Cullen

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

 

[ID:829] From: T Shiels / To: Dr William Cullen (Professor Cullen) / Regarding: T Shiels (Patient), Mr Knox (Patient) / July 1772 / (Incoming)

Letter, from former Edinburgh student Shiells in Dublin (though no closer as letter is incomplete), concerning the cases of Mr Knox, but most of the letter concerns Shiells' own headaches.

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Metadata

FieldData
DOC ID 829
RCPE Catalogue Number CUL/1/2/96
Main Language English
Document Direction Incoming
DateJuly 1772
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter, from former Edinburgh student Shiells in Dublin (though no closer as letter is incomplete), concerning the cases of Mr Knox, but most of the letter concerns Shiells' own headaches.
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:1340]
Case of T. Shiells, medical practitioner in Ireland, who has developed severe headaches after catching fever while attending patients.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:349]Author T Shiels
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:350]PatientMr Knox
[PERS ID:349]Patient T Shiels
[PERS ID:349]Patient's Physician / Surgeon / Apothecary T Shiels
[PERS ID:1036]Other Physician / SurgeonDr Hunter

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Dublin Mid Ireland Ireland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe inferred
Therapeutic Recommendation Edinburgh Edinburgh and East Scotland Europe certain
Mentioned / Other England Europe certain
Mentioned / Other Ireland Europe certain
Mentioned / Other Dublin Mid Ireland Ireland Europe certain
Mentioned / Other Edinburgh Edinburgh and East Scotland Europe certain
Mentioned / Other London London and South-East England Europe certain

Normalized Text

[Page 1]
Dear Sir


I thank you most heartely for the favor of
your last letter and for the very friendly manner in which you was pleased
to introduce me to Doctor Hunter, the pleasure of knowing an ingenious
man, was the only end I proposed in his acquaintance your advice
for Mr. Knox came to hand in due time. He and I are both much oblig'd
for the attention you were pleased to bestow on his case my dependance
is great on your Judgement, you therefore may rely on having your
directions attended to with the utmost punctuality. Here it's proper to
observe to you that ↑a↑ matter of great moment rendered it necessary for
him to come to London, and to attend him was my only business
here. As he had laid aside the use of the Diuretic remedies, I ordered
for him in Ireland, and in consequence of sitting constantly in
a carriage during a journey of near 300 Miles, He had a return
of the swelling in his Legs on his arrival here, on this and not
receiving your Letter as soon as we expected He had a consultation



[Page 2]

of Physicians here, the result of which was this entire approbation of
the course laid downe by me, & recommending a continuance of it as the
most unlikely means of effecting a cure, He imediately resumed the use of
the remedies, and they have answered my expectations fully, as the swelling
is entirely removed from one Leg, and scarcely perceptible in the other
The Gentlemen seemed inclined to attribute the Dropsical swelling to
an obstruction in the Liver, for my part tho I cou'd not not deny the
possibility or indeed the probability of an affection in the Liver still
I did not think it sufficient to produce a dropsy, and was confirmed in
my oppinion by it's easy removal by remedies that were not designed
to act imediately on the Liver, or resolve any obstruction, & I think
it's removal a second time a confirmation of my oppinion.


You are very kind in your wishes for my health, the state of which I assure
is far from being tolerable, I desired giving you an account of it untill
I received your last favor: You are already acquainted with my Habit of Body,
in which there is no other change than my growing very fatt, tho I take
a great deal of exercise
, I have ever been a temperate Liver, and enjoyed
from the time I left Edinburgh an uninterrupted state of good Health,
untill Last August when I was called to see a Gentleman in a dangerous



[Page 3]

Putrid Fever, I was at the distance of 40 Miles when sent for, and rode
to him by night, it rained almost the whole way, and I got wet in my feet
on my arrival I found the family in great distress and had it not in my
power to shift for halfe an Hour. the next day I perceived a slight uneasiness
in my forehead which continued (without any great encrease) for six days
after (It is here necessary to observe that for the first time in my Life,
I became timorous & headed I had been infected by the Gentleman)
on my return home (the 6th. May) I became very heavy was seized with
Horripilations, became highly feverish, skin Hot: thirst great: Pulse 130
imadiately on going to Bed the most profuse sweat I ever saw broke
out and continued without the least diminution for 24 Hourse after it
I found my Fever entirely subdued (Pulse downe to 64) but still had
the same uneasiness in my Head, after a few days confinement, I was
sent for to see a Patient at about 30 Miles distance & as I had no other
complaint than the slight pain in my Head, I rode it in one day, as
soon as I got there I again became highly feverish & got myselfe largely
blooded
, & on giving into Bed a sweat equally profuse with the
former came on, & continued without remission for 3 days, after it
my Fever disapeared, but still the Pain in my Head continued




[Page 4]

On my return Home suspecting it might be owing to my stomach
I took two or three vomits which {illeg} to me, as the pain
was but slight I continued riding as usual, but my appetite became
bad
my spirits very low, and I had at night a constant frequency
of Pulse
, a Putrid Epidemic prevailed in the Country I was daily
called upon and had the greatest temor & apprehension of the Fever,
as I every night suspected I had got a fresh infection, to which
I attributed the frequency of Pulse. In this situation I continued untill
8 o'clock, when finding I had no settled Fever, & harrassed with appre¬
hensions I resolved I wou'd neither feel or reckon my Pulse for the
future, the pain continued daily and apeared to me to the superficial
affecting only the Integuments of the Head mostly on the left. Parietal Bone
towards January it became more deep seated & violent on this I blistered
my
neck & Shoulders without any advantages, & afterwards got about
12 ounces of
blood taken from the Temporal Artery. & with very little benefit
I indeed thought my selfe easier for two or 3 days, I got ↑it↑ repeated twice
after with as little advantage. I remained nearly in this situation
untill last May when I came to Dublin, I commenced a course of herbal
remedies: As: Assafotid: Valerian: Cinab. Camph & those purged me


[Page 5]

uncommonly, generally 5 or 6 times a day, the Head ache became more
violent & deep seated, affecting both sides, forehead & occiput alternately
tho still more enclined to the left Parietal Bone than any other part.
I mentioned to you that I scarcely ever passed an entire day without the pain
still generally it did not affect me untill after I had been out of Bed for some
time in the morning, (10 or 15 minutes) I therefore resolved on a trial of the
Barke, which I took to the quantity of 2 or 3 drachms every day for 6 days
I was prevented continuing its use by a smart pain I felt in one of my
feet & which at times affected my great toe & soal of my Foot so as to
render me unable to walk 3 or 4 nights, without great uneasiness
I suspected it to be the Gout & therefore laid aside the use of the Barke
least it shou'd prevent the efforts of nature in filling the matter in
the feet, I bathed my feet constantly in warm water every night since,
to no purpose, no gout has settled, as the headach as bad as ever, at
times extremely violent, the day I landed in England without any
occasional cause (as I had not been sick at tea) it becam insuffe¬
reable, in so much that I dreaded an appoplexy, I got myselfe
largely blooded
, went to Bed & awoke quite free from it but it
returned in a few hours after I arose, the proportion of serum was


[Page 6]

very large & of a wheyish muddy color, last Friday it imadeately
after getting out of bed, attacked the right Parietal Bone, with incredible
violence, I got my head cup'd & scarified, & had twenty ounces of blood taken
from it, the Pain was removed but returned the following night
on a change of weather which always (I conceit affects ↑me↑) since that
time I have been better than usual: I think it very material to
mention to you that my Parents have been Martyrs to the Gout, and
that my Father had a constant Headache for 14 Months which was owing
to an obstruction of Perspiration after a fit of the Gout, which ended in
a fatal appoplexy, and I must owne to you my Dear Friend, that
I dread very much the like Isue to my disorder unless relieved by you
on whose Judgement my entire hopes of recovery are founded.
It is necessary to observe that from the commencement of complaints
to this day that there has been an entire stoppage of perspiration
in my Feet, not the smallest moisture ever appears in them
altho naturally the discharge was so great as to require
my changing stockings twice a day in Summer, indeed
the Ballance of the circulation seems entirely destroyed


[Page 7]

and an encreased determination to the Head, as on the
slightest exercise the sweat pours profusely from my
Head, & is as great as usual in my Body: Instantly on
immersing my Feet in warm water, the Sweat breaks out
on the Head. I don't recollect any circumstance to add
but that the Pain is generally confined to the left
Parietal Bone
, & took frequently to the Eye & Ear, & to
the Cervical Vertebrae: and that generally on awaking
in the morning am free from it untill I rize.
Belly regular Pulse 66 : appetite Good : rest as
well & and in every respect as well as usual, except
the complaint in the Head. I have poured cold water
on my Head, & used the cold Bark without
advantage. I have now my Dear Sir troubled you
with a full recital of my situation, the many proofs
of your goodness I have experienced, satisfy me you will


[Page 8]

bestow all necessary attention to its consideration, and
pardon the trouble I have given you. for which
I can at present make no adequate return, tho it shall
be not forgot by me, at least I think there is a strong
prospect of my returning you thanks in Person, next
winter, as I have brought Mr Knox to promise that if
He has the least return of it or any other complaint
on his return to Ireland, that He will imadeately
sett off for Edinburgh with his Family, & spend the winter
there, as the time He is most liable to complaints
that He may have your constant care & attention, and
that I may be more fully acquainted with sentiment
advice & directions for him. I have not the least doubt
in my owne mind of our going, I must owne myself
the greatest degree mortified at my bad luck in you
not giving a course of Practise, however I shall be happy
in spending a winter with you, and know I must
[improve?] by Your Lectures on any subject. Pray would it

Diplomatic Text

[Page 1]
Dear Sir


I thank you most heartely for the favor of
your last letter and for the very friendly manner in which you was pleased
to introduce me to Doctor Hunter, the pleasure of knowing an ingenious
man, was the only end I proposed in his acquaintance your advice
for Mr. Knox came to hand in due time. He and I are both much oblig'd
for the attention you were pleased to bestow on his case my dependance
is great on your Judgement, you therefore may rely on having your
directions attended to with the utmost punctuality. Here it's proper to
observe to you that ↑a↑ matter of great moment rendered it necessary for
him to come to London, and to attend him was my only business
here. As he had laid aside the use of the Diuret: remedies, I ordered
for him in Ireland, and in consequence of sitting constantly in
a carriage during a journey of near 300 Miles, He had a return
of the swelling in his Legs on his arrival here, on this and not
receiving your Letter as soon as we expected He had a consultation



[Page 2]

of Physicians here, the result of which was this entire approbation of
the course laid downe by me, & recommending a continuance of it as the
most unlikely means of effecting a cure, He imediately resumed the use of
the remedies, and they have answered my expectations fully, as the swelling
is entirely removed from one Leg, and scarcely perceptible in the other
The Gentlemen seemed inclined to attribute the Dropsical swelling to
an obstruction in the Liver, for my part tho I cou'd not not deny the
possibility or indeed the probability of an affection in the Liver still
I did not think it sufficient to produce a dropsy, and was confirmed in
my oppinion by it's easy removal by remedies that were not designed
to act imediately on the Liver, or resolve any obstruction, & I think
it's removal a second time a confirmation of my oppinion.


You are very kind in your wishes for my health, the state of which I assure
is far from being tolerable, I desired giving you an account of it untill
I recd. your last favor: You are already acquainted with my Habit of Body,
in which there is no other change than my growing very fatt, tho I take
a great deal of exercise
, I have ever been a temperate Liver, and enjoyed
from the time I left Edinbr. an uninterrupted state of good Health,
untill Last August when I was called to see a Gentleman in a dangerous



[Page 3]

Putrid Fever, I was at the distance of 40 Miles when sent for, and rode
to him by night, it rained almost the whole way, and I got wet in my feet
on my arrival I found the family in great distress and had it not in my
power to shift for halfe an Hour. the next day I perceived a slight uneasiness
in my forehead which continued (without any great encrease) for six days
after (It is here necessary to observe that for the first time in my Life,
I became timorous & headed I had been infected by the Gentleman)
on my return home (the 6th. May) I became very heavy was seized with
Horripilations, became highly feverish, skin Hot: thirst great: Pulse 130
imadiately on going to Bed the most profuse sweat I ever saw broke
out and continued without the least diminution for 24 Hourse after it
I found my Fever entirely subdued (Pulse downe to 64) but still had
the same uneasiness in my Head, after a few days confinement, I was
sent for to see a Patient at about 30 Miles distance & as I had no other
complaint than the slight pain in my Head, I rode it in one day, as
soon as I got there I again became highly feverish & got myselfe largely
blooded
, & on giving into Bed a sweat equally profuse with the
former came on, & continued without remission for 3 days, after it
my Fever disapeared, but still the Pain in my Head continued




[Page 4]

On my return Home suspecting it might be owing to my stomach
I took two or three vomits which {illeg} to me, as the pain
was but slight I continued riding as usual, but my appetite became
bad
my spirits very low, and I had at night a constant frequency
of Pulse
, a Putrid Epidemic prevailed in the Country I was daily
called upon and had the greatest temor & apprehension of the Fever,
as I every night suspected I had got a fresh infection, to which
I attributed the frequency of Pulse. In this situation I continued untill
8 o'clock, when finding I had no settled Fever, & harrassed with appre¬
hensions I resolved I wou'd neither feel or reckon my Pulse for the
future, the pain continued daily and apeared to me to the superficial
affecting only the Integuments of the Head mostly on the left. Parietal Bone
towards January it became more deep seated & violent on this I blistered
my
neck & Shoulders without any advantages, & afterwards got about
12 oz of
blood taken from the Temporal Artery. & with very little benefit
I indeed thought my selfe easier for two or 3 days, I got ↑it↑ repeated twice
after with as little advantage. I remained nearly in this situation
untill last May when I came to Dublin, I commenced a course of herbl.
remedies: As: Assafotid: Valerian: Cinab. Camph & those purged me


[Page 5]

uncommonly, generally 5 or 6 times a day, the Head ache became more
violent & deep seated, affecting both sides, forehead & occiput alternately
tho still more enclined to the left Parietal Bone than any other part.
I mentioned to you that I scarcely ever passed an entire day without the pain
still generally it did not affect me untill after I had been out of Bed for some
time in the morning, (10 or 15 minutes) I therefore resolved on a trial of the
Barke, which I took to the quantity of 2 or 3 drms. every day for 6 days
I was prevented continuing its use by a smart pain I felt in one of my
feet & which at times affected my great toe & soal of my Foot so as to
render me unable to walk 3 or 4 nights, without great uneasiness
I suspected it to be the Gout & therefore laid aside the use of the Barke
least it shou'd prevent the efforts of nature in filling the matter in
the feet, I bathed my feet constantly in warm water every night since,
to no purpose, no gout has settled, as the headach as bad as ever, at
times extremely violent, the day I landed in England without any
occasional cause (as I had not been sick at tea) it becam insuffe¬
reable, in so much that I dreaded an appoplexy, I got myselfe
largely blooded
, went to Bed & awoke quite free from it but it
returned in a few hours after I arose, the proportion of serum was


[Page 6]

very large & of a wheyish muddy color, last Friday it imadeately
after getting out of bed, attacked the right Parietal Bone, with incredible
violence, I got my head cup'd & scarified, & had twenty ozs. of blood taken
from it, the Pain was removed but returned the following night
on a change of weather which always (I conceit affects ↑me↑) since that
time I have been better than usual: I think it very material to
mention to you that my Parents have been Martyrs to the Gout, and
that my Father had a constant Headache for 14 Months which was owing
to an obstruction of Perspiration after a fit of the Gout, which ended in
a fatal appoplexy, and I must owne to you my Dear Friend, that
I dread very much the like Isue to my disorder unless relieved by you
on whose Judgement my entire hopes of recovery are founded.
It is necessary to observe that from the commencement of complaints
to this day that there has been an entire stoppage of perspiration
in my Feet, not the smallest moisture ever appears in them
altho naturally the discharge was so great as to require
my changing stockings twice a day in Summer, indeed
the Ballance of the circulation seems entirely destroyed


[Page 7]

and an encreased determination to the Head, as on the
slightest exercise the sweat pours profusely from my
Head, & is as great as usual in my Body: Instantly on
immersing my Feet in warm water, the Sweat breaks out
on the Head. I don't recollect any circumstance to add
but that the Pain is generally confined to the left
Parietal Bone
, & took frequently to the Eye & Ear, & to
the Cervical Vertebrae: and that generally on awaking
in the morning am free from it untill I rize.
Belly regular Pulse 66 : appetite Good : rest as
well & and in every respect as well as usual, except
the complaint in the Head. I have poured cold water
on my Head, & used the cold Bark without
advantage. I have now my Dear Sir troubled you
with a full recital of my situation, the many proofs
of your goodness I have experienced, satisfy me you will


[Page 8]

bestow all necessary attention to its consideration, and
pardon the trouble I have given you. for which
I can at present make no adequate return, tho it shall
be not forgot by me, at least I think there is a strong
prospect of my returning you thanks in Person, next
winter, as I have brought Mr Knox to promise that if
He has the least return of it or any other complaint
on his return to Ireland, that He will imadeately
sett off for Edenbr. with his Family, & spend the winter
there, as the time He is most liable to complaints
that He may have your constant care & attention, and
that I may be more fully acquainted with sentiment
advice & directions for him. I have not the least doubt
in my owne mind of our going, I must owne myself
the greatest degree mortified at my bad luck in you
not giving a course of Practise, however I shall be happy
in spending a winter with you, and know I must
[improve?] by Yr Lectures on any subject. Pray would it

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