Cullen

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

 

[ID:491] From: Dr William Cullen (Professor Cullen) / To: Mr Thomas Duncanson / Regarding: Mr A C (Patient) / 27 April 1774 / (Outgoing)

Reply to Mr Thomas Duncanson, Surgeon at Forres, on treatment of his friend or relative, Mr. A. C., who has a variety of symptoms. Cullen concentrates on his abdominal swelling and evening fever. A diuretic prescription follows. Below the prescription, there are some random marks suggesting the testing of a quill-pen (not transcribed).

Facsimile

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Metadata

FieldData
DOC ID 491
RCPE Catalogue Number CUL/1/1/3/69
Main Language English
Document Direction Outgoing
Date27 April 1774
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply to Mr Thomas Duncanson, Surgeon at Forres, on treatment of his friend or relative, Mr. A. C., who has a variety of symptoms. Cullen concentrates on his abdominal swelling and evening fever. A diuretic prescription follows. Below the prescription, there are some random marks suggesting the testing of a quill-pen (not transcribed).
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:456]
Case of Mr. A. C., who has a variety of symptoms. including abdominal swelling and evening fever.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1564]AddresseeMr Thomas Duncanson
[PERS ID:1305]PatientMr A C
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:1564]Patient's Physician / Surgeon / ApothecaryMr Thomas Duncanson
[PERS ID:1564]Patient's Relative / Spouse / FriendMr Thomas Duncanson

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 Forres East Highlands Scotland Europe certain

Normalized Text

[Page 1]
To Mr Thomas Duncanson Surgeon at
Forres.


I have considered to all the attention I am capable
off the whole history of your friends complaints & shall be very happy
to give him relief & you satisfaction. I consider the cough
rheumatic pains & coldness of his stomach & bowels as gone & out
of the question & at present I attend only to his swellings & evening
fever
. With respect to the 1st I regret a little that you have nt told
me whether there is any fluctuation to be felt in the abdomen but from



[Page 2]

the swelling you mention of late increasing towards
the pit of his stomach with scarcity of urine & emaciation of the [rest?]
of his body I conclude he is or will be very soon, evi¬
dently Ascitic & from the circumstances in the cause & conduct
of his disease I suspect there may be visceral obstructions
This opinion implies an unfavourable prognostic but
I hope matters are nt desperate & that the following measures
may be of service.


The dose of Crem. Tart. & Jalap you mention seems to
have been well judged & to have had good effects & I would
have it repeated every 2 or 3 day as his strength may bear.
In the intermediate days let him take a dose of crem. Tart.
in the morn but no more than to give him one stool. The
same day at noon & towards evening let him take a dose
of the Diuretic Infusion ordered below & he may also take a dose on
the evenings of the days he takes the Purgatives. In the dose
of Crem. Tart. & Jal. you employed I suppose the first was in
large & the 2d
in small proportion & so I would wish it
to be as, while his evening fever continues. I think he will
not bear any strong Hydragogue.


Every day that he takes not the Physic he should continue to
go on horseback & take what exercise in that way he can easily
bear.


His diet may be of any plain light meat his appetite leads
him but he must as much as possible avoid broth & all liquid food.
His drink may be Rhenish wine with a large proportion
of water but he should take as little of either as he can be satisfied
with.


If the swelling of his belly goes on increasing & gets any
[considerable?] let it be anointed all over with Olive oil.
Let the rubbing of it be gentle but long continued. If
that has no sensible effect in promoting urine in the course
of 8 or 10 days the trouble of it may be afterwards saved.
In the whole of the above you may perceive upon what
supposition I have proceeded but from some imperfection



[Page 3]

in the description of the case there may be some uncertainty
in my judgment of it & therefore if you suspect any thing
of this kind I desire you will write me & give me the facts
more exactly & in the meantime as circumstances may be
daily changing I leave matters to your discretion.

For Mr. A. C.

Take half an ounce each of Wild Carrot seeds and Juniper. Crush well and pour over two pints of boiling water. Steep overnight and add two drachms of Salts of Tartar. After it has settled, strain. Label: Diuretic Infusion, 2 tablespoonfuls to be taken for a dose.

W. C.
27 April.
1774.
1

Notes:

1: The marks to be seen on the page at this point are probably just the result of testing of a new quill (pen).

Diplomatic Text

[Page 1]
To Mr Thomas Duncanson Surgeon at
Forres.


I have considered to all ye attention I am capable
off ye wle history of yr friends compts & shall be very happy
to give him relief & you satisfaction. I consider ye cough
rheumatic pains & coldn of his stomach & bowels as gone & out
of ye question & at prest I attend only to his swell.gs & evening
fever
. W respt to ye 1st I regret a little yt you have nt told
me wer there is any fluctuatn to be felt in ye abdomen bt fm



[Page 2]

ye swelling you mention of late increasing towards
ye pit of his stom. w scarcity of urine & emaciatn of ye [rest?]
of his body I conclude he is or will be very soon, evi¬
dently Ascitic & fm ye circumstances in ye cause & conduct
of his disease I suspect yre may be visceral obstructions
This opinion implies an unfavourable prognostic bt
I hope matters are nt desperate & yt ye following measures
may be of service.


The dose of Crem. Tart. & Jalap you mention seems to
have been well judged & to have had good effts & I would
have it repeated every 2 or 3 day as his strength may bear.
In ye intermediate days let him take a dose of crem. Tart.
in ye morn bt no more yn to give him one stool. The
same day at noon & towards eveng let him take a dose
of ye Diuretic Infusn ordd below & he may also take a dose on
ye evenings of ye days he takes ye Purgatives. In ye dose
of Crem. Tart. & Jal. you employed I suppose ye first was in
large & ye 2d
in small proportion & so I would wish it
to be as, while his evening fever cont. I think he will
not bear any strong Hydragogue.


Every day yt he takes not ye Physic he should cont. to
go on horseback & take wt exercise in yt way he can easily
bear.


His diet may be of any plain light meat his appetite leads
him bt he must as mc as possible avoid broth & all liquid food.
His drink may be Rhenish wine w a large proportion
of water bt he should take as little of either as he can be satisfied
w.


If ye swelling of his belly goes on increasing & gets any
[consider?] let it be anointed all over w Olive oil.
Let the rubbing of it be gentle bt long continued. If
yt has no sensible effect in promoting urine in ye course
of 8 or 10 days ye trouble of it may be afterwards saved.
In ye whole of the above you may perceive upon wt
supposition I have proceeded bt from some imperfectn



[Page 3]

in ye description of ye case yre may be some uncertainty
in my judgment of it & yrefore if you suspect any yg
of ys kind I desire you will write me & give me ye facts
more exactly & in ye meantime as circumstances may be
daily changing I leave matters to your discretion.

For Mr. A. C.


Sem. Dauc. Silvestr. Bacc. Junip. @ ℥ſs
Bene contuses affunde Aq. Bullient lbii. Digere pr
noct. & adde Sal. Tart. ʒii Post subsidentiam cola
Signa Diuretic Infusion 2 tablesp. f.s to be t.n for a dose.

W. C.
27 April.
1774.
1

Notes:

1: The marks to be seen on the page at this point are probably just the result of testing of a new quill (pen).

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