Cullen

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

 

[ID:5349] From: Dr William Cullen (Professor Cullen) / To: Dr Antonio Giuseppe Testa / Regarding: Prince Abbondio Rezzonico (Patient) / 9 October 1786 / (Outgoing)

Reply, for 'Prince Rezzonico', probably to his physician Dr Testa. Cullen apologises for his delay in replying: ' it came to hand when some singular circumstance and even distress occupied in such a manner, as rendered it very difficulty to write to you as soon as I wished' (Mrs Cullen had died in August). He refers to previous advice given when the prince consulted Cullen in person, and to his 'gouty disposition'. He advises on the construction and use of the shower-bath.

Facsimile

There are 9 images for this document.

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[Page 2]


 

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Metadata

FieldData
DOC ID 5349
RCPE Catalogue Number CUL/1/1/19/160
Main Language English
Document Direction Outgoing
Date9 October 1786
Annotation None
TypeMachine copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply, for 'Prince Rezzonico', probably to his physician Dr Testa. Cullen apologises for his delay in replying: ' it came to hand when some singular circumstance and even distress occupied in such a manner, as rendered it very difficulty to write to you as soon as I wished' (Mrs Cullen had died in August). He refers to previous advice given when the prince consulted Cullen in person, and to his 'gouty disposition'. He advises on the construction and use of the shower-bath.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1928]
Case of Prince Abbondio Rezzonico who has no specific disease but who is advised on strengthening his 'relaxed habit' (i.e. a weak constitution which predisposes him to gout).
9


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1812]AddresseeDr Antonio Giuseppe Testa
[PERS ID:1031]PatientPrince Abbondio Rezzonico
[PERS ID:1812]Patient's Physician / Surgeon / ApothecaryDr Antonio Giuseppe Testa
[PERS ID:3864]Patient's Physician / Surgeon / ApothecaryDr
[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 Cullen's House / Mint Close Edinburgh Edinburgh and East Scotland Europe certain
Destination of Letter London London and South-East England Europe inferred
Mentioned / Other Scotland Europe certain
Mentioned / Other London London and South-East England Europe certain
Mentioned / Other Rome Italy Italy Europe certain

Normalized Text

[Page 1]

Prince Rezzonico

Sir


I had the honour of your polite letter
some days ago, but it came to hand when some sin¬
gular circumstance and even distress occupied
me in such a manner, as rendered it very
difficulty to write to you as soon as I wished. 1


The Excellency Prince Rezzonico's Con¬
sulting me about his health I considered as the
highest honour, and I shall certainly show the,
utmost attention at all times in giving his Excellency
the best advice I possibly can.


When I had the honour of conversing
with him here I could not discern that for
the time any disease was present, but per¬
ceived a laxity of his habit that might [render?]
him ↑liable↑ to various ailments, and I thought the
only means of obviating these was by giving
as much tone and firmness to his constitution



[Page 2]

as we possibly could, and you must perceive
that the whole of the advice that I had the
honour to present to his Excellency proceeded
upon that plan. I thought it particularly
happy for me that my advice was to come
into your hands. I have great reason to
believe well of your knowledge and judgement
in Physic, and that from your particular
acquaintance with and experience of the Prince['s]
constitution you was in the best condition
to direct the conduct of his health, and I
willingly Submitted my advice to your
revisal and expressed my desire to Prince
Rezzonicos to have your opinion upon the
Subject. It flatters me very much to find by you[r]
very polite and obliging letter that your Senti¬
ments are so very much the same with mine
and I shall endeavour to confirm them as well
as I can.




[Page 3]


In the little Sore upon the Princes neck
I perceived as I judge some remains of a Scrophulous
habit
, but hoped that at the Princes time of life
there was nothing considerable of that kind, or
if there was I thought the only means of obvi¬
ating its effects was the tonic I proposed.


I did not overlook the disposition to
Gout
, which both from the family constitution
and from what had even happened to the
Prince himself was to be supposed latent in
his System. But you know will how little
it is in our power to direct the motions of the
gouty diathesis, and the oedematous Swelling
which had appeared so long without pain or
inflammatory appearance made me conclude
that the Princes System, was not in a proper
condition to give the inflammatory determina¬
tion
to the extremities that was to be wished for



[Page 4]

and when I said that the Oedematous swellings
were not gouty I mean no more than that they
were not from the inflammatory determination
I speak of, and indeed I am much disposed to
think they had no connexion with it, and depen¬
ded entirely upon the general flaccidity of the
System.


Supposing Prince Rezzonico to have in his
constitution a disposition to the gout, and that in
all such cases some inflammatory determination
to the extremities is to be desired, it is however
very generally observed that such determination
requires some vigour in the general constitu¬
tion, and I strongly suspect that Prince
Rezzonicos constitution at present is not in
that condition. It is upon this latter suppo¬
sition that I hae offered any advice, and
no reflexion or consideration that I can
employ leads me to make any change in it



[Page 5]

I would willingly believe that you agree
with me in the general opinion, but suspect
you may have some doubts, and perhaps foresee
some difficulties in the execution of one particular
of my advice, and that is with respect to cold
bathing. When there is the least appearance
of in gouty dispositions of a determination to
the extremities I abstain from cold bathing, and
often from the beginning of Spring to the beginning
of Summer when such determinations most
commonly take place I also abstain from
cold bathing, but in other circumstances and
in other Seasons I have found it of great service
to gouty persons, and especially in Flaccid
and inert constitutions, such as I think our
patients is to be.


From what I have heard and seen of him
I am clearly of opinion that if I had had the



[Page 6]

care of Prince Rezzonicos health in his infant
years I should certainly have advised the em¬
ployment of cold bathing, and why his Physician
at Rome did not I cannot understand, and till
I should know better the foundation of that
learned Gentlemans opinion I cannot now
pay any regard to it.


It is possible that from that Gentlemans
opinion, or by shrinking from a painful practice
Prince Rezzonico may now be averse to try
Cold Bathing, but I hope he may be reconciled
to it, by the following measures. You must
practice only with the Shower bath for the
constitution of which you must be directed
by some persons who have been acquainted
with it in Scotland, or if you cannot find much
persons to direct the making of it at London
let me know and I shall send you very quickly



[Page 7]

the chief part of the apparatus ready made
from hence.


The machine as I make it employs ↑at most↑ only
ten English gallons of water. At first you are
to put into the Cylinders only five gallons, four of
which are to be quite cold taken from any
familys Cistern that is kept tolerably cool
is to be taken every time it is employed from
the same Cistern. For the first day to the four
gallons of cold water you are to add one gallon
of boiling water, and stirring there a little
together, they are to be ↑immediately↑ let fall upon the Pa¬
tients head and Shoulders, and when it has
now quite down he is to be immediately dried
with coarse all over with coarse towels, and
have his ordinary Cloaths put on.


This Shower of water, the person will



[Page 8]

hardly feel cold, or very moderately so, and cannot
call it a painful practice. But every day after¬
wards half a pint of cold water is to be added
and half a pint of boiling water is to be kept out
and thus in the course of fourteen days a person
is brought gradually to bear the water quite
cold, and when more cold water may by degrees
be added to the Cylinder till it is quite filled.


In the manner I have brought the
most weakly and delicate persons to bear Cold
bathing, and in many cases by cooling the water
and other means I have brought persons to
bear a great degree of cold applied in this way.


By this manner of doing two advanta¬
ges arise, one is, that if the bathing is truly
improper for the constitution of the person
by pro you may have warning of this before
you proceed to an extreme degree. Another



[Page 9]

advantage in [ind?] which indeed is obtained from
every kind of cold bathing, but must conveniently
from this, which is practised in a persons own
Chamber and at the most proper time of day is
that persons very liable to be affected by cold, and
to have Coryza, Cough, and other ailments induced
by it; by practising Cold Bathing in the morning
are rendered more hardy and less liable to be
affected by external cold. I hope you shall re¬
concile the Prince to this practice, and that
his Excellency shall have much benefit from it


Please present my most repectful
Compliments to him and when you can desire
any further explanations or advices you may
command me who have the honour of being with
great esteem


Sir
Your most obedient and
most humble Servant

William Cullen

Edinburgh 9th. October
1786

Notes:

1: This may refer to the death of Cullen's wife, Anna Johnstone Cullen, on 7 August 1786, just a week before the earliest letter in this case.

Diplomatic Text

[Page 1]

Prince Rezzonico

Sir


I had the honour of your polite letter
some days ago, but it came to hand when some sin¬
gular circumstance and even distress occupied
me in such a manner, as rendered it very
difficulty to write to you as soon as I wished. 1


The Excellency Prince Rezzonico's Con¬
sulting me about his health I considered as the
highest honour, and I shall certainly show the,
utmost attention at all times in giving his Excellency
the best advice I possibly can.


When I had the honour of conversing
with him here I could not discern that for
the time any disease was present, but per¬
ceived a laxity of his habit that might [render?]
him ↑liable↑ to various ailments, and I thought the
only means of obviating these was by giving
as much tone and firmness to his constitution



[Page 2]

as we possibly could, and you must perceive
that the whole of the advice that I had the
honour to present to his Excellency proceeded
upon that plan. I thought it particularly
happy for me that my advice was to come
into your hands. I have great reason to
believe well of your knowledge and judgement
in Physic, and that from your particular
acquaintance with and experience of the Prince['s]
constitution you was in the best condition
to direct the conduct of his health, and I
willingly Submitted my advice to your
revisal and expressed my desire to Prince
Rezzonicos to have your opinion upon the
Subject. It flatters me very much to find by you[r]
very polite and obliging letter that your Senti¬
ments are so very much the same with mine
and I shall endeavour to confirm them as well
as I can.




[Page 3]


In the little Sore upon the Princes neck
I perceived as I judge some remains of a Scrophulous
habit
, but hoped that at the Princes time of life
there was nothing considerable of that kind, or
if there was I thought the only means of obvi¬
ating its effects was the tonic I proposed.


I did not overlook the disposition to
Gout
, which both from the family constitution
and from what had even happened to the
Prince himself was to be supposed latent in
his System. But you know will how little
it is in our power to direct the motions of the
gouty diathesis, and the oedematous Swelling
which had appeared so long without pain or
inflammatory appearance made me conclude
that the Princes System, was not in a proper
condition to give the inflammatory determina¬
tion
to the extremities that was to be wished for



[Page 4]

and when I said that the Oedematous swellings
were not gouty I mean no more than that they
were not from the inflammatory determination
I speak of, and indeed I am much disposed to
think they had no connexion with it, and depen¬
ded entirely upon the general flaccidity of the
System.


Supposing Prince Rezzonico to have in his
constitution a disposition to the gout, and that in
all such cases some inflammatory determination
to the extremities is to be desired, it is however
very generally observed that such determination
requires some vigour in the general constitu¬
tion, and I strongly suspect that Prince
Rezzonicos constitution at present is not in
that condition. It is upon this latter suppo¬
sition that I hae offered any advice, and
no reflexion or consideration that I can
employ leads me to make any change in it



[Page 5]

I would willingly believe that you agree
with me in the general opinion, but suspect
you may have some doubts, and perhaps foresee
some difficulties in the execution of one particular
of my advice, and that is with respect to cold
bathing. When there is the least appearance
of in gouty dispositions of a determination to
the extremities I abstain from cold bathing, and
often from the beginning of Spring to the beginning
of Summer when such determinations most
commonly take place I also abstain from
cold bathing, but in other circumstances and
in other Seasons I have found it of great service
to gouty persons, and especially in Flaccid
and inert constitutions, such as I think our
patients is to be.


From what I have heard and seen of him
I am clearly of opinion that if I had had the



[Page 6]

care of Prince Rezzonicos health in his infant
years I should certainly have advised the em¬
ployment of cold bathing, and why his Physician
at Rome did not I cannot understand, and till
I should know better the foundation of that
learned Gentlemans opinion I cannot now
pay any regard to it.


It is possible that from that Gentlemans
opinion, or by shrinking from a painful practice
Prince Rezzonico may now be averse to try
Cold Bathing, but I hope he may be reconciled
to it, by the following measures. You must
practice only with the Shower bath for the
constitution of which you must be directed
by some persons who have been acquainted
with it in Scotland, or if you cannot find much
persons to direct the making of it at London
let me know and I shall send you very quickly



[Page 7]

the chief part of the apparatus ready made
from hence.


The machine as I make it employs ↑at most↑ only
ten English gallons of water. At first you are
to put into the Cylinders only five gallons, four of
which are to be quite cold taken from any
familys Cistern that is kept tolerably cool
is to be taken every time it is employed from
the same Cistern. For the first day to the four
gallons of cold water you are to add one gallon
of boiling water, and stirring there a little
together, they are to be ↑immediately↑ let fall upon the Pa¬
tients head and Shoulders, and when it has
now quite down he is to be immediately dried
with coarse all over with coarse towels, and
have his ordinary Cloaths put on.


This Shower of water, the person will



[Page 8]

hardly feel cold, or very moderately so, and cannot
call it a painful practice. But every day after¬
wards half a pint of cold water is to be added
and half a pint of boiling water is to be kept out
and thus in the course of fourteen days a person
is brought gradually to bear the water quite
cold, and when more cold water may by degrees
be added to the Cylinder till it is quite filled.


In the manner I have brought the
most weakly and delicate persons to bear Cold
bathing, and in many cases by cooling the water
and other means I have brought persons to
bear a great degree of cold applied in this way.


By this manner of doing two advanta¬
ges arise, one is, that if the bathing is truly
improper for the constitution of the person
by pro you may have warning of this before
you proceed to an extreme degree. Another



[Page 9]

advantage in [ind?] which indeed is obtained from
every kind of cold bathing, but must conveniently
from this, which is practised in a persons own
Chamber and at the most proper time of day is
that persons very liable to be affected by cold, and
to have Coryza, Cough, and other ailments induced
by it; by practising Cold Bathing in the morning
are rendered more hardy and less liable to be
affected by external cold. I hope you shall re¬
concile the Prince to this practice, and that
his Excellency shall have much benefit from it


Please present my most repectful
Compliments to him and when you can desire
any further explanations or advices you may
command me who have the honour of being with
great esteem


Sir
Your most obedient and
most humble Servant

William Cullen

Edinr. 9th. Octr.
1786

Notes:

1: This may refer to the death of Cullen's wife, Anna Johnstone Cullen, on 7 August 1786, just a week before the earliest letter in this case.

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