The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:718] From: Dr William Cullen (Professor Cullen) / To: Mr J. Spens / Regarding: Mr J. Spens (Patient) / 25 February 1783 / (Outgoing)
Reply, 'Mr J. S.'. Cullen is unsure of the nature of the patient's condition, but advises him to take strengthening powders and injections of plain oil.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 4 images for this document.
[Page 1]
[Page 2]
[Page 3]
[Page 4]
Metadata
| Field | Data |
|---|---|
| DOC ID | 718 |
| RCPE Catalogue Number | CUL/1/1/15/205 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 25 February 1783 |
| Annotation | None |
| Type | Machine copy |
| Enclosure(s) | Enclosure(s) present |
| Autopsy | No |
| Recipe | Yes |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply, 'Mr J. S.'. Cullen is unsure of the nature of the patient's condition, but advises him to take strengthening powders and injections of plain oil. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1468] |
Case of Mr J. Spens who is thought to have gout, but his primary problem is a urinary stricture associated with a venereal infection which he has discussed with the surgeon John Hunter. |
6 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:2782] | Addressee | Mr J. Spens |
| [PERS ID:2782] | Patient | Mr J. Spens |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:2689] | Patient's Physician / Surgeon / Apothecary | Dr William Hunter |
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 |
Normalized Text
Mr J. S.
Yours of the 13th I ↑have↑ allowed to ly by me
for some days both because I have been much hurried and -
↑because↑ your case required much consideration. After all I am un¬
certain what may be your present condition. If you have now
got an incontinency of urine it is a very different state from that
you was in when you wrote the first part of your letter and
will require a different treatment. If the incontinency con¬
tinues I advise you to take the strengthening powders prescribed
in the inclosed and continue them for two or three weeks as
they are not unsuitable to any other state your complaints may
be in but if the incontinency is removed I do not insist upon -
your taking these powders at all tho I do not give them ↑up↑ as un¬
suitable to the case of frequent spasms but because if this is the
case you must employ other remedies more necessary. I join
very willingly with Mr Hunter in advising the use of Hemlock
and that to a considerable quantity for some length of time as
he will direct. I must tell you that I suspect you have a tumour
near the neck of the bladder in what we call the prostate and this
I think Mr Hunter may be able to determine. If this is ↑the↑ case
[Page 2]
I believe that Hemlock is the only promising remedy. Mercury
might be thought of if it had not been tried before but you have
of late had such a long course of it as shews it will not mend your
urethra. While your incontinency of urine remains there can
be no question about Bougies but it is possible that your former
spasms may return and absolutely require the bougie. With res¬
pect to using them they may be absolutely necessary to take off a
present suppression but I am clear that they should be used no
more than that necessity requires, and that the letting ↑them↑ ly in
any longer could do no service in the present state of your
complaints and would indeed do a great deal of harm.
With respect to Mercurial Injections I think they can hardly
be of any service towards correcting the morbid state of your ure¬
thra and I particularly think so with respect to both the -
prescriptions you have got at London which employ mucilage
but I have bound an injection of plain oil usefull both in
obviating and removing Spasms of the urethra and that more
usefull still by the addition of Mercurial ointment. If therefore
you shall hereafter find any place for injection you will make
use of the Mercurial Oil prescribed on the paper inclosed
[Page 3]
With respect to the balsamick remedies I formerly advised
I still think that moderately used they might be service in
obviating the return of Spasms but I am not so confident in ad¬
vising those remedies as before as I think the state of the parts
is much more irritable than formerly and you give me a parti¬
cular proof of it when you tell me they give so much inclination
to make water. I think it very possible that this effect may not
always follow and therefore that you may try the solution again
but let it be in a less does as half a spoonfull and if you shall
find that this obviates the spasm without giving
so much inclination to make water you may per¬
haps take such a dose of half a spoonfull both at
night and morning. Wishing most earnestly for your -
relief I am most sincerely Dear Sir
Edinburgh 25th February
1783.
[Page 4]
For Mr J. S.
Take two ounces of powdered bearberry leaves, half an ounce of powdered Peruvian bark, a drachm of cinnamon. Mix to make a Powder to be divided into individual doses of forty grams. Label Strengthening Powders one to be taken in a glass of water three times a day.
Take half an ounce of Mercurial Ointment prepared according to the norms of the Edinburgh Pharmacopoeia. In a glass or stone mortar, little by little add four ounces of very good olive oil, and carefully mix while crushing. Label Mercurial Oil a table spoonful of it to be taken injected into the Urethra two or three times a dy, taking care to shake the Phial always very well before pouring it out.
Diplomatic Text
Mr J. S.
Yours of the 13th I ↑have↑ allowed to ly by me
for some days both because I have been much hurried and -
↑because↑ your case required much consideration. After all I am un¬
certain what may be your present condition. If you have now
got an incontinency of urine it is a very different state from that
you was in when you wrote the first part of your letter and
will require a different treatment. If the incontinency con¬
tinues I advise you to take the strengthening powders prescribed
in the inclosed and continue them for two or three weeks as
they are not unsuitable to any other state your complaints may
be in but if the incontinency is removed I do not insist upon -
your taking these powders at all tho I do not give them ↑up↑ as un¬
suitable to the case of frequent spasms but because if this is the
case you must employ other remedies more necessary. I join
very willingly with Mr Hunter in advising the use of Hemlock
and that to a considerable quantity for some length of time as
he will direct. I must tell you that I suspect you have a tumour
near the neck of the bladder in what we call the prostate and this
I think Mr Hunter may be able to determine. If this is ↑the↑ case
[Page 2]
I believe that Hemlock is the only promising remedy. Mercury
might be thought of if it had not been tried before but you have
of late had such a long course of it as shews it will not mend your
urethra. While your incontinency of urine remains there can
be no question about Bougies but it is possible that your former
spasms may return and absolutely require the bougie. With res¬
pect to using them they may be absolutely necessary to take off a
present suppression but I am clear that they should be used no
more than that necessity requires, and that the letting ↑them↑ ly in
any longer could do no service in the present state of your
complaints and would indeed do a great deal of harm.
With respect to Mercurial Injections I think they can hardly
be of any service towards correcting the morbid state of your ure¬
thra and I particularly think so with respect to both the -
prescriptions you have got at London which employ mucilage
but I have bound an injection of plain oil usefull both in
obviating and removing Spasms of the urethra and that more
usefull still by the addition of Mercurial ointment. If therefore
you shall hereafter find any place for injection you will make
use of the Mercurial Oil prescribed on the paper inclosed
[Page 3]
With respect to the balsamick remedies I formerly advised
I still think that moderately used they might be service in
obviating the return of Spasms but I am not so confident in ad¬
vising those remedies as before as I think the state of the parts
is much more irritable than formerly and you give me a parti¬
cular proof of it when you tell me they give so much inclination
to make water. I think it very possible that this effect may not
always follow and therefore that you may try the solution again
but let it be in a less does as half a spoonfull and if you shall
find that this obviates the spasm without giving
so much inclination to make water you may per¬
haps take such a dose of half a spoonfull both at
night and morning. Wishing most earnestly for your -
relief I am most sincerely Dear Sir
Edinr. 25th Febry
1783.
[Page 4]
For Mr J. S.
℞ Pulv. folior. uva ursi ℥ij
---- cort. Peruvian. ℥ſs
---- cinnamom. Ʒj
ℳ fiat Pulvis dividendus in dos. sing. gr. XL↓40↓
Sig. Strengthening Powders one to be taken in a glass
of water three times a day.
℞ Unguent. Mercurial. ad normam
Pharm. Edinens. parat. ℥ſs
In mortario vitreo vel lapidea paulatim adde
Ol. olivar. opt. ℥iv
et diligenter tereus misce.
Sig. Mercurial Oil a table spoonful of
it to be taken injected into the Urethra two or
three times a dy, taking care to shake the Phial
always very well before pouring it out.
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