Cullen

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

 

[ID:4788] From: Dr William Cullen (Professor Cullen) / To: Dr Colin Ross / Regarding: Mr John Parish (J.P.; Mr P.) (Patient) / 1 March 1784 / (Outgoing)

Reply, 'Dr Ross'. Cullen says that he has heard from Dr Johnstone concerning 'your patient Mr. P.' (John Parish). He gives dietary advice and also advice on use of a carriage for exercise, describing the springing of carriages used in Britain (presumably different from that used in Germany). He now suspects 'a Schirrosity of the Prostate Gland near the neck of the Bladder' and advises the use of Cicuta. He tells Ross he has not yet had any news regarding his son or his brother, Hercules Ross of Rossie.

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Metadata

FieldData
DOC ID 4788
RCPE Catalogue Number CUL/1/1/16/192
Main Language English
Document Direction Outgoing
Date1 March 1784
Annotation None
TypeMachine scribal copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply, 'Dr Ross'. Cullen says that he has heard from Dr Johnstone concerning 'your patient Mr. P.' (John Parish). He gives dietary advice and also advice on use of a carriage for exercise, describing the springing of carriages used in Britain (presumably different from that used in Germany). He now suspects 'a Schirrosity of the Prostate Gland near the neck of the Bladder' and advises the use of Cicuta. He tells Ross he has not yet had any news regarding his son or his brother, Hercules Ross of Rossie.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1664]
Case of 'J. P.' [identified as likely being John Parrish] an unnamed male patient with a urinary disorder as reported by Colin Ross in Hamburg.
4


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:2968]AddresseeDr Colin Ross
[PERS ID:3613]PatientMr John Parish (J.P.; Mr P.)
[PERS ID:2968]Patient's Physician / Surgeon / ApothecaryDr Colin Ross
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:3618]Patient's Relative / Spouse / FriendMrs Parish
[PERS ID:3616]Patient's Relative / Spouse / FriendMr Hercules Ross (of Rossie)
[PERS ID:3615]OtherMr Hercules Ross
[PERS ID:3616]OtherMr Hercules Ross (of Rossie)
[PERS ID:3617]OtherReverend David Johnstone (Johnston; Dr Johnstone)

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 Hamburg Germany Germany Europe inferred
Mentioned / Other Rossie / Rossie Estate Montrose East Highlands Scotland Europe certain

Normalized Text

[Page 1]
Dr. Ross
Dear Sir


It gave me great pleasure to hear from
Dr. Johnstone that your patient Mr. P. was so
much relieved by the medicine I ↑had↑ prescribed for him
and I am glad to have it confirmed by a more
exact amount from you. I am sorry however for
the additional information you give me which shows
that for some time past he has been a good deal
distressed and had little or no relief from the
same medicines. Upon this subject allow me
to tell you that though in several such cases
I have had benefit from these remedies in
several other Cases I have found them entirely
ineffectual and particularly in such cases as had
frequent returns of feverish fits and in such
cases I doubt if the Bearberry be quite safe and
I have found the balsam directly hurtful. It
appears that your patient has of late been



[Page 2]

liable to frequent returns of a feverish state and to
this I impute the failure of my remedies and would
now advise him to lay them aside and particularly
the balsam for a month or two and in the mean
time to take some measures for obviating the return
of the feverish fits. On this subject however
I find it difficult to advise as I cannot clearly
perceive upon what the recurrence of his feverish
fits
especially depend whether upon the disease
at the neck of the bladder or in the prostate
gland
or whether upon some more general fault
in his constitution. It is you that must assist
me in determining this question but in the
mean time I shall give you some opinion.


Let him abstain entirely from every kind of fer¬
mented liquor, but if his former habits require
some Cordial drunk let him take some spirit
with a good deal of water [though I wish?] he



[Page 3]

could abstain from every kind of spirituous liquor
and let his only drink be the Arabic Emulsion
or water with a large proportion of the Gum in it.
Plentiful dilution is proper for him and therefore
he may take other liquids as Tea, Coffee, weak
Chocolate and weak broths but the latter with
as little salt as possible. If he digests milk
easily he may take it for a great part of his
diet and with it or without it the farinacea
should make a considerable part of his food.
He may take moderately of the lighter kinds
of Animal food for he must avoid Roots, greens
or other garden things liable to acescency and
with his Animal food he must avoid every
thing acid and therefore pickles of all kinds.
[Salts?] and spiceries are also improper and my
[plan?] is {illeg} [order?] the whole of his meat and
[drink as?] {illeg} [good milk?] as possible and I


[Page 4]

have found such a measure necessary and often
useful in all ailments of the neck of the bladder.


Another measure which I have found equally
proper is the avoiding every degree of costiveness
and at the same time every purgative that is
liable to irritate the rectum. In case of Costive¬
ness
therefore let him avoid all Aloetics and
acrid purgatives. Cream of Tartar as an acid is
also improper for the neck of the bladder. If
White Magnesia will operate moderately it
may be employed but what I think may
answer best of all is the Castor Oil if
his stomach bears it easily and it will operate
in a small quantity for let me observe
that large purging from any medicine
whatever will irritate the rectum and
neck of the bladder.




[Page 5]


Exercise in fresh weather may be very necessary
for Mr. P. health but the former must be ma¬
naged with great discretion. Walking should be
very gentle and but little at one time. Riding
except at a foot pace will readily do much harm
and the only exercise which can be quite safe
is going in an easy Carriage upon smooth roads.
Our Carriages are now made by Seats with Canvass
bottoms instead of boards and with Eight springs
four of them being applied to the bottom of the
Carriage and by more or less of these precautions
Mr. P. may have a good deal of exercise and at
least as the Season advances a great deal of fresh
air but in every situation he must take care
to avoid cold especially as applied to his feet and
legs, and [guard against it.?] If his Chamber or bed
is greatly {illeg} for him {illeg}


{illeg} [long?]



[Page 6]

frequent desire to make water and this especially
in the night time very much interrupting sleep
and increasing fever. The only effectual remedy in
this case is an Opiate but I must leave it en¬
tirely to your discretion to judge how far or how
often in may be employed both with respect to
fever and costiveness. When suppression of urine
occurs you may perhaps find relief by injecting
a few Ounces of the best and freshest florence
Oil
into the rectum.


I have thus given you my best advice in
many particulars but in each submitted to
your discretion who as being upon the spot
can be the most proper Judge and there is one
other object of my anxiety to be admitted in the
same manner. I strongly suspect that there
is a [Schirrosity of the Prostate Gland?] near
the [neck of the Bladder and?] unless we can in



[Page 7]

some measure remove this all our other labour
may be very much lost. For that purpose the only
medicine I can propose is the Cicuta and I would
have you try it to such a length as to have sen¬
sible effects. If it does not dissolve the schirrosity
it will at least be of service as an Anodyne.


I have not yet got any intelligence of your
Brother the Laird of Rossie and therefore of
your Son but I am making enquiry
and you may depend upon my attention
to both. I am with the utmost regard

Dear Sir
Your most obedient Servant
William Cullen
Edinburgh 1st. March
1784


P. S. Dont forget as I have [time about any reas–
of {illeg} write to your Patients wife I hope
{illeg}?] to his Case.

Diplomatic Text

[Page 1]
Dr. Ross
Dear Sir


It gave me great pleasure to hear from
Dr. Johnstone that your patient Mr. P. was so
much relieved by the medicine I ↑had↑ prescribed for him
and I am glad to have it confirmed by a more
exact amount from you. I am sorry however for
the additional information you give me which shows
that for some time past he has been a good deal
distressed and had little or no relief from the
same medicines. Upon this subject allow me
to tell you that though in several such cases
I have had benefit from these remedies in
several other Cases I have found them entirely
ineffectual and particularly in such cases as had
frequent returns of feverish fits and in such
cases I doubt if the Uva Ursi be quite safe and
I have found the balsam directly hurtful. It
appears that your patient has of late been



[Page 2]

liable to frequent returns of a feverish state and to
this I impute the failure of my remedies and would
now advise him to lay them aside and particularly
the balsam for a month or two and in the mean
time to take some measures for obviating the return
of the feverish fits. On this subject however
I find it difficult to advise as I cannot clearly
perceive upon what the recurrence of his feverish
fits
especially depend whether upon the disease
at the neck of the bladder or in the prostate
gland
or whether upon some more general fault
in his constitution. It is you that must assist
me in determining this question but in the
mean time I shall give you some opinion.


Let him abstain entirely from every kind of fer¬
mented liquor, but if his former habits require
some Cordial drunk let him take some spirit
with a good deal of water [though I wish?] he



[Page 3]

could abstain from every kind of spirituous liquor
and let his only drink be the Emulsis Arabica
or water with a large proportion of the Gum in it.
Plentiful dilution is proper for him and therefore
he may take other liquids as Tea, Coffee, weak
Chocolate and weak broths but the latter with
as little salt as possible. If he digests milk
easily he may take it for a great part of his
diet and with it or without it the farinacea
should make a considerable part of his food.
He may take moderately of the lighter kinds
of Animal food for he must avoid Roots, greens
or other garden things liable to acescency and
with his Animal food he must avoid every
thing acid and therefore pickles of all kinds.
[Salts?] and spiceries are also improper and my
[plan?] is {illeg} [order?] the whole of his meat and
[drink as?] {illeg} [good milk?] as possible and I


[Page 4]

have found such a measure necessary and often
useful in all ailments of the neck of the bladder.


Another measure which I have found equally
proper is the avoiding every degree of costiveness
and at the same time every purgative that is
liable to irritate the rectum. In case of Costive¬
ness
therefore let him avoid all Aloetics and
acrid purgatives. Cream of Tartar as an acid is
also improper for the neck of the bladder. If
Magnesia Alba will operate moderately it
may be employed but what I think may
answer best of all is the Oleum Ricini if
his stomach bears it easily and it will operate
in a small quantity for let me observe
that large purging from any medicine
whatever will irritate the rectum and
neck of the bladder.




[Page 5]


Exercise in fresh weather may be very necessary
for Mr. P. health but the former must be ma¬
naged with great discretion. Walking should be
very gentle and but little at one time. Riding
except at a foot pace will readily do much harm
and the only exercise which can be quite safe
is going in an easy Carriage upon smooth roads.
Our Carriages are now made by Seats with Canvass
bottoms instead of boards and with Eight springs
four of them being applied to the bottom of the
Carriage and by more or less of these precautions
Mr. P. may have a good deal of exercise and at
least as the Season advances a great deal of fresh
air but in every situation he must take care
to avoid cold especially as applied to his feet and
legs, and [guard against it.?] If his Chamber or bed
is greatly {illeg} for him {illeg}


{illeg} [long?]



[Page 6]

frequent desire to make water and this especially
in the night time very much interrupting sleep
and increasing fever. The only effectual remedy in
this case is an Opiate but I must leave it en¬
tirely to your discretion to judge how far or how
often in may be employed both with respect to
fever and costiveness. When suppression of urine
occurs you may perhaps find relief by injecting
a few Ounces of the best and freshest florence
Oil
into the rectum.


I have thus given you my best advice in
many particulars but in each submitted to
your discretion who as being upon the spot
can be the most proper Judge and there is one
other object of my anxiety to be admitted in the
same manner. I strongly suspect that there
is a [Schirrosity of the Prostate Gland?] near
the [neck of the Bladder and?] unless we can in



[Page 7]

some measure remove this all our other labour
may be very much lost. For that purpose the only
medicine I can propose is the Cicuta and I would
have you try it to such a length as to have sen¬
sible effects. If it does not dissolve the schirrosity
it will at least be of service as an Anodyne.


I have not yet got any intelligence of your
Brother the Laird of Rossie and therefore of
your Son but I am making enquiry
and you may depend upon my attention
to both. I am with the utmost regard

Dear Sir
Your most obedient Servant
William Cullen
Edinr. 1st. March
1784


P. S. Dont forget as I have [time about any reas–
of {illeg} write to your Patients wife I hope
{illeg}?] to his Case.

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