Cullen

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

 

[ID:810] From: Mr Gavin Fullarton / To: Dr William Cullen (Professor Cullen) / Regarding: Miss Donald (Donald) (Patient), Anonymous (Patient), Anonymous (Patient), Anonymous (Patient), Anonymous (Patient), Anonymous (Patient), Anonymous (Patient), Anonymous (Patient), Anonymous (Patient), Anonymous (Patient) / 14 April 1772 / (Incoming)

Account (unsigned), of inoculating nine children for smallpox over several weeks from January to February 1771; amongst them are two young male patients of Dr Wilson's and Mr Donald's daughter. Writer identified as the Greenock surgeon Gavin Fullerton from linking this enclosure to his cover-letter (ID:819).

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Metadata

FieldData
DOC ID 810
RCPE Catalogue Number CUL/1/2/79
Main Language English
Document Direction Incoming
Date14 April 1772
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Account (unsigned), of inoculating nine children for smallpox over several weeks from January to February 1771; amongst them are two young male patients of Dr Wilson's and Mr Donald's daughter. Writer identified as the Greenock surgeon Gavin Fullerton from linking this enclosure to his cover-letter (ID:819).
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:426]
Case of nine children inoculated against small-pox by Greenock surgeon Gavin Fullarton.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:623]AuthorMr Gavin Fullarton
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:946]Patient
[PERS ID:947]Patient
[PERS ID:948]Patient
[PERS ID:949]Patient
[PERS ID:950]Patient
[PERS ID:915]PatientMiss Donald
[PERS ID:951]Patient
[PERS ID:944]Patient
[PERS ID:952]Patient
[PERS ID:945]Patient
[PERS ID:132]Patient's Physician / Surgeon / ApothecaryDr William Wilson
[PERS ID:623]Patient's Physician / Surgeon / ApothecaryMr Gavin Fullarton
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:86]Other Physician / SurgeonDr David Colquhoun
[PERS ID:914]Patient's Relative / Spouse / FriendMr William Donald

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Greenock Glasgow and West Scotland Europe inferred
Destination of Letter Edinburgh Edinburgh and East Scotland Europe inferred

Normalized Text

[Page 1]


On Wednesday the 23d. of January 1771, I was informed by
Mr Wilson that he had that Day inoculated his two children
for the small pox from a Lad, that had been sent on shore &
put under his Care from a Tender in the road, 1 who had so
favourable a Sort, that he had some Doubt whether it was
the Small pox or not - He had the strongest reason however
he told me for believing that it could be no other Disease (not¬
withstanding of the Appearance at present being a little
ambiguous) from the Lad's Declaration, that he did not remem¬
ber or know of his having had the Small pox, and that he
had lately been in the House, and even in the same Room
with a Child, who was certainly under that Disease. It was
now the fourth Day from their first Appearance, which had
been on Sunday the 20th. and he had had a smart fever
attended with Vomiting, sharp pains in his head, & Back &c.
from the Thursday preceeding - I call'd to see him on Thursday
the 24th. in the Evening, and got the same History from himself.
The pox appeared remarkably small and thinly scattered; but
seemed to have pretty well concocted pus in them, and I thought
I had often seen, in that Stage of the Disease, a favourable
kind of Small pox with precisely the same Appearance -
It was in the Dusk of the Evening indeed; and I had so little
Doubt of its' being the Small pox from the History I had
got, that I did not examine them with all the Accuracy
and Doubt, that I afterwards wish'd I had done, but concluded
at once, and firmly that it was. In consequence of this, next
forenoon, I had seven Children carried to the House where the
Lad lodged to inoculate, after Dimsdales Method, with the
recent Matter from an infected Lancet - Till this time I had
seen him only the one time above mentioned, when I had no
Doubt; but I was now very much staggered with the Appearance
of the pox, and concealed my Embarassment so ill, that a Lady



[Page 2]

who attended the Children to the House and was present, took
Notice of it, and, (without my speaking a single word of my
Doubts) immediately said, I wish, seeing you are not clear
about this being the Small pox, that the Children had not
been brought here - I replied, that they had changed their
Appearance amazingly since the Night before; so much
indeed, that, had not the Lad been in the way of catching In¬
fection from the Small pox, I should now hesitate in believing
that it was the Small pox - The pustules on his face & Neck,
were turned already into little black, dry Scabs; but there was
still Matter in some of these upon his Legs - I had been so
firmly persuaded the Night before of its being the Small pox,
that I concluded, it must be my timidity, and over caution, that
was making me waver now; and, I was perhaps a little ashamed
to avow a Doubt of an Opinion which I had, but the Evening
before so positively asserted - Besides, there could be no harm from
it, I thought, supposing it should not be; and should it turn
out to be the Small pox, which the two Children which Mr
Wilson had inoculated, might soon bring a certain proof of, I
should be blamed for missing so good an Opportunity; as the
Parents of the Children were very anxious to have the Affair over -
I pluck'd up Resolution, and inoculated all the seven Children -
My mind however was not easy - I visited the Lad again that
same Afternoon, and had still more reason to be dissatisfied. I
enquired of him, at what time he had been in the house with
the Child, he was supposed to have catched the Infection from,
(a question I had stupidly neglected till then) and was informed,
that it had been only two Days before he himself sickened -
Mr Wilson & Mr Colquhoun visited him the same Evening, on
hearing that I had been inoculating from him, with the View of
taking Matter likewise for some of their Patients; but were much
dissatisfied with the look of the pox, and would not risque it -
They ↑have↑ both told me, that they then believed it was not the Small¬
pox
- It will be easily imagined that I watched with the utmost
Anxiety, the Appearances upon the Arms of the inoculated children;


[Page 3]

Day after Day elapsed without the smallest Degree of Inflam¬
mation
upon any of them, excepting Mr Wilson's youngest
Child's, which began to inflame about the fifth or sixth Day,
and proceeded regularly to increase and spread, precisely as in the
Small pox - The other eight Children's Arms had all healed
immediately and perfectly, which, by this time, I was very
glad of, as I, and every body had concluded from that circum¬
stance, and the doubtful Appearance of the Pock the Inoculation
was from, that Mr Wilson's Child was about to have an Eruption
of Chicken pox, or Swine pox, or any thing but the Small pox.
No fever however, nor Eruption ensue - the Inflammation
on the Arm began to subside, and the fieryfirey pimples
it was covered with, to dissapear in a Scars from the twelfth Day;
a blackish Scab is form'd upon where the Incision had been made,
and remains for a while; then drops of, and leaves a Scar - -
Upon Sunday the 10th. Feby. I was sent for to see Mr Willm.
Donald's Daughter, who was one of the seven I had inoculated
on the friday fortnight before, and was shown a pimple upon the
inoculated Arm, that had been only observed that Morning. It was,
I dare say, upon the very place where the Incision had been made,
but was neither preceeded by fever, or Sickness of any kind; nor by
the usual Appearances of Inflammation; at least, none were observed;
and I had daily examined the Arm from the Day she was inoculated
for eight or nine Days; when I left of visiting her, it seemed so
perfectly healed, that no trace of the Incision remained - The
Pock which now appeared upon her Arm was nearly of the Size
of a Small Pock about the fourth Day with and had a little
Lymph in it - It was of smaller Size, and more pointed than
the Vesicle upon the Arm after Inoculation; it had no hardness
or Inflammation round it; and, in short, look'd so little like
the effect of Inoculation from the Small pox, that I had not
the slightest Suspicion of it's being so - It only alarmed me a little
for my other little Patients, lest they should still who had been
inoculated at the same time, lest they should still be liable
to some such, or worse, Eruption; and my fears of this were not
lessened upon being told by Mr Wilson on the Tuesday following


[Page 4]

which was the 12th. of February, that an Eruption had appeared
that Morning upon his eldest boy who had been inoculated
twenty Days ago - he had been fretful & feverish from the
Sunday before, but as his Arm had been so perfectly heal, that
the mark of the Incision had long ago been quite effaced, Mr.
Wilson never thought of examining it till now, when he found it
inflamed to a considerable Extent, and crowded with small fiery
pimples exactly resembling the Appearance of the youngest's
Arm, and indeed, the common Appearance after Inoculation from
the Small pox - The pustules increased till the Sunday following
when they had so much the Appearance of a mild, distinct Small
pox
, that Mr Wilson & I agreed, that unless we had been so
lately deceived by such Appearances, and knew from the inflamed
State of the Arm, that the present Eruption must be the Effect
↑of that Inoculation,↑ and not of a natural Infection, we should not hesitate a
moment of pronouncing the Disease to be the Small pox - -
From the Sunday they speedily declined tho Mr Wilson says
there was Pus in some of them till the Tuesday, which was
the eighth Day - A large black Scab form'd on the Arm,
remained some weeks, then dropt of, and left a pretty deep
mark - From the preceeding History, there was surely much
reason to believe that we had been inoculating from what
was not the Small pox - Nine Children had been inoculate{illeg}
from a Pock that had but an ambiguous Appearance. Six
of these miss the Infection. The other three show marks of
Infection, and produce the irregular Appearances I have described
I had inoculated a great Number of Children about 2 Years
before, after the same Method, and never had Occasion to repeat
the Operation - Not one of them miss'd the Infection - This no
doubt had its' own Weight in fixing my belief early, that we
had been in a Mistake - but, new Difficulties arise; The whole
of these nine Children are inoculated a few Weeks after this
fray from a Small pox that sufficiently characterized itself
and had no ambiguous Appearance. The six that had miss'd
before show marks of Infection in the proper time, and go through
the Disease regularly and easily - Mr Wilson's two Children and


[Page 5]

Miss Donald refuse to be infected - This look'd odd - I had only to
say that it might be an Accident, and urged a repetition of it -
The three are inoculated again - All their Arms heal immediately
as before, but, Mr Wilson's youngest Child grows fretful
and sickens on the fifth Day after this last Inoculation, and,
on the 8th. when I first saw him under this Ailment he was
indeed very sick & feverish, and had several very distinct Small
pox
upon his face. No doubt was express'd by Mr Wilson
or any body that saw them of their being Small pox - They
sufficiently distinguished themselves as indeed the fever did -
This Eruption certainly was not the consequence of any of the two last Inoculations, for his Arm healed perfectly after
both - I met Mr Wilson that same Evening; he told me
with Concern that the Child had a rash upon his Skin, was
much sicker than when I had seen him in the forenoon, and
that he apprehended the Child was to have a Confluent
Small pox - The fever & Rash however took of that night
and the Child was chearful next Day with very few additional
Pustules to what were seen the Day before - Mr Wilson
is alarmed for his other Boy, and notwithstanding the former
failures inoculates him again, that Day - Mr Donald is
in the same Situation and will have his Daughter inoculated
too - I made an Incision in each Arm to secure her being
infected now if it was possible, and doub'd them with more than
the common quantity of Matter - but, it would not do - Her Arms
heal presently; Mr Wilson's boy's Arm does the same - and tho'
the Small pox raged in this place fore more than six Months from
that time, and no pains ↑was↑ taken to keep them out of the way
of Infection, they still escaped - Mr Wilson's youngest child
proceeds regularly to the 5th. or sixth Day from the Eruption
when they begin to grow hard and crust on the Top - This gave
me no suspicion of their Nature as I was daily seeing the same
where the pustules were few - If ever I saw the Small pox,
he had them upon this Occasion - - -

Notes:

1: A 'Tender' is a type of ship and 'the road' refers to a shipping lane or navigable channel in the River Clyde at Greenock where Fullerton lives.

Diplomatic Text

[Page 1]


On Wednesday the 23d. of January 1771, I was informed by
Mr Wilson that he had that Day inoculated his two children
for the small pox from a Lad, that had been sent on shore &
put under his Care from a Tender in the road, 1 who had so
favourable a Sort, that he had some Doubt whether it was
the Small pox or not - He had the strongest reason however
he told me for believing that it could be no other Disease (not¬
withstanding of the Appearance at present being a little
ambiguous) from the Lad's Declaration, that he did not remem¬
ber or know of his having had the Small pox, and that he
had lately been in the House, and even in the same Room
with a Child, who was certainly under that Disease. It was
now the fourth Day from their first Appearance, which had
been on Sunday the 20th. and he had had a smart fever
attended with Vomiting, sharp pains in his head, & Back &c.
from the Thursday preceeding - I call'd to see him on Thursday
the 24th. in the Evening, and got the same History from himself.
The pox appeared remarkably small and thinly scattered; but
seemed to have pretty well concocted pus in them, and I thought
I had often seen, in that Stage of the Disease, a favourable
kind of Small pox with precisely the same Appearance -
It was in the Dusk of the Evening indeed; and I had so little
Doubt of its' being the Small pox from the History I had
got, that I did not examine them with all the Accuracy
and Doubt, that I afterwards wish'd I had done, but concluded
at once, and firmly that it was. In consequence of this, next
forenoon, I had seven Children carried to the House where the
Lad lodged to inoculate, after Dimsdales Method, with the
recent Matter from an infected Lancet - Till this time I had
seen him only the one time above mentioned, when I had no
Doubt; but I was now very much staggered with the Appearance
of the pox, and concealed my Embarassment so ill, that a Lady



[Page 2]

who attended the Children to the House and was present, took
Notice of it, and, (without my speaking a single word of my
Doubts) immediately said, I wish, seeing you are not clear
about this being the Small pox, that the Children had not
been brought here - I replied, that they had changed their
Appearance amazingly since the Night before; so much
indeed, that, had not the Lad been in the way of catching In¬
fection from the Small pox, I should now hesitate in believing
that it was the Small pox - The pustules on his face & Neck,
were turned already into little black, dry Scabs; but there was
still Matter in some of these upon his Legs - I had been so
firmly persuaded the Night before of its being the Small pox,
that I concluded, it must be my timidity, and over caution, that
was making me waver now; and, I was perhaps a little ashamed
to avow a Doubt of an Opinion which I had, but the Evening
before so positively asserted - Besides, there could be no harm from
it, I thought, supposing it should not be; and should it turn
out to be the Small pox, which the two Children which Mr
Wilson had inoculated, might soon bring a certain proof of, I
should be blamed for missing so good an Opportunity; as the
Parents of the Children were very anxious to have the Affair over -
I pluck'd up Resolution, and inoculated all the seven Children -
My mind however was not easy - I visited the Lad again that
same Afternoon, and had still more reason to be dissatisfied. I
enquired of him, at what time he had been in the house with
the Child, he was supposed to have catched the Infection from,
(a question I had stupidly neglected till then) and was informed,
that it had been only two Days before he himself sickened -
Mr Wilson & Mr Colquhoun visited him the same Evening, on
hearing that I had been inoculating from him, with the View of
taking Matter likewise for some of their Patients; but were much
dissatisfied with the look of the pox, and would not risque it -
They ↑have↑ both told me, that they then believed it was not the Small¬
pox
- It will be easily imagined that I watched with the utmost
Anxiety, the Appearances upon the Arms of the inoculated children;


[Page 3]

Day after Day elapsed without the smallest Degree of Inflam¬
mation
upon any of them, excepting Mr Wilson's youngest
Child's, which began to inflame about the fifth or sixth Day,
and proceeded regularly to increase and spread, precisely as in the
Small pox - The other eight Children's Arms had all healed
immediately and perfectly, which, by this time, I was very
glad of, as I, and every body had concluded from that circum¬
stance, and the doubtful Appearance of the Pock the Inoculation
was from, that Mr Wilson's Child was about to have an Eruption
of Chicken pox, or Swine pox, or any thing but the Small pox.
No fever however, nor Eruption ensue - the Inflammation
on the Arm began to subside, and the fieryfirey pimples
it was covered with, to dissapear in a Scars from the twelfth Day;
a blackish Scab is form'd upon where the Incision had been made,
and remains for a while; then drops of, and leaves a Scar - -
Upon Sunday the 10th. Feby. I was sent for to see Mr Willm.
Donald's Daughter, who was one of the seven I had inoculated
on the friday fortnight before, and was shown a pimple upon the
inoculated Arm, that had been only observed that Morning. It was,
I dare say, upon the very place where the Incision had been made,
but was neither preceeded by fever, or Sickness of any kind; nor by
the usual Appearances of Inflammation; at least, none were observed;
and I had daily examined the Arm from the Day she was inoculated
for eight or nine Days; when I left of visiting her, it seemed so
perfectly healed, that no trace of the Incision remained - The
Pock which now appeared upon her Arm was nearly of the Size
of a Small Pock about the fourth Day with and had a little
Lymph in it - It was of smaller Size, and more pointed than
the Vesicle upon the Arm after Inoculation; it had no hardness
or Inflammation round it; and, in short, look'd so little like
the effect of Inoculation from the Small pox, that I had not
the slightest Suspicion of it's being so - It only alarmed me a little
for my other little Patients, lest they should still who had been
inoculated at the same time, lest they should still be liable
to some such, or worse, Eruption; and my fears of this were not
lessened upon being told by Mr Wilson on the Tuesday following


[Page 4]

which was the 12th. of February, that an Eruption had appeared
that Morning upon his eldest boy who had been inoculated
twenty Days ago - he had been fretful & feverish from the
Sunday before, but as his Arm had been so perfectly heal, that
the mark of the Incision had long ago been quite effaced, Mr.
Wilson never thought of examining it till now, when he found it
inflamed to a considerable Extent, and crowded with small fiery
pimples exactly resembling the Appearance of the youngest's
Arm, and indeed, the common Appearance after Inoculation from
the Small pox - The pustules increased till the Sunday following
when they had so much the Appearance of a mild, distinct Small
pox
, that Mr Wilson & I agreed, that unless we had been so
lately deceived by such Appearances, and knew from the inflamed
State of the Arm, that the present Eruption must be the Effect
↑of that Inoculation,↑ and not of a natural Infection, we should not hesitate a
moment of pronouncing the Disease to be the Small pox - -
From the Sunday they speedily declined tho Mr Wilson says
there was Pus in some of them till the Tuesday, which was
the eighth Day - A large black Scab form'd on the Arm,
remained some weeks, then dropt of, and left a pretty deep
mark - From the preceeding History, there was surely much
reason to believe that we had been inoculating from what
was not the Small pox - Nine Children had been inoculate{illeg}
from a Pock that had but an ambiguous Appearance. Six
of these miss the Infection. The other three show marks of
Infection, and produce the irregular Appearances I have described
I had inoculated a great Number of Children about 2 Years
before, after the same Method, and never had Occasion to repeat
the Operation - Not one of them miss'd the Infection - This no
doubt had its' own Weight in fixing my belief early, that we
had been in a Mistake - but, new Difficulties arise; The whole
of these nine Children are inoculated a few Weeks after this
fray from a Small pox that sufficiently characterized itself
and had no ambiguous Appearance. The six that had miss'd
before show marks of Infection in the proper time, and go through
the Disease regularly and easily - Mr Wilson's two Children and


[Page 5]

Miss Donald refuse to be infected - This look'd odd - I had only to
say that it might be an Accident, and urged a repetition of it -
The three are inoculated again - All their Arms heal immediately
as before, but, Mr Wilson's youngest Child grows fretful
and sickens on the fifth Day after this last Inoculation, and,
on the 8th. when I first saw him under this Ailment he was
indeed very sick & feverish, and had several very distinct Small
pox
upon his face. No doubt was express'd by Mr Wilson
or any body that saw them of their being Small pox - They
sufficiently distinguished themselves as indeed the fever did -
This Eruption certainly was not the consequence of any of the two last Inoculations, for his Arm healed perfectly after
both - I met Mr Wilson that same Evening; he told me
with Concern that the Child had a rash upon his Skin, was
much sicker than when I had seen him in the forenoon, and
that he apprehended the Child was to have a Confluent
Small pox - The fever & Rash however took of that night
and the Child was chearful next Day with very few additional
Pustules to what were seen the Day before - Mr Wilson
is alarmed for his other Boy, and notwithstanding the former
failures inoculates him again, that Day - Mr Donald is
in the same Situation and will have his Daughter inoculated
too - I made an Incision in each Arm to secure her being
infected now if it was possible, and doub'd them with more than
the common quantity of Matter - but, it would not do - Her Arms
heal presently; Mr Wilson's boy's Arm does the same - and tho'
the Small pox raged in this place fore more than six Months from
that time, and no pains ↑was↑ taken to keep them out of the way
of Infection, they still escaped - Mr Wilson's youngest child
proceeds regularly to the 5th. or sixth Day from the Eruption
when they begin to grow hard and crust on the Top - This gave
me no suspicion of their Nature as I was daily seeing the same
where the pustules were few - If ever I saw the Small pox,
he had them upon this Occasion - - -

Notes:

1: A 'Tender' is a type of ship and 'the road' refers to a shipping lane or navigable channel in the River Clyde at Greenock where Fullerton lives.

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