The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:2321] From: Mr William Clapham / To: Dr William Cullen (Professor Cullen) / Regarding: Mr Holt (Patient) / 20 September 1783 / (Incoming)
Letter from William Clapham, concerning the case of Mr Holt, 'a particular friend of mine'.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 4 images for this document.
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[Page 2]
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Metadata
| Field | Data |
|---|---|
| DOC ID | 2321 |
| RCPE Catalogue Number | CUL/1/2/1378 |
| Main Language | English |
| Document Direction | Incoming |
| Date | 20 September 1783 |
| 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 William Clapham, concerning the case of Mr Holt, 'a particular friend of mine'. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | Yes |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1593] |
Case of Mr Holt with a history of nephritis and swollen feet which may have been gout, but who is now suffering from a severe asthma. |
2 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:3453] | Author | Mr William Clapham |
| [PERS ID:1] | Addressee | Dr William Cullen (Professor Cullen) |
| [PERS ID:3452] | Patient | Mr Holt |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:3453] | Patient's Physician / Surgeon / Apothecary | Mr William Clapham |
Places linked to this document
| Role in document | Specific Place | Settlements / Areas | Region | Country | Global Region | Confidence |
|---|---|---|---|---|---|---|
| Place of Writing | Whitby | North-East | England | Europe | certain | |
| Destination of Letter | Edinburgh | Edinburgh and East | Scotland | Europe | inferred | |
| Mentioned / Other | York | North-East | England | Europe | certain | |
| Place of Handstamp | Whitby | North-East | England | Europe | certain |
Normalized Text
Sir
Mr. Holt, a particular friend of mine, has been long
indispos'd; and as he now appears to me to be in much danger,
I have prevail'd upon him to have your opinion upon his
case. --- He is 64 years of age, of a robust, full, and rather corpulent
habit, and of a temperament approaching nearest to the sanguine.
He has been accustom'd to a good deal of exercise, has been always
temperate in the use of liquors, but his diet has generally been
a full one, and consisted chiefly of animal food. He enjoy'd good
health till about five years ago, when he was attack'd with some
nephritic symptoms, accompanied with a large discharge of gravel
and small stones, which, after having continued for no very great
length of time, gradually decreas'd and soon left him in a state of
perfect health. Since that, the same complaint has return'd once
a year, but terminated in a different manner, being always
followed by a slight pain, some degree of redness, but not much
swelling in different parts of one or both feet and about the Ankle
joints. These symptoms were not of any long continuance, till
the last Autumn, when he remain'd lame and was under the necessity
of wearing large shows, to the best of my remembrance, near three
months. After that lameness went off, however, he was, as formerly,
left in the possession of good health, and continued so till the
month of last May, when he removed to a country seat of his in
the vicinity of York. After he had been there a very little time, he
was suddenly attack'd with symptoms of Asthma, which return'd
upon him every night after he had been an hour or two in bed,
but always left him before the morning. According to his own
account, (for he was now at a considerable distance from me, and
under the direction of the York Physicians) the difficulty of breathing
and sense of constriction in the Thorax were sometimes to that
degree, that his attendants were often under the necessity of,
removing him out of his chamber, and carrying him into the
open field for air. -- After trying a variety of remedies without
[Page 2]
discovering any happy effects from them, the faculty recommended
his native air to him, - in consequence of which he came hither
the latter end of last month. After his arrival his fits still
continued to return. Sometime between the hours of twelve and two
in the morning he awaked suddenly with a sense of an uncommon
constriction in the breast, yet had not, apparently, much quickness
or even difficulty of breathing. He was oblig'd to be kept in an erect
posture, and to have the door and windows of his chamber constantly
open. His pulse was full and strong but not quick. his skin
was cool, and he had no symptom of fever upon him whatever.
The sense of constriction always left him almost entirely before
six o'Clock in the morning, but without any expectoration
whatever, although he frequently seem'd to force a kind of cough as
if he wish'd to dislodge something from his Lungs. After the fit
was over, he seem'd much dejected, but was able to ride either in
his carriage or on horseback, and even cou'd walk pretty well,
unless it was up a place of difficult ascent. His appetite was
pretty good; but he was inclineable to costiveness, which he
obviated by an Electuary he brought from York with him. --
I was unacquainted with the mode of treatment which had been
pursued at York, any farther than some restrictions regarding
his regimen: -- but as I had reason to suspect in his former
complaints the prevalence of a Gouty diathesis, I conjectured
this might be the Gout under its Atonic form. I therefore order'd
him a preparation of the red Bark, and at the same time gave
him the rust of Iron. I also applie'd two blisters, one to each
ankle, and was very happy to find that as soon as they had
taken effect, his fits were much abated in their violence. I
was also much more pleas'd to find, two or three days after the
application of the blisters, a considerable degree of redness and
tension in one of his great Toes, accompanied with excruciating
pain. The inflammation continued, in a greater or less degree
six or seven days, during which time he was perfectly free
[Page 2]
from his fits, and his rest was never disturb'd by any thing
but the violence of the pain. -- At the expiration, however, of
the time above mention'd, the inflammation suddenly disappear'd,
and his Asthma return'd again and has continued ever since in
its former shape. His appetite is now not so good as it was,
and he is a good deal reduced and so much weaken'd as not to
be able to take much exercise, excepting that which his
carriage affords him. He complains, too, very frequently, of
a violent palpitation of the heart, and his pulse, I have
observed, is at these times often irregular. - Yesterday he was
seized, while in his carriage, with violent sickness and vomiting,
which was immediately follow'd by considerable pain in the
small of his back; -- and during the night and this morning,
he has discharged by urine three small stones, and a considerable
quantity of gritty matter of a brick-like appearance. -- He has
still no feverish symptoms; and he never sweats.
[I] think I have now enumerated most of the
particu[lars] relating to my good friend's case, though I a[m]
ashamed of the inaccurate form in which they are
presented to you. -- If you will be kind enough to give them
a consideration, and propose the plan which you have
reason to think, from the data you have to go upon, will
be the most eligible to be pursued, you will confer an
obligation upon, and always receive the thanks of,
Sir,
Your much obliged,
and most obedient Servant
William Clapham
Whitby
Yorkshire
September 20th. - 1783 --
P.S. If the return, which you will find enclosed, be not
sufficient, I beg you will mention it, and I will take
care to make a proper addition to it.
[Page 4]
Professor Cullen
Edinburgh
Dr. Clapham
Concerning Mr. Holt.
September 1783
V. xv. p.267.
Diplomatic Text
Sir
Mr. Holt, a particular friend of mine, has been long
indispos'd; and as he now appears to me to be in much danger,
I have prevail'd upon him to have your opinion upon his
case. --- He is 64 years of age, of a robust, full, and rather corpulent
habit, and of a temperament approaching nearest to the sanguine.
He has been accustom'd to a good deal of exercise, has been always
temperate in the use of liquors, but his diet has generally been
a full one, and consisted chiefly of animal food. He enjoy'd good
health till about five years ago, when he was attack'd with some
nephritic symptoms, accompanied with a large discharge of gravel
and small stones, which, after having continued for no very great
length of time, gradually decreas'd and soon left him in a state of
perfect health. Since that, the same complaint has return'd once
a year, but terminated in a different manner, being always
followed by a slight pain, some degree of redness, but not much
swelling in different parts of one or both feet and about the Ankle
joints. These symptoms were not of any long continuance, till
the last Autumn, when he remain'd lame and was under the necessity
of wearing large shows, to the best of my remembrance, near three
months. After that lameness went off, however, he was, as formerly,
left in the possession of good health, and continued so till the
month of last May, when he removed to a country seat of his in
the vicinity of York. After he had been there a very little time, he
was suddenly attack'd with symptoms of Asthma, which return'd
upon him every night after he had been an hour or two in bed,
but always left him before the morning. According to his own
account, (for he was now at a considerable distance from me, and
under the direction of the York Physicians) the difficulty of breathing
and sense of constriction in the Thorax were sometimes to that
degree, that his attendants were often under the necessity of,
removing him out of his chamber, and carrying him into the
open field for air. -- After trying a variety of remedies without
[Page 2]
discovering any happy effects from them, the faculty recommended
his native air to him, - in consequence of which he came hither
the latter end of last month. After his arrival his fits still
continued to return. Sometime between the hours of twelve and two
in the morning he awaked suddenly with a sense of an uncommon
constriction in the breast, yet had not, apparently, much quickness
or even difficulty of breathing. He was oblig'd to be kept in an erect
posture, and to have the door and windows of his chamber constantly
open. His pulse was full and strong but not quick. his skin
was cool, and he had no symptom of fever upon him whatever.
The sense of constriction always left him almost entirely before
six o'Clock in the morning, but without any expectoration
whatever, although he frequently seem'd to force a kind of cough as
if he wish'd to dislodge something from his Lungs. After the fit
was over, he seem'd much dejected, but was able to ride either in
his carriage or on horseback, and even cou'd walk pretty well,
unless it was up a place of difficult ascent. His appetite was
pretty good; but he was inclineable to costiveness, which he
obviated by an Electuary he brought from York with him. --
I was unacquainted with the mode of treatment which had been
pursued at York, any farther than some restrictions regarding
his regimen: -- but as I had reason to suspect in his former
complaints the prevalence of a Gouty diathesis, I conjectured
this might be the Gout under its Atonic form. I therefore order'd
him a preparation of the red Bark, and at the same time gave
him the rust of Iron. I also applie'd two blisters, one to each
ankle, and was very happy to find that as soon as they had
taken effect, his fits were much abated in their violence. I
was also much more pleas'd to find, two or three days after the
application of the blisters, a considerable degree of redness and
tension in one of his great Toes, accompanied with excruciating
pain. The inflammation continued, in a greater or less degree
six or seven days, during which time he was perfectly free
[Page 2]
from his fits, and his rest was never disturb'd by any thing
but the violence of the pain. -- At the expiration, however, of
the time above mention'd, the inflammation suddenly disappear'd,
and his Asthma return'd again and has continued ever since in
its former shape. His appetite is now not so good as it was,
and he is a good deal reduced and so much weaken'd as not to
be able to take much exercise, excepting that which his
carriage affords him. He complains, too, very frequently, of
a violent palpitation of the heart, and his pulse, I have
observed, is at these times often irregular. - Yesterday he was
seized, while in his carriage, with violent sickness and vomiting,
which was immediately follow'd by considerable pain in the
small of his back; -- and during the night and this morning,
he has discharged by urine three small stones, and a considerable
quantity of gritty matter of a brick-like appearance. -- He has
still no feverish symptoms; and he never sweats.
[I] think I have now enumerated most of the
particu[lars] relating to my good friend's case, though I a[m]
ashamed of the inaccurate form in which they are
presented to you. -- If you will be kind enough to give them
a consideration, and propose the plan which you have
reason to think, from the data you have to go upon, will
be the most eligible to be pursued, you will confer an
obligation upon, and always receive the thanks of,
Sir,
Your much obliged,
and most obedient Servant
William Clapham
Whitby
Yorkshire
Septemr. 20th. - 1783 --
P.S. If the return, which you will find enclosed, be not
sufficient, I beg you will mention it, and I will take
care to make a proper addition to it.
[Page 4]
Professor Cullen
Edinburgh
Dr. Clapham
C Mr. Holt.
Septr. 1783
V. xv. p.267.
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