However that may be there is another
medicine that I would propose, for relieving the fits, & that
is a full dose of a teaspoonfull of good æther given
properly in a little water & upon occasion this dose may
be doubled or repeated as the effects shall direct. I have no
objection to Mr Riddels continuing the pills of soap rhubarb
&c & shall think them very regular (↑proper↑) if they keep his belly
regular without purging. I think his diet is at present very
well ordered & particularly his taking milk & water instead
of tea broth in the morning & afternoon. I have no more
to say of your son but that I see no use for his co¬
ming to Edinburgh unless he were to remain here for months
which would not be otherwise for his health & I think it is not
any ways necessary. I address this letter to you leaving you to
communicate it to the Gentlemen concerned but from them I expect
to have remarks & a further report. I expect that your son
shall in due time be entirely relieved & wish I could give
as good hopes of your nephew but think that pains should
still be taken for his relief. I find nothing to be added to my
last to Mr Yourston. Have sent a repeat of the medicine
last advised to Mr Ferguson who knows best how it may be transmitted
dont chuse to send more at once because of its keeping

W C

Diplomatic Text

[Page 1]
Walter Riddell Esqr. Dumfries. –
Novr 11th
Sir


I shall be very anxious to be of service to your son and
therefore have considered every part of ye information concerning
him with great attention. The case is difficult but I must form
a judgement of it as well as I can.


From the state of his urine Urine & ye yellowness of his
skin
at the end of his fits there is certainly an obstruction
and regurgitation of bile attends those fits, and I believe
the cause of this to be the cause of all the symptoms.


Let it therefore be examined whether he passes any biliary
stones
. From the coming on of his fits till four or five
days after them, let every thing he passes in stool be diffused
very perfectly in water, & passed through a hair sieve, so that
if there be any biliary concretions they may be retained upon
the sieve. This examination cannot be omitted but at ye same time
I must own that I do not think biliary stone the cause of
the disorder, and from the time that ye disease has lasted (Dr
Gilchrist says from an early age) from his having grown very
fast, from ye pains & vomitings wc attend ye fits, and fm ye absence
of all inflamatory symptoms, particularly fm ye relief he lately
had from a belt
, I am persuaded yt ye disease is purely spasmodic
& I would accordingly propose ye means of cure to be cold bathing
exercise, bark and Chalybeates, but I will not advise or insist
upon any of these till ye examination proposed above is once
made. In ye mean time if a fit should come on, let care



[Page 2]

be taken in ye first place to have his belly sufficiently
opened, let him at same time have recourse to his belt.
For ye rest I would trust to opiates for putting an end to ye fit.
Dr Gilchrist observes that Mr Riddel bears opiates well
but yt ye seem to do little service towards shortening ye fits.
It may be so & in that case I would not insist upon them, but
I suspect yt they have not been given in such large doses as
are commonly necessary. However yt may be there is another
medicine that I would propose, for relieving ye fits, & that
is a full dose of a teaspoonfull of good æther given
properly in a little water & upon occasion this dose may
be doubled or repeated as ye effects shall direct. I have no
objection to Mr Riddels continuing ye pills of soap rhubarb
&c & shall think them very regular (↑proper↑) if they keep his belly
regular wtout purging. I think his diet is at present very
well ordered & particularly his taking milk & water instead
of tea broth in ye morng & afternoon. I have no more
to say of your son but that I see no use for his co¬
ming to Edinr unless he were to remain here for months
which would not be otherwise for his health & I think it is not
any ways necessary. I address this letter to you leaving you to
communicate it to the Gentlemen concerned but from them I expect
to have remarks & a further report. I expect that your son
shall in due time be entirely relieved & wish I could give
as good hopes of your nephew but think that pains should
still be taken for his relief. I find nothing to be added to my
last to Mr Yourston. Have sent a repeat of the medicine
last advised to Mr Ferguson who knows best how it may be transmitted
dont chuse to send more at once because of its keeping

W C

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