Cullen

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

 

[ID:828] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mr Knox (Patient), Mrs Knox (Patient) / July 1772 / (Outgoing)

Reply in the form of an incomplete corrected draft by Cullen on the cases of Mr and Mrs Knox answering an enquiry from T. Shiels in Dublin. It is all in Cullen's own hand, but a recipe and editorial corrections have clearly been added with a different pen. The cross and other marks are Cullen's system for marking where amendments are to be integrated into to polished version.

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Metadata

FieldData
DOC ID 828
RCPE Catalogue Number CUL/1/2/95
Main Language English
Document Direction Outgoing
DateJuly 1772
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply in the form of an incomplete corrected draft by Cullen on the cases of Mr and Mrs Knox answering an enquiry from T. Shiels in Dublin. It is all in Cullen's own hand, but a recipe and editorial corrections have clearly been added with a different pen. The cross and other marks are Cullen's system for marking where amendments are to be integrated into to polished version.
Manuscript Incomplete? Yes
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:168]
Case of Mr Knox who has an inflamed liver.
3
[Case ID:169]
Case of Mrs Knox who has stomach pains.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:351]PatientMrs Knox
[PERS ID:350]PatientMr Knox
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Edinburgh Edinburgh and East Scotland Europe certain
Destination of Letter Dublin Mid Ireland Ireland Europe inferred

Normalized Text

[Page 1]


[Start of margin text]XX[End of margin text]With respect to bath waters I am believe they
might ↑perhaps↑ be usefull to the Gout but that is ↓2↓not
certain and I am well ↓2↓ persuaded they mg (↑might↑)
would be very hurtfull
to the state of the liver
[↑that↑?] in Mr Knox's case.


I go on now to speak of the case of Mrs. Knox
which tho not dangerous is↑from its long continouance↑ likely to be very
obstinate and difficult to cure but I shall give
you my best opinion. ↑N.1.↑ I believe it does not de¬
pend upon the Stomach and therefore would
not fatgue her with fruitless vomits and bitters but if a¬
mongst the bitters she has formerly employed
if She has never taken the bark in any
quantity there is still hopes from this remedy.
If you can observe that the pain tho pretty con¬
stant has its exacerbations or greatest severity
at ↑regularly↑ a certain time of day you may conclude it
of an intermittent nature and to be relieved by
the bark especially if Mrs. Knox has ↑also↑ some feelings



[Page 2]

that denounce the approach fo the pain and
therefore (↑by↑) mark the opportunity ofor giving the
bark, as (↑for indeed↑) after the pain is (↑has↑) once taken its
seat if (↑tho bark) will be too late. If therefore such
circumstances and opportunity take place
in this case, let the bark be given beginning
early in the morning and continuing to give
it as frequently as her Stomach will bear
till noon or two hours after it. Nothing less
than half an ounce taken in the course of a
forenoon can be of service and if she can take
more it will better secure the effect, and It will
be right to repeat the same ↑quantity↑ the next day if
the pain has still kept off. In this way I have
had success in cases which had continued
long and seemed very obstinate but I must own
that where there is no regular exacerbation nor
descernment of the approach, the bark is of no
service. In such cases I have sometimes succeeded


[Page 3]

by aperpetual ifoue (blister) on the crown of the head
keept open for a long time. In some other cases
I have had remarkable success with the
following external application ✍↑ordered below.↑

Take four ounces of rectified alcohol, two drachms of opium and dissolve [ according to the art?] and strain, add half an ounce of camphor, label "Anodyne Tincture". A compress of Linnen four fold of the Size of an inch Square to be dipt in this and applied to the temple upon the coming on of the pain


[Start of margin text]†.[End of margin text] W.C. ✍I shall be glade to find that
any of these measures prove usefull to Mrs.
Knox. Whichever of them are employed it will
still be necessary for her to guard against the
occasional Causes which her own experience
must have directed her to Observe and I must
know more of these and other circumstances
of her case in order to advise more positively
and Upon further Information you may depend
upon my attention in advising for her as well
as I can


[Start of margin text]X[End of margin text] It is on one hand to avoid fullness & irritation from animal
food and on the other hand to avoid the too much acescency
and weakening power of vegetables. I will only add one
word more to avoid his being misled by the Doctors in fashion



[Page 4]

and that is that well leavened bread may ↑with advantage↑ be a large part of
his diet.


[Start of margin text]†.[End of margin text] The compress may be moistened again and applied in an
hour or two after but no more for that day and I would
not wish to repeat this application too often. It will
soon discover how far it is suited to the disease and must
accordingly be guided by your discretion

Diplomatic Text

[Page 1]


[Start of margin text]XX[End of margin text]With respect to bath waters I am believe they
might ↑perhaps↑ be usefull to the Gout but that is ↓2↓not
certain and I am well ↓2↓ persuaded they mg (↑might↑)
would be very hurtfull
to the state of the liver
[↑that↑?] in Mr Knox's case.


I go on now to speak of the case of Mrs. Knox
which tho not dangerous is↑from its long continouance↑ likely to be very
obstinate and difficult to cure but I shall give
you my best opinion. ↑N.1.↑ I believe it does not de¬
pend upon the Stomach and therefore would
not fatgue her with fruitless vomits and bitters but if a¬
mongst the bitters she has formerly employed
if She has never taken the bark in any
quantity there is still hopes from this remedy.
If you can observe that the pain tho pretty con¬
stant has its exacerbations or greatest severity
at ↑regularly↑ a certain time of day you may conclude it
of an intermittent nature and to be relieved by
the bark especially if Mrs. Knox has ↑also↑ some feelings



[Page 2]

that denounce the approach fo the pain and
therefore (↑by↑) mark the opportunity ofor giving the
bark, as (↑for indeed↑) after the pain is (↑has↑) once taken its
seat if (↑tho bark) will be too late. If therefore such
circumstances and opportunity take place
in this case, let the bark be given beginning
early in the morning and continuing to give
it as frequently as her Stomach will bear
till noon or two hours after it. Nothing less
than half an ounce taken in the course of a
forenoon can be of service and if she can take
more it will better secure the effect, and It will
be right to repeat the same ↑quantity↑ the next day if
the pain has still kept off. In this way I have
had success in cases which had continued
long and seemed very obstinate but I must own
that where there is no regular exacerbation nor
descernment of the approach, the bark is of no
service. In such cases I have sometimes succeeded


[Page 3]

by aperpetual ifoue (blister) on the crown of the head
keept open for a long time. In some other cases
I have had remarkable success with the
following external application ✍↑ordered below.↑


℞ Spir. Vin. rect.
℥iv Opij ʒij. Solve [s.a.?] et colaturae adde Camphor. ℥fs. Sig. Anodyne
Tincture
. A compress of Linnen four fold of the Size of an inch Square to be
dipt in this and applied to the temple upon the coming on of the pain


[Start of margin text]†.[End of margin text] W.C. ✍I shall be glade to find that
any of these measures prove usefull to Mrs.
Knox. Whichever of them are employed it will
still be necessary for her to guard against the
occasional Causes which her own experience
must have directed her to Observe and I must
know more of these and other circumstances
of her case in order to advise more positively
and Upon further Information you may depend
upon my attention in advising for her as well
as I can


[Start of margin text]X[End of margin text] It is on one hand to avoid fullness & irritation from animal
food and on the other hand to avoid the too much acescency
and weakening power of vegetables. I will only add one
word more to avoid his being misled by the Doctors in fashion



[Page 4]

and that is that well leavened bread may ↑with advantage↑ be a large part of
his diet.


[Start of margin text]†.[End of margin text] The compress may be moistened again and applied in an
hour or two after but no more for that day and I would
not wish to repeat this application too often. It will
soon discover how far it is suited to the disease and must
accordingly be guided by your discretion

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