Cullen

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

 

[ID:843] Case Note / Regarding: Anonymous (Patient) / March 1773 / (Incoming)

Unsigned case note of an unnamed 38-year-old man who has suffered from a variety of symptoms since being 'seized with a tertian Ague' some years previously. Unclear if drawn up by the patient or another party, but penned in very fine handwriting.

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Metadata

FieldData
DOC ID 843
RCPE Catalogue Number CUL/1/2/110
Main Language English
Document Direction Incoming
DateMarch 1773
Annotation None
TypeUnattributed
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Unsigned case note of an unnamed 38-year-old man who has suffered from a variety of symptoms since being 'seized with a tertian Ague' some years previously. Unclear if drawn up by the patient or another party, but penned in very fine handwriting.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:400]
Case of a 38-year-old man who has suffered from a variety of symptoms since being 'seized with a tertian Ague' some years previously.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:717]Author
[PERS ID:716]Patient
[PERS ID:717]Patient's Physician / Surgeon / Apothecary

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No places linked to this Document.

Normalized Text

[Page 1]
March 1773.
Case


The Patient is 38 years of Age, and has spent a
good part of his Life in a sedentary manner, tho' at times
he has taken sufficient Exercise.


In 1760, he was seized with a tertian Ague, which
very soon formed, and was allowed to have it's free course
the Patient not having taken the Bark or any other medi¬
cine to stop it.


Under this Illness he continued two months and
upwards, viz. from the middle of May to the end of July,
and the fits being very severe, was reduced to a mere
skeleton
. He recovered his strength, very slowly, and at
last got pretty well again.


In the beginning of the following year, he was again
attack'd by an aguish Indisposition, which did not form
regularly. He was never well for twenty four hours to¬
gether, being constantly harrass'd with Head-aches, pains
in the back, attended with great Thirst, Lassitude, Listness¬
ness and Langour
. He took the Bark in various forms,
without any sensible effect, He was in this languishing
way
from January to September 1761, when he went to
the country for some weeks, and having taken moderate
Exercise every day, his complaints left him entirely,
and her was now in hopes that his Health was perfect¬
ly re-established.


During the 1762, - 63 & 1764, he enjoyed very
good Health.


Early in the 1765, he was again seized with agu¬
ish complaints
, which continued to the beginning of
summer.


In the beginning of the 1766 & - 67, he had returns
of the same complaints which lasted till the warm
weather began to set in. Tho' these irregular attacks
of the Disease, in the course of the three years last men¬
tioned, were neither so frequent nor so severe, as in
the 1761, they were attended with the most disagreeable
sensations and Effects. He had an immoderate Thirst,
with loss of Appetite; was oppress'd with the utmost



[Page 2]

Listlessness, Langour and Dejection of Spirits in so
much that he could seldom attend to any sort of Business
and besides was extremely weaken'd by profuse sweats,
which came upon him generally in the mornings.


In August 1765, a Tumor that had been growing
for two or three years before upon the top his right
Thigh
, broke out into a running sore; and as it did
not give him much uneasiness either before or for a
considerable time after it broke out, it was neglected
and mismanaged till it became ulcerous, and spread
to a considerable breadth. It was then very painful
and troublesome, but by proper applications and
medicine, chiefly mercurial, it was at last entirely
healed up in the summer 1768.


From the last mentioned period to September 1770
the Patient was in perfect Health, and had not the
smallest complaint. But in the beginning of that
month, he was seiz'd with intolerable stinging pains
in his Head
, which gave him a great Uneasiness; and
as they came suddenly and without any warning,
would make him start as if an Arrow had been
shot through his Temples. These flying pains con¬
tinued worse and worse to the middle of December
thereafter, when a small swelling began to appear
on the top of his Head. He had the forepart of his
Head
blistered, by which he was considerably relieved
of the pains, and the swelling almost disappeared.


A few Weeks afterwards he was taken very
ill with aguish complaints, and severe pains &
weakness in his Limbs. He was at the same time
seized with shivering & sweating Fits, attended with
feverishness & Thirst, which came upon him com¬
monly early in the morning, sometimes every
morning for several days running, and at other
times they would intermit for three or four days.


At this period too, he began to feel his Nerves
much affected, and was subject to low nervous
fits
through the day. He swallowed a great quan¬
tity of Bark & other medicines, without any good
effect. Indeed the Bark never agreed with him,



[Page 3]

for instead of bracing, it always proved laxative.


In this languid state he continued with
some short intermissions, till the month of October
1771, when he was seiz'd with a violent pain in his
right side, that affected his breathing in a very
alarming manner. This he was told by a Physi¬
cian he consulted, proceeded from an Obstruction
in the
Bowels, and was probably the consequence
of having swallowed so great a quantity of Bark, as
it had not the due effect. In a few weeks that pain
yielded to proper applications & medicine. During
it's continuance, he was let blood of several times,
which gave him a temporary Relief. The Blood was
remarkably bad & sizy.


Soon after this the shivering & sweating Fits
attack'd him with double force. They became peri¬
odical, coming upon him regularly once every ten
or twelve days. They commonly lasted four or five
days at a time, and by these sweats, which were
most immoderate, he was reduced to the utmost
Debility. Mean while, he took a great deal of Medi¬
cine which had little or no effect upon him.


In March 1772, the above mentioned swel¬
ling
of the top of his Head having increas'd and
feeling soft, was opened with a Lancet. The Wound
has seemingly healed up several times, but has as
often broke out again and still continues open.
It is very troublesome at times, and discharges a
kind of matter, which for the most part is but thin.


The Patient still continues under this lingering
Illness, being subject to low nervous Fits, frequent
want of Appetite
, feverishness & thirst, much spit¬
ting of tough phlegm
, shiverings & sweatings, by
which his constitution is much wasted. For seve¬
ral months past too, he has been greatly distress'd
with flying pains all over his Body and especially
in his Legs and Arms, by which he is often entirely
lame & unable to walk. These Pains chiefly affect
his left Leg & left Arm, the last of which he has almost
lost the use of




[Page 4]


Having laboured so long under this obstinate
Indisposition, and tried so many Remedies with¬
out success, he is anxious about himself, and wants
to be advised of the most probably means of removing
all his complaints and recovering his Health.

Diplomatic Text

[Page 1]
March 1773.
Case


The Patient is 38 years of Age, and has spent a
good part of his Life in a sedentary manner, tho' at times
he has taken sufficient Exercise.


In 1760, he was seized with a tertian Ague, which
very soon formed, and was allowed to have it's free course
the Patient not having taken the Bark or any other medi¬
cine to stop it.


Under this Illness he continued two months and
upwards, viz. from the middle of May to the end of July,
and the fits being very severe, was reduced to a mere
skeleton
. He recovered his strength, very slowly, and at
last got pretty well again.


In the beginning of the following year, he was again
attack'd by an aguish Indisposition, which did not form
regularly. He was never well for twenty four hours to¬
gether, being constantly harrass'd with Head-aches, pains
in the back, attended with great Thirst, Lassitude, Listness¬
ness and Langour
. He took the Bark in various forms,
without any sensible effect, He was in this languishing
way
from January to September 1761, when he went to
the country for some weeks, and having taken moderate
Exercise every day, his complaints left him entirely,
and her was now in hopes that his Health was perfect¬
ly re-established.


During the 1762, - 63 & 1764, he enjoyed very
good Health.


Early in the 1765, he was again seized with agu¬
ish complaints
, which continued to the beginning of
summer.


In the beginning of the 1766 & - 67, he had returns
of the same complaints which lasted till the warm
weather began to set in. Tho' these irregular attacks
of the Disease, in the course of the three years last men¬
tioned, were neither so frequent nor so severe, as in
the 1761, they were attended with the most disagreeable
sensations and Effects. He had an immoderate Thirst,
with loss of Appetite; was oppress'd with the utmost



[Page 2]

Listlessness, Langour and Dejection of Spirits in so
much that he could seldom attend to any sort of Business
and besides was extremely weaken'd by profuse sweats,
which came upon him generally in the mornings.


In August 1765, a Tumor that had been growing
for two or three years before upon the top his right
Thigh
, broke out into a running sore; and as it did
not give him much uneasiness either before or for a
considerable time after it broke out, it was neglected
and mismanaged till it became ulcerous, and spread
to a considerable breadth. It was then very painful
and troublesome, but by proper applications and
medicine, chiefly mercurial, it was at last entirely
healed up in the summer 1768.


From the last mentioned period to Septr. 1770
the Patient was in perfect Health, and had not the
smallest complaint. But in the beginning of that
month, he was seiz'd with intolerable stinging pains
in his Head
, which gave him a great Uneasiness; and
as they came suddenly and without any warning,
would make him start as if an Arrow had been
shot through his Temples. These flying pains con¬
tinued worse and worse to the middle of December
thereafter, when a small swelling began to appear
on the top of his Head. He had the forepart of his
Head
blistered, by which he was considerably relieved
of the pains, and the swelling almost disappeared.


A few Weeks afterwards he was taken very
ill with aguish complaints, and severe pains &
weakness in his Limbs. He was at the same time
seized with shivering & sweating Fits, attended with
feverishness & Thirst, which came upon him com¬
monly early in the morning, sometimes every
morning for several days running, and at other
times they would intermit for three or four days.


At this period too, he began to feel his Nerves
much affected, and was subject to low nervous
fits
through the day. He swallowed a great quan¬
tity of Bark & other medicines, without any good
effect. Indeed the Bark never agreed with him,



[Page 3]

for instead of bracing, it always proved laxative.


In this languid state he continued with
some short intermissions, till the month of October
1771, when he was seiz'd with a violent pain in his
right side, that affected his breathing in a very
alarming manner. This he was told by a Physi¬
cian he consulted, proceeded from an Obstruction
in the
Bowels, and was probably the consequence
of having swallowed so great a quantity of Bark, as
it had not the due effect. In a few weeks that pain
yielded to proper applications & medicine. During
it's continuance, he was let blood of several times,
which gave him a temporary Relief. The Blood was
remarkably bad & sizy.


Soon after this the shivering & sweating Fits
attack'd him with double force. They became peri¬
odical, coming upon him regularly once every ten
or twelve days. They commonly lasted four or five
days at a time, and by these sweats, which were
most immoderate, he was reduced to the utmost
Debility. Mean while, he took a great deal of Medi¬
cine which had little or no effect upon him.


In March 1772, the above mentioned swel¬
ling
of the top of his Head having increas'd and
feeling soft, was opened with a Lancet. The Wound
has seemingly healed up several times, but has as
often broke out again and still continues open.
It is very troublesome at times, and discharges a
kind of matter, which for the most part is but thin.


The Patient still continues under this lingering
Illness, being subject to low nervous Fits, frequent
want of Appetite
, feverishness & thirst, much spit¬
ting of tough phlegm
, shiverings & sweatings, by
which his constitution is much wasted. For seve¬
ral months past too, he has been greatly distress'd
with flying pains all over his Body and especially
in his Legs and Arms, by which he is often entirely
lame & unable to walk. These Pains chiefly affect
his left Leg & left Arm, the last of which he has almost
lost the use of




[Page 4]


Having laboured so long under this obstinate
Indisposition, and tried so many Remedies with¬
out success, he is anxious about himself, and wants
to be advised of the most probably means of removing
all his complaints and recovering his Health.

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