Cullen

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

 

[ID:713] From: Dr William Cullen (Professor Cullen) / To: Dr Thomas Stephen / Regarding: Captain Grant (Patient) / 18 February 1783 / (Outgoing)

Reply to Dr Stephens regarding his patient Captain Grant. Cullen believes his symptoms to be moderate, but their persistence indicates 'a tubercle in the lungs'. Cullen is not certain whether his genital swelling is related to previous venereal disease, and discusses the use of mercury in cases where a patient has both phthisical and venereal ailments. He refers to the late Dr John Stevenson and Sir John Pringle.

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Metadata

FieldData
DOC ID 713
RCPE Catalogue Number CUL/1/1/15/200
Main Language English
Document Direction Outgoing
Date18 February 1783
Annotation None
TypeMachine copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply to Dr Stephens regarding his patient Captain Grant. Cullen believes his symptoms to be moderate, but their persistence indicates 'a tubercle in the lungs'. Cullen is not certain whether his genital swelling is related to previous venereal disease, and discusses the use of mercury in cases where a patient has both phthisical and venereal ailments. He refers to the late Dr John Stevenson and Sir John Pringle.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1377]
Case of Captain Grant who has consumptive symptoms and also swelling of the genitals.
4


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:820]AddresseeDr Thomas Stephen
[PERS ID:3077]PatientCaptain Grant
[PERS ID:820]Patient's Physician / Surgeon / ApothecaryDr Thomas Stephen
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:974]Other Physician / SurgeonDr John Stevenson
[PERS ID:522]Other Physician / SurgeonSir John Pringle
[PERS ID:3949]Patient's Relative / Spouse / FriendMrs Grant

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 Elgin East Highlands Scotland Europe inferred
Therapeutic Recommendation Europe certain
Mentioned / Other Britain Europe certain
Mentioned / Other Highlands East Highlands Scotland Europe certain

Normalized Text

[Page 1]
Dr Stephens Concerning Captn Grant
Dear Sir


Yours of the 12th. came to hand only yester¬
day and I answer it as soon as I possibly could as I
am anxious to show the utmost attention to Capt. Grant
Though his symptoms of Cough expectoration & pulse
are very moderate
they are however so considerable and
have lasted so long as unavoidably to give suspicion
of a tubercle in
his lungs. In such a Case I have long
given over my hopes of doing much good by medicine
& have thought that the patient's safety depended
upon avoiding all irritation by a proper regimen,
& particularly by avoiding the application of cold.
With respect to the latter I was anxious in per¬
suading Capt. Grant that though he was so well
when he left this that he might hazard a Visit to
the North yet that upon the return & continuance
of his Breast complaints he should immediately



[Page 2]

quit the North & return to a Climate further [South than?]
any part of Britain & I am much afraid that the Capt.
has neglected this advice too long though it is still the
only one I can offer with respect to his Breast Com¬
plaints
.


With respect to his other complaints the attack
of Piles
promise to do him service & in the mean
time you treated the matter with the greatest
propriety & will do so again if the piles should
return
.


With respect to the tumour on the Epidydymus
it may be a consequence of former Venereal ailments
but after such a long interval as I suppose since
any thing occurred been marque appeared in that
way I must doubt of it & would not wish to hazard
much on that supposition. I am much disposed
to think that swelled testicles & swelled Epidydymus
aalmost always depend upon some affection near to



[Page 3]

the neck of the Bladder about the orifices of the Vesicules
Seminales
& would suspect that Capt. Grants present
complaint may proceed from some inward piles com¬
municated to the prostate glands & neighbouring parts
as frequently happens. From this View of things you
will perceive that I would not be hasty in considering
the matter as Venereal
& therefore in having recourse
to mercury
which w certainly we could not (↑hardly↑) use with so
much freedom as would be necessary to eradicate
a taint lurking in the whole System. The measures
you have pursued have been very proper & if
your poultice has been made with
Lead Sugar I hope that with this & proper suspension
the ailment is by this time very much gone off.
But if I should be mistaken in this I shall not
object to the trial of some mercury with all the caution
that I know your discretion will employ. It is the
most probable means of removing the obstruction,
which I suppose to take place in this case and


[Page 4]

though I do not think that Mercury is well adapted
to Phthisical complaints yet I must own that the
late Dr. Stevenson of this place & the late Sir John
Pringle frequently employed it in such cases & where
Venereal Ailments were ↑evidently↑ combined with the Phthisical
I have myself employed it but in all cases I have
found that where the Phthisis was the principal
disease the mercury could not be pushed far without
doing much mischief. If therefore from Capt. Grants
information you have more reason to think the
present complaint Venereal
& especially if the
ailment prove obstinate to other remedies I agree
to your trying a little mercury. Let a little of a weak
ointment
be rubbed on the tumour every night &
let him take internally half a grain of mercury every
night & morning, that is, taking half of one of the
mercurial pills of our Dispensatory
& this may
be continued till the breath is a little tainted or


[Page 5]

till somewhat of a Copper taste is perceived in the
the mouth & upon either of these appearances you must
cease giving the pills for two or perhaps three days
till you are certain that the mercury is not come
into the mouth too fast (but being certain of this you
may again return to give half a grain once or twice
a day as you shall judge proper. My plan would
be to throw some mercury into the System & that
for some length of time but always taking care that
it never goes the length of any Salivation. This is
all that I can say to give a general plan & I have
no doubt in trusting to your discretion in the
conduct of it. I hope you shall have no occasion
for mercury at all but that in no case Capt. Grant
think his ailments neglected I consent to it in
the manner I have now proposed. I should have said
before that I think that your [Decoction?] of S{illeg} 1 & milk
was & will be a very proper measure. With regard


[Page 6]

to Regimen I need not offer you any direction & I believe
the regimen I formerly directed for Capt. Grant cannot
be improper upon this occasion. With very respectful
Compliments to Capt. Grant & his Lady I am with great
regard Sir

Your most Obedient Servant
William Cullen
Edinburgh 18th.
February 1783.

Notes:

1: Unfortunately no incoming communication has been traced to establish precisely what this blurred mention of a medication refers to.

Diplomatic Text

[Page 1]
Dr Stephens C Captn Grant
Dear Sir


Yours of the 12th. came to hand only yester¬
day and I answer it as soon as I possibly could as I
am anxious to show the utmost attention to Capt. Grant
Though his symptoms of Cough expectoration & pulse
are very moderate
they are however so considerable and
have lasted so long as unavoidably to give suspicion
of a tubercle in
his lungs. In such a Case I have long
given over my hopes of doing much good by medicine
& have thought that the patient's safety depended
upon avoiding all irritation by a proper regimen,
& particularly by avoiding the application of cold.
With respect to the latter I was anxious in per¬
suading Capt. Grant that though he was so well
when he left this that he might hazard a Visit to
the North yet that upon the return & continuance
of his Breast complaints he should immediately



[Page 2]

quit the North & return to a Climate further [South than?]
any part of Britain & I am much afraid that the Capt.
has neglected this advice too long though it is still the
only one I can offer with respect to his Breast Com¬
plaints
.


With respect to his other complaints the attack
of Piles
promise to do him service & in the mean
time you treated the matter with the greatest
propriety & will do so again if the piles should
return
.


With respect to the tumour on the Epidydymus
it may be a consequence of former Venereal ailments
but after such a long interval as I suppose since
any thing occurred been marque appeared in that
way I must doubt of it & would not wish to hazard
much on that supposition. I am much disposed
to think that swelled testicles & swelled Epidydymus
aalmost always depend upon some affection near to



[Page 3]

the neck of the Bladder about the orifices of the Vesicules
Seminales
& would suspect that Capt. Grants present
complaint may proceed from some inward piles com¬
municated to the prostate glands & neighbouring parts
as frequently happens. From this View of things you
will perceive that I would not be hasty in considering
the matter as Venereal
& therefore in having recourse
to mercury
which w certainly we could not (↑hardly↑) use with so
much freedom as would be necessary to eradicate
a taint lurking in the whole System. The measures
you have pursued have been very proper & if
your poultice has been made with
Saccharum
Saturni
I hope that with this & proper suspension
the ailment is by this time very much gone off.
But if I should be mistaken in this I shall not
object to the trial of some mercury with all the caution
that I know your discretion will employ. It is the
most probable means of removing the obstruction,
which I suppose to take place in this case and


[Page 4]

though I do not think that Mercury is well adapted
to Phthisical complaints yet I must own that the
late Dr. Stevenson of this place & the late Sir John
Pringle frequently employed it in such cases & where
Venereal Ailments were ↑evidently↑ combined with the Phthisical
I have myself employed it but in all cases I have
found that where the Phthisis was the principal
disease the mercury could not be pushed far without
doing much mischief. If therefore from Capt. Grants
information you have more reason to think the
present complaint Venereal
& especially if the
ailment prove obstinate to other remedies I agree
to your trying a little mercury. Let a little of a weak
ointment
be rubbed on the tumour every night &
let him take internally half a grain of mercury every
night & morning, that is, taking half of one of the
mercurial pills of our Dispensatory
& this may
be continued till the breath is a little tainted or


[Page 5]

till somewhat of a Copper taste is perceived in the
the mouth & upon either of these appearances you must
cease giving the pills for two or perhaps three days
till you are certain that the mercury is not come
into the mouth too fast (but being certain of this you
may again return to give half a grain once or twice
a day as you shall judge proper. My plan would
be to throw some mercury into the System & that
for some length of time but always taking care that
it never goes the length of any Salivation. This is
all that I can say to give a general plan & I have
no doubt in trusting to your discretion in the
conduct of it. I hope you shall have no occasion
for mercury at all but that in no case Capt. Grant
think his ailments neglected I consent to it in
the manner I have now proposed. I should have said
before that I think that your [Decoction?] of S{illeg} 1 & milk
was & will be a very proper measure. With regard


[Page 6]

to Regimen I need not offer you any direction & I believe
the regimen I formerly directed for Capt. Grant cannot
be improper upon this occasion. With very respectful
Compliments to Capt. Grant & his Lady I am with great
regard Sir

Your most Obedient Servant
William Cullen
Edinr. 18th.
Feby 1783.

Notes:

1: Unfortunately no incoming communication has been traced to establish precisely what this blurred mention of a medication refers to.

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