Cullen

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

 

[ID:834] From: Mr Andrew Liddell (Liddle) / To: Dr William Cullen (Professor Cullen) / Regarding: Mr James Sinclair (of Harpsdale) (Patient), Miss (Patient) / 18 July 1772 / (Incoming)

Letter from Andrew Liddell on the 'Case of Mr Sinclair of Harpsdale', who has been 'troubled with a scorbutic eruption on the back of his hand'. Also contains an update on a scrophulous patient (identifiable from elsewhere as 'a Young Lady in Orkney') who has been following Cullen's directions.

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Metadata

FieldData
DOC ID 834
RCPE Catalogue Number CUL/1/2/101
Main Language English
Document Direction Incoming
Date18 July 1772
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from Andrew Liddell on the 'Case of Mr Sinclair of Harpsdale', who has been 'troubled with a scorbutic eruption on the back of his hand'. Also contains an update on a scrophulous patient (identifiable from elsewhere as 'a Young Lady in Orkney') who has been following Cullen's directions.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:419]
Case of Mr Sinclair of Harpsdale', who has been 'troubled with a scorbutic eruption on the back of his hand'.
1
[Case ID:420]
Case of an unnamed female patient from Orkney, suffering from 'scrophulous complaints' for several years. Cullen had been giving advice on her treatment over the previous two years.
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:339]AuthorMr Andrew Liddell (Liddle)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:354]PatientMr James Sinclair (of Harpsdale)
[PERS ID:977]PatientMiss
[PERS ID:339]Patient's Physician / Surgeon / ApothecaryMr Andrew Liddell (Liddle)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:704]Patient's Relative / Spouse / FriendMr Sinclair

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Thurso North Highlands Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain
Mentioned / Other Orkneys Scotland Europe certain

Normalized Text

[Page 1]
Case of Mr. Sinclair of Harpsdale July 18th 1772 --


He is aged about 50, & for these 8 years' has been from time to time troubled with
a scorbutic eruption of the back of his hand, sometimes in both hands, & once a simi¬
lar eruption appeared on one of his Legs.


It consists at first of ↑very↑ small elevations from the skin, containing a serous
humour, very itchy, & discharged upon scratching the part. These run into
clusters & form circumscribed spots, generally circular, which sometimes
unite
so as to cover the back of the hand intirely. The whole then ap¬
pears elevated, rough, & of a fiery colour. When about to heal, small
white scales fall off, leaving the part very smooth, glossy & red. The
skin soon after recovers the natural appearance, or more frequent¬
ly this is prevented by a new eruption. -- At Intervels both
hands seem quite well, & have sometimes continued so for a twelvemonth
together. It is most disposed to break out in the Spring. This disorder,
at present is confined to the metacarpus: the cuticle thro' the rest of
the body is smooth & white.


The Patient is neither corpulent nor very thin: his Pulse natural
his appetite very good, & his excretions regular. He has no other Ailment.


Last spring, being then first called upon to see the Gentleman, I put
him under a course of the solution of sublimate in spirits with Decoction of the woods, the part affected being rubbed every night with mer¬
curial Ointment
. He was kept moderately warm, & this course
continued for 4 weeks. -- At first the eruptions seemed to abate for
some time, but all at once it broke out worse than ever in both
hands. He was tired with the confinement & discouraged: so it was
given up. The sublimate did not excite sweat, & not above 1/4 grains of it
could be given daily without occasioning loose stools, which was avoided as
much as possible.


A Liniment of Saccharum Saturni with oil & wax ↑was↑ applied a few days with no
advantage.




[Page 2]


A lesser attack of this complaint had been formerly for some time
carried off, as was supposed, by the use of saltwater taken in large
doses twice or thrice a week. -- After some Weeks interval, therefore,
I desired Mr Sinclair to take Saltwater every morning so as to procure
a loose stool every day. Also he took a draught of the Infusion amarum
twice a day. Nothing was applied to his hand but Diapalma.
This course was continued for two months, till now. About 3 weeks ago
the eruptions were almost quite removed: in a few days after
they returned, & continue in both hands as inveterate as ever.


His diet since spring had been almost intirely vegetable, with
sometimes Fowl or Mutton. But no salt or highseasoned food was allowed
him, nor fish. He does not exceed 4 or 5 glasses of Wine or Punch daily.


I would have tried a Salivation, but at Mr Sinclairs time of life
I was affraid to do it without your advice. I am now to intermit
all medicine till I have your opinion about the Nature & proper
treatment of this disorder, which it's expected will be as soon as you
can conveniently.

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------

Dear Sir,


I have been favoured with yours of the 10th & 26th
of June, 1 & your directions in both shall be punctually complied
with. --- The scrophulous patient is using the expressed juice of Tu¬
ssilago
, which agrees well enough with her stomach, tho' I have
given it to her simply expressed without any depuration, for fear of
injuring it's properties. If you disapprove of this it will be altered.


The Extract Cicutæ & Mezereon have not yet come to hand, so the other
patient continues the Pulvis Cicuta.


The inclosed above is the case of a brother of the late Mr Sinclair of



[Page 3]

Ulbster: He is very anxious about his complaint, being in a part so
conspicuous. ---


I cannot help taking your kind offers of assistance & advice in
the conclusion of your Letters as something more than compliment,
because you was always very ready to bestow them upon me when
even a greater stranger than at present. I will therefore venture
to trouble you sometimes with a Query for my own instruction, in¬
dependent of the patient who consults you. ---


I wish to be informed of the nature of the disease commonly called
scorbutic. Is it a genus or species? How are the species distinguish¬
able? Do they require difference treatment?


I remember to have heard you say, in a lecture, that mercury was
what was most to be depended upon in procuring a return of obstruc¬
ted menses
. If that is not a mistake of mine, in what circum¬
stances is this the proper remedy for Obstructed Mensuim, & how is it {illeg}
administered? --


What are the immediate & ultimate effects of Mezereon. I am quite
unacquainted with it. --- A short answer upon these heads, or
your recommending such books as may give me infomation will very
much add to your former obligations.


I hope, Sir, you'll pardon all this freedom, for it is really the con¬
sequence of a high opinion of your knowledge & goodness: and my sin¬
cerity need not be doubted in this, altho' it had not been the public
opinion; for any sense of the former led me at first, when a stranger to
you, to solicit your acquaintance; & several years experience has now
confirmed me in the certainty of both. -- I would not make use of
[pr?]ofessions, if had a more substansial opportunity of expressing my
regard: and were there any method of serving you from such a corner



[Page 4]

as this, it would be doing me the greatest favour to acquaint me of it.

With best wishes & compliments to you, your Lady, & Family, I am
Dear Sir,
your much obliged humble servant
Andrew Liddell
Thurso 18 July 1772

1772


To
Doctor William Cullen Physician
at Edinburgh

Notes:

1: Untraced, but see other letters linked to Case ID:420

Diplomatic Text

[Page 1]
Case of Mr. Sinclair of Harpsdale July 18th 1772 --


He is aged about 50, & for these 8 years' has been from time to time troubled with
a scorbutic eruption of the back of his hand, sometimes in both hands, & once a simi¬
lar eruption appeared on one of his Legs.


It consists at first of ↑very↑ small elevations from the skin, containing a serous
humour, very itchy, & discharged upon scratching the part. These run into
clusters & form circumscribed spots, generally circular, which sometimes
unite
so as to cover the back of the hand intirely. The whole then ap¬
pears elevated, rough, & of a fiery colour. When about to heal, small
white scales fall off, leaving the part very smooth, glossy & red. The
skin soon after recovers the natural appearance, or more frequent¬
ly this is prevented by a new eruption. -- At Intervels both
hands seem quite well, & have sometimes continued so for a twelvemonth
together. It is most disposed to break out in the Spring. This disorder,
at present is confined to the metacarpus: the cuticle thro' the rest of
the body is smooth & white.


The Patient is neither corpulent nor very thin: his Pulse natural
his appetite very good, & his excretions regular. He has no other Ailment.


Last spring, being then first called upon to see the Gentleman, I put
him under a course of the solution of sublimate in spirits with Dec¬
coct' of the woods
, the part affected being rubbed every night with mer¬
curial Ointment
. He was kept moderately warm, & this course
continued for 4 weeks. -- At first the eruptions seemed to abate for
some time, but all at once it broke out worse than ever in both
hands. He was tired with the confinement & discouraged: so it was
given up. The sublimate did not excite sweat, & not above 1/4 gr. of it
could be given daily without occasion g. loose stools, which was avoided as
much as possible.


A Liniment of Saccar. Saturni with oil & wax ↑was↑ applied a few days with no
advantage.




[Page 2]


A lesser attack of this complaint had been formerly for some time
carried off, as was supposed, by the use of saltwater taken in large
doses twice or thrice a week. -- After some Weeks interval, therefore,
I desired Mr Sinclair to take Saltwater every morning so as to procure
a loose stool every day. Also he took a draught of the Infus. amarum
twice a day. Nothing was applied to his hand but Diapalma.
This course was continued for two months, till now. About 3 weeks ago
the eruptions were almost quite removed: in a few days after
they returned, & continue in both hands as inveterate as ever.


His diet since spring had been almost intirely vegetable, with
sometimes Fowl or Mutton. But no salt or highseasoned food was allowed
him, nor fish. He does not exceed 4 or 5 glasses of Wine or Punch daily.


I would have tried a Salivation, but at Mr Sinclairs time of life
I was affraid to do it without your advice. I am now to intermit
all medicine till I have your opinion about the Nature & proper
treatment of this disorder, which it's expected will be as soon as you
can conveniently.

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------

Dear Sir,


I have been favoured with yours of the 10th & 26th
of June, 1 & your directions in both shall be punctually complied
with. --- The scrophulous patient is using the expressed juice of Tu¬
ssilago
, which agrees well enough with her stomach, tho' I have
given it to her simply expressed without any depuration, for fear of
injuring it's properties. If you disapprove of this it will be altered.


The Extr: Cicutæ & Mezereon have not yet come to hand, so the other
patient continues the Pulv. Cicuta.


The inclosed above is the case of a brother of the late Mr Sinclair of



[Page 3]

Ulbster: He is very anxious about his complaint, being in a part so
conspicuous. ---


I cannot help taking your kind offers of assistance & advice in
the conclusion of your Letters as something more than compliment,
because you was always very ready to bestow them upon me when
even a greater stranger than at present. I will therefore venture
to trouble you sometimes with a Query for my own instruction, in¬
dependent of the patient who consults you. ---


I wish to be informed of the nature of the disease commonly called
scorbutic. Is it a genus or species? How are the species distinguish¬
able? Do they require difference treatment?


I remember to have heard you say, in a lecture, that mercury was
what was most to be depended upon in procuring a return of obstruc¬
ted menses
. If that is not a mistake of mine, in what circum¬
stances is this the proper remedy for Ob: Mensuim, & how is it {illeg}
administered? --


What are the immediate & ultimate effects of Mezereon. I am quite
unacquainted with it. --- A short answer upon these heads, or
your recommendg. such books as may give me infomation will very
much add to your former obligations.


I hope, Sir, you'll pardon all this freedom, for it is really the con¬
sequence of a high opinion of your knowledge & goodness: and my sin¬
cerity need not be doubted in this, altho' it had not been the public
opinion; for any sense of the former led me at first, when a stranger to
you, to solicit your acquaintance; & several years experience has now
confirmed me in the certainty of both. -- I would not make use of
[pr?]ofessions, if had a more substansial opportunity of expressing my
regard: and were there any method of serving you from such a corner



[Page 4]

as this, it would be doing me the greatest favour to acquaint me of it.

With best wishes & compliments to you, your Lady, & Family, I am
Dr Sir,
your much obliged humble servt
Andrew Liddell
Thurso 18 July 1772

1772


To
Doctor William Cullen Physician
at Edinburgh

Notes:

1: Untraced, but see other letters linked to Case ID:420

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