The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:1462] From: Dr George Carlyle / To: Dr William Cullen (Professor Cullen) / Regarding: Miss Waugh (Patient), Anonymous (Patient) / 1 November 1777 / (Incoming)
Letter from George Carlyle concerning an unnamed male patient, a relative of his, who has had some sort of stroke and is now having mental blackouts. A substantial, detailed account. He briefly mentions another patient, Miss Waugh.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 8 images for this document.
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Metadata
Field | Data |
---|---|
DOC ID | 1462 |
RCPE Catalogue Number | CUL/1/2/556 |
Main Language | English |
Document Direction | Incoming |
Date | 1 November 1777 |
Annotation | None |
Type | Authorial original |
Enclosure(s) | No enclosure(s) |
Autopsy | No |
Recipe | No |
Regimen | No |
Letter of Introduction | No |
Case Note | No |
Summary | Letter from George Carlyle concerning an unnamed male patient, a relative of his, who has had some sort of stroke and is now having mental blackouts. A substantial, detailed account. He briefly mentions another patient, Miss Waugh. |
Manuscript Incomplete? | No |
Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
Case ID | Description | Num Docs |
---|---|---|
[Case ID:83] |
Case of Miss Waugh with an 'intermittent fever'. |
2 |
[Case ID:892] |
Case of an unnamed male patient, a retired solicitor and relative of Dr George Carlyle, who has been having stroke-like 'fits' and complete mental blackouts.. |
2 |
People linked to this document
Person ID | Role in document | Person |
---|---|---|
[PERS ID:2154] | Author | Dr George Carlyle |
[PERS ID:1] | Addressee | Dr William Cullen (Professor Cullen) |
[PERS ID:2224] | Patient | Miss Waugh |
[PERS ID:2226] | Patient | |
[PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
[PERS ID:2153] | Other Physician / Surgeon | Dr Walter Stirling |
[PERS ID:2225] | Patient's Relative / Spouse / Friend | Waugh |
[PERS ID:2212] | Patient's Relative / Spouse / Friend | Mrs Bowes |
[PERS ID:2218] | Patient's Relative / Spouse / Friend | Carlyle |
[PERS ID:2213] | Other |
Places linked to this document
Role in document | Specific Place | Settlements / Areas | Region | Country | Global Region | Confidence |
---|---|---|---|---|---|---|
Place of Writing | Carlisle | North-West | England | Europe | inferred | |
Destination of Letter | Edinburgh | Edinburgh and East | Scotland | Europe | inferred | |
Mentioned / Other | Scotland | Europe | certain | |||
Mentioned / Other | Carlisle | North-West | England | Europe | certain | |
Mentioned / Other | Carron | Edinburgh and East | Scotland | Europe | certain | |
Mentioned / Other | Dumfries | Borders | Scotland | Europe | certain | |
Mentioned / Other | Edinburgh | Edinburgh and East | Scotland | Europe | certain | |
Mentioned / Other | Glasgow | Glasgow and West | Scotland | Europe | certain | |
Mentioned / Other | Loch Lomond | Glasgow and West | Scotland | Europe | certain | |
Mentioned / Other | London | London and South-East | England | Europe | certain | |
Mentioned / Other | Scarborough | North-East | England | Europe | certain |
Normalized Text
I have now with me a most worthy
Friend and Relation, whose Situaton gives me very
great concern: you will much oblige me by taking
it into your attention & consideration, and sending
me your opinion upon it, as soon as convenient.
He is about 40. of a Family subject to no particular
Complaints, of either Gout, Rheumatism, Stones, Scurvy
or nervous Disorders: his mother reached the age of 82,
subject only to occasional Attacks of asthma. He is
of rather a full Habit, short neck, and large Head;
has passed most of his Time in London, but for a
month or two of the Summers yearly, in full and
extensive Practise, as a Solicitor; till about a year
an half agoe, tired of its [Fateagues?], and desirous of
Quiet and Retirement, he determined to give it up;
and having, about a year agoe, married my Niece
Bowes, whom you may remember with my Daughter
at Edinburgh, he has resided constantly in the Country: happy
in his Family, and easy in his Circumstances, perhaps
he gave too little attention to necessary Exercise, while
he fed plentifully; tho He never indulged in Excess,
being by Inclination regular, as He had also been while
[Page 2]
in Business, as much as his extensive Connections, and
cheerful social Disposition, much esteemed by his
Friends, would admitt. He had in general enjoyed
good Health, but that for several years he had, from
Colds, inflammatory Fevers in the Spring, 'till the last
4 or 5 years he escaped them; they however always
terminated happily. About three or four months
agoe, he became less inclined to Exercise than usual;
would fall asleep in his Chair after Dinner, and in¬
dulged longer than he was wont in Bed in a morning.
About ten weeks agoe, having taken his Hat and Stick
to walk out in the afternoon, before he got out of the
Room he was observed to faulter in his Step; and
immediately, upon being got to his Chair, his Stick
dropped out his Hand, his left Eye was contracted,
his mouth drawn a little to that side, and his Speech
was not quite perfect: these appearances however
went off in a very short Time; he fell into a quite Sleep
for about an Hour, and awoke without Complaints: he
had a good night afterwards, and next morning was
very well: at the Desire however of his Friends, he was
bled that Day, took a vomit, and afterwards a Dose of
Physick; after which he seemed as well as He had been
[Page 3]
for some time: tho' ever after this his, Friends observed,
a much less Quantity of Liquor used to make an Alte¬
ration in him than before. Having occasion to go
upon some Business to Carron, about a month agoe
we took a Tour, by Dumfries, Glasgow, Loch Lomond,
&c. and came to Carron in seeming good Health, October 4.th;
on the 5.th he dined in Company, and had drank rather
more freely than usual: but the next Day had no Com¬
plaint, and went thro' Business with his usual accura¬
cy and Dispatch. On the 7.th after Dinner, he became
drowsy, and, when at Cards in the afternoon, lost
his attention, made some mistakes, and immediately
had his Face affected much as in his former Fit: this
being perceived, he was put to Bed, slept well thro' the
Night, and rose in the morning without Complaint;
yet had lost all Recollection of where he was, what he
had been about, what brought him there, &c. tho' he
knew every Body, gave regular answers to all Questions
asked him, and moved every Part with Ease and Stea¬
diness: He consented however to be bled, and took a
Dose of Physick: after which, D.r Stirling being sent
for prescribed him no medicines, but advised his going
Home immediately, and that He should live well upon
[Page 4]
the Road: my Son was his Companion, who brought him
back by easy Stages; but kept to a cool Regimen, being
affraid of heating him too much. I was sorry they had
not called upon you on their way thro' Edinburgh; that how¬
ever was neglected. when they arrived here, he looked
well, and sensible; saluted every one properly, &c. but
had no Ideas remaining, of any one Incident, from his
leaving Carlisle, about Ten Days before; not even of
what had passed but an Hour or two before, or during
their last Stays. He rested but indifferently that night;
next morning I found his Skin gentle, and rather
moist, but hot; his Tongue at the Edges a florid red, in
the middle had a thick and yellowish white Cover, but
quite moist, he had a frequent hawking up of viscid
mucus from his Throat; yet had no Thirst, tho' he was
pleased with cooling Liquids: his Breath was very
offensive: his Pulse regular, but quick, and low: He
made no Kind of Complaint; said always he was very well,
nor would he allow he had any Pain or uneasiness, in
any one Part, either Headach ↑or↑ Giddiness; nor had he any
Tremors, or the motion of any Part impared: his urine
was very high colored, and without sediment. he
had no Stool for some Days. An emollient Glyster was
therefore injected; a Blister laid to his Back; and he
[Page 5]
took a Teaspoonfull of the Tinct. Guajac. vol three or
four Times a Day, 'till his Pulse had recovered a little
Firmness: a neutral mixture, with Sal. C. C. & Succin.
vol. was then added to it; and Plenty of cooling Dilu¬
ents. about the 9th Day of the Disorder, he came to a
free Perspiration on the 12th, his urine deposited a
copious Sediment, his Tongue cleared, his Stool came
regularly, and the offensiveness of his Breath went off:
notwithstanding all which, his Recollecion continued
as imperfect as ever. I then tried him with the Tart.
Tartarisat. to ℥ſs a Day, with Honey, dissolved in Water,
as recommended by [Mr Zell?]; from which I have seen
much advantage received in like Cases: This seems to
agree with him, his Pulse being now quite calm, and
regular, and of a proper Fullness; his Stools, and Urine,
as they should be in perfect Health; his Tongue
clear, skin soft, Sleep sound at night; yet he able to
keep up thro' a great Part of the Day: his appetite is
moderate; and no Thirst. Four Days agoe he had a
Blister laid to the Top of his Head; it discharged most
plentifully, as the one upon his Back had done, but I
took it off yesterday, as I thought it raised him, and
made him more talkative, and his Eyes wilder, with¬
out any Improvement in his Ideas; rather the contrary.
[Page 6]
He has been kept as quiet as possible, and no one allowed
to come in his Sight but his necessary attendants; and
every Conversation avoided that could lead to any Con¬
fusion of Ideas: nor does he ever oppose what is desired
of him, being the best natured Patient, the easiest
managed, and most complyant to Directions, of any I
ever was concerned with. I am at a Loss to represent,
clearly to you the Nature of his want of Recollection,
and his State of Mind: He is as sensible as ever, to present
Impressions: and, to a Stranger, would seem to labor
under no Defect, during a long Conversation; talking
but little, but mostly to the Purpose: he can read, and
judges very properly of objects; but seems to have no
Power, of himself, to recall any Idea; but now and then
comes out with vague and wild ones. He has not yet
recovered the Idea of any occurrence, during his whole
Journey to, and from Scotland: cannot even be persuaded
he was ever at Glasgow, &c. of Carron, where his principal
Business lay, he can be brought to but a very faint Recol¬
lection; but knows nothing of what was transacted there,
nor of the Parties who met. His other affairs at home, and
which he was most solicitous about, he now never
mentions of himself; if spoken of to him, he gives proper
Replies; but in half an Hour, will forget they have ever
been mentioned. Persons, and Places, he recollects when
[Page 7]
they are named; but often mistakes, both their Situati¬
ons and Qualities: nor can he repeat what has been
said but immediately before. The Occurrances of the
Day, and even of the Hour, escape his memory as
entirely as if they had never been. His mother has
been dead about 4 months, and he wears mourning
for her, yet has often asked how she did since he came
here, has fancied his mourning was for another Person,
one he was not in the least connected with; and, upon
the Death of ↑his↑ mothers being lately accidentally named
before him, fell into a most distressing Flood of Tears,
which held him longer than any Impressions He has
lately had; declaring he had never heard of it before:
yet even this he had forgot in an Hour; and, probably by
tomorrow, may ask for her again as alive: you'll excuse
my detaining you with such minute Incidents, as I
could not describe his Situation so properly as by them.
He seems mostly quite easy, and composed, takes few
Directions of himself, but such as are given him; yet
will enter, in his usual way, into a merry Tale; and be
much diverted with it. He rarely asks for either
Food or Drinks, his Chamber pot he regularly calls
for; his Close Stool never, 'till he is put in mind of it;
tho' then he would appear to have wanted it much.
[Page 8]
It is surprising he has never enquired, how the many
affairs he is engaged in, have gone on during his Confine¬
ment, who used to be so punctual and regular in all his
Transactions; but he often says, he came but home
yesterday, and that they must return tomorrow.
I need not detain you further with more Circumstan¬
ces of his Case; from the above you will clearly see how
he is affected: I wish you may be able to point out how
he may be brought out of his affecting State. should
he be put upon Exercise? he could bear it very well, if
there be no Danger of confusing his Head more by it.
or should more Company be admitted to him? he always
loved society, tho' he shows no want of it at present.
What medical Regimen shall we pursue in future?
and what Hopes are there, of any happy Termination
of the Disorder? your opinion, will at least relieve
in some measure my anxiety of mind for him: and I
can promise for his complying, with any Directions
are thought likely to relieve him.
My Daughter continues very well, and gratefully
remembers your kind attention to her. Miss Waugh
also holds well, tho' she lately went thro' a very distressing
Scene, by the sudden Death of her Brother at Scarbrough,
while she was with him.
I am, with dure Regard,
Dear Sir, your obliged humble Servant
D.r {illeg} Carlyle
November 1777
8. p. 27 1
Notes:
1: Unusually, this annotation was added at the head of this letter because there was no space left to add it to the final page.
Diplomatic Text
I have now with me a most worthy
Friend and Relation, whose Situaton gives me very
great concern: you will much oblige me by taking
it into your attention & consideration, and sending
me your opinion upon it, as soon as convenient.
He is about 40. of a Family subject to no particular
Complaints, of either Gout, Rheumatism, Stones, Scurvy
or nervous Disorders: his mother reached the age of 82,
subject only to occasional Attacks of asthma. He is
of rather a full Habit, short neck, and large Head;
has passed most of his Time in London, but for a
month or two of the Summers yearly, in full and
extensive Practise, as a Solicitor; till about a year
an half agoe, tired of its [Fateagues?], and desirous of
Quiet and Retirement, he determined to give it up;
and having, about a year agoe, married my Niece
Bowes, whom you may remember with my Daughter
at Ed.r, he has resided constantly in the Country: happy
in his Family, and easy in his Circumstances, perhaps
he gave too little attention to necessary Exercise, while
he fed plentifully; tho He never indulged in Excess,
being by Inclination regular, as He had also been while
[Page 2]
in Business, as much as his extensive Connections, and
cheerful social Disposition, much esteemed by his
Friends, would admitt. He had in general enjoyed
good Health, but that for several years he had, from
Colds, inflammatory Fevers in the Spring, 'till the last
4 or 5 years he escaped them; they however always
terminated happily. About three or four months
agoe, he became less inclined to Exercise than usual;
would fall asleep in his Chair after Dinner, and in¬
dulged longer than he was wont in Bed in a morning.
About ten weeks agoe, having taken his Hat and Stick
to walk out in the afternoon, before he got out of the
Room he was observed to faulter in his Step; and
immediately, upon being got to his Chair, his Stick
dropped out his Hand, his left Eye was contracted,
his mouth drawn a little to that side, and his Speech
was not quite perfect: these appearances however
went off in a very short Time; he fell into a quite Sleep
for about an Hour, and awoke without Complaints: he
had a good night afterwards, and next morning was
very well: at the Desire however of his Friends, he was
bled that Day, took a vomit, and afterwards a Dose of
Physick; after which he seemed as well as He had been
[Page 3]
for some time: tho' ever after this his, Friends observed,
a much less Quantity of Liquor used to make an Alte¬
ration in him than before. Having occasion to go
upon some Business to Carron, about a month agoe
we took a Tour, by Dumfries, Glasgow, Loch Lomond,
&c. and came to Carron in seeming good Health, Oct.r 4.th;
on the 5.th he dined in Company, and had drank rather
more freely than usual: but the next Day had no Com¬
plaint, and went thro' Business with his usual accura¬
cy and Dispatch. On the 7.th after Dinner, he became
drowsy, and, when at Cards in the afternoon, lost
his attention, made some mistakes, and immediately
had his Face affected much as in his former Fit: this
being perceived, he was put to Bed, slept well thro' the
Night, and rose in the morning without Complaint;
yet had lost all Recollection of where he was, what he
had been about, what brought him there, &c. tho' he
knew every Body, gave regular answers to all Questions
asked him, and moved every Part with Ease and Stea¬
diness: He consented however to be bled, and took a
Dose of Physick: after which, D.r Stirling being sent
for prescribed him no medicines, but advised his going
Home immediately, and that He should live well upon
[Page 4]
the Road: my Son was his Companion, who brought him
back by easy Stages; but kept to a cool Regimen, being
affraid of heating him too much. I was sorry they had
not called upon you on their way thro' Ed.r; that how¬
ever was neglected. when they arrived here, he looked
well, and sensible; saluted every one properly, &c. but
had no Ideas remaining, of any one Incident, from his
leaving Carlisle, about Ten Days before; not even of
what had passed but an Hour or two before, or during
their last Stays. He rested but indifferently that night;
next morning I found his Skin gentle, and rather
moist, but hot; his Tongue at the Edges a florid red, in
the middle had a thick and yellowish white Cover, but
quite moist, he had a frequent hawking up of viscid
mucus from his Throat; yet had no Thirst, tho' he was
pleased with cooling Liquids: his Breath was very
offensive: his Pulse regular, but quick, and low: He
made no Kind of Complaint; said always he was very well,
nor would he allow he had any Pain or uneasiness, in
any one Part, either Headach ↑or↑ Giddiness; nor had he any
Tremors, or the motion of any Part impared: his urine
was very high colored, and without sediment. he
had no Stool for some Days. An emollient Glyster was
therefore injected; a Blister laid to his Back; and he
[Page 5]
took a Teaspoonfull of the Tinct. Guajac. vol three or
four Times a Day, 'till his Pulse had recovered a little
Firmness: a neutral mixture, with Sal. C. C. & Succin.
vol. was then added to it; and Plenty of cooling Dilu¬
ents. about the 9th Day of the Disorder, he came to a
free Perspiration on the 12th, his urine deposited a
copious Sediment, his Tongue cleared, his Stool came
regularly, and the offensiveness of his Breath went off:
notwithstanding all which, his Recollecion continued
as imperfect as ever. I then tried him with the Tart.
Tartarisat. to ℥ſs a Day, with Honey, dissolved in Water,
as recommended by [Mr Zell?]; from which I have seen
much advantage received in like Cases: This seems to
agree with him, his Pulse being now quite calm, and
regular, and of a proper Fullness; his Stools, and Urine,
as they should be in perfect Health; his Tongue
clear, skin soft, Sleep sound at night; yet he able to
keep up thro' a great Part of the Day: his appetite is
moderate; and no Thirst. Four Days agoe he had a
Blister laid to the Top of his Head; it discharged most
plentifully, as the one upon his Back had done, but I
took it off yesterday, as I thought it raised him, and
made him more talkative, and his Eyes wilder, with¬
out any Improvement in his Ideas; rather the contrary.
[Page 6]
He has been kept as quiet as possible, and no one allowed
to come in his Sight but his necessary attendants; and
every Conversation avoided that could lead to any Con¬
fusion of Ideas: nor does he ever oppose what is desired
of him, being the best natured Patient, the easiest
managed, and most complyant to Directions, of any I
ever was concerned with. I am at a Loss to represent,
clearly to you the Nature of his want of Recollection,
and his State of Mind: He is as sensible as ever, to present
Impressions: and, to a Stranger, would seem to labor
under no Defect, during a long Conversation; talking
but little, but mostly to the Purpose: he can read, and
judges very properly of objects; but seems to have no
Power, of himself, to recall any Idea; but now and then
comes out with vague and wild ones. He has not yet
recovered the Idea of any occurrence, during his whole
Journey to, and from Scotland: cannot even be persuaded
he was ever at Glasgow, &c. of Carron, where his principal
Business lay, he can be brought to but a very faint Recol¬
lection; but knows nothing of what was transacted there,
nor of the Parties who met. His other affairs at home, and
which he was most solicitous about, he now never
mentions of himself; if spoken of to him, he gives proper
Replies; but in half an Hour, will forget they have ever
been mentioned. Persons, and Places, he recollects when
[Page 7]
they are named; but often mistakes, both their Situati¬
ons and Qualities: nor can he repeat what has been
said but immediately before. The Occurrances of the
Day, and even of the Hour, escape his memory as
entirely as if they had never been. His mother has
been dead about 4 months, and he wears mourning
for her, yet has often asked how she did since he came
here, has fancied his mourning was for another Person,
one he was not in the least connected with; and, upon
the Death of ↑his↑ mothers being lately accidentally named
before him, fell into a most distressing Flood of Tears,
which held him longer than any Impressions He has
lately had; declaring he had never heard of it before:
yet even this he had forgot in an Hour; and, probably by
tomorrow, may ask for her again as alive: you'll excuse
my detaining you with such minute Incidents, as I
could not describe his Situation so properly as by them.
He seems mostly quite easy, and composed, takes few
Directions of himself, but such as are given him; yet
will enter, in his usual way, into a merry Tale; and be
much diverted with it. He rarely asks for either
Food or Drinks, his Chamber pot he regularly calls
for; his Close Stool never, 'till he is put in mind of it;
tho' then he would appear to have wanted it much.
[Page 8]
It is surprising he has never enquired, how the many
affairs he is engaged in, have gone on during his Confine¬
ment, who used to be so punctual and regular in all his
Transactions; but he often says, he came but home
yesterday, and that they must return tomorrow.
I need not detain you further with more Circumstan¬
ces of his Case; from the above you will clearly see how
he is affected: I wish you may be able to point out how
he may be brought out of his affecting State. should
he be put upon Exercise? he could bear it very well, if
there be no Danger of confusing his Head more by it.
or should more Company be admitted to him? he always
loved society, tho' he shows no want of it at present.
What medical Regimen shall we pursue in future?
and what Hopes are there, of any happy Termination
of the Disorder? your opinion, will at least relieve
in some measure my anxiety of mind for him: and I
can promise for his complying, with any Directions
are thought likely to relieve him.
My Daughter continues very well, and gratefully
remembers your kind attention to her. Miss Waugh
also holds well, tho' she lately went thro' a very distressing
Scene, by the sudden Death of her Brother at Scarbrough,
while she was with him.
I am, with dure Regard,
Dr Sir, your obliged humble Serv.t
D.r {illeg} Carlyle
Nov.r 1777
8. p. 27 1
Notes:
1: Unusually, this annotation was added at the head of this letter because there was no space left to add it to the final page.
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