Cullen

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

 

[ID:943] From: Mr James Fea (of Clestrain) / To: Dr William Cullen (Professor Cullen) / Regarding: Mr Andrew Ross (Patient) / 10 December 1774 / (Incoming)

Letter from James Fea on the case of Andrew Ross, who is delirious and suffers attacks of pain but whose condition seems to be improving. Gives a diary of the progress of the illness and course of treatment.

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Metadata

FieldData
DOC ID 943
RCPE Catalogue Number CUL/1/2/203
Main Language English
Document Direction Incoming
Date10 December 1774
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 James Fea on the case of Andrew Ross, who is delirious and suffers attacks of pain but whose condition seems to be improving. Gives a diary of the progress of the illness and course of treatment.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:139]
Case of Mr Andrew Ross suffering from abdominal discomforts and interrupted sleep which eventually leave him delirious. Cullen considers it 'hypochondriasis'.
5


People linked to this document

Person IDRole in documentPerson
[PERS ID:447]AuthorMr James Fea (of Clestrain)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:266]PatientMr Andrew Ross
[PERS ID:447]Patient's Physician / Surgeon / ApothecaryMr James Fea (of Clestrain)

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Kirkwall Orkneys Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe inferred

Normalized Text

[Page 1]
Kirkwall, 10th December 1774
Sir --


Your agreeable favours (relating to Mr Ross's
case,) came to his hand in Course of Post.-


But tho the Return was as Desireable to
him as could have been wisht, yet his Disorder
(Before it's arrivall) had taken a very unfavour¬
ble turn.-


His Greate complaint (as formerly mentioned)
was a collection of wind in the stomach & Bowels &
which att that time, Give him some little respite, but
since has arissen the most alarming hight, & has
now reduced him to the last degree of weakness &
Langour.-


By this Increase of his Disorder he has been
prevented from rest, almost for whole nights- And
if at any time he slumbered he was awaked by
frightfull Dreams, & startings- And in this situ¬
ation (Doctor Groat the Physician who attended him
& who has done every thing in his power for his
ease) Greatly feared a Delerium from his Great
Watchings, Breaking of wind &c- Therefore the
Doctor judged it necessary to take some Blood from
him more especially as his pulse was rather quick
& strong
- The quantity taken was nearest to eight
ounces, which when cold appeared to be very ritch
without the appearance of any thin Inflam¬
matory- This anxiety, & dread of the approach¬
ing delerium (as stated above), made him very
unhappy- to ease which the Doctor applyed a blister
to the top of his head more by way of prevention
than otherwise, keeping it open in the ordinary
way- & that for about a fortnight-




[Page 2]

The Blister being thus keept open eased his
mind, & keept the symptoms he so much dread¬
ed greatly att Bay-


You may remember you was wrote to of
his taking the Bark, but it purging him it was left
off, & this renewed for about a week it seemed to be
do him but little good- Therefore was Dropt in
the species, & about three weeks afterwards which
Doctor give it him in Decoction which answered well
(but this last shall be stated in its proper place).


The above management was previous to his
receiving your Excellent Instructions, which he's fol¬
lowed as close as possible in Every Instance- On¬
ly exercise which he's totally deprived off, first
on account of his great weakness, & next the cli¬
mate, & season of the year.-


The chewing of the Rhubarb he had
left off & only used the tincture by the Doctors directi¬
on to give him a stool or so-


Matters thus stood on the most distresfull
state with very little alteration untill the 19th [Att?]
about five o clock in the evening, when he was
all of a sudden seized with Great shiverings like
Aguishfitts, strong & quick pulse, great
Drowth with an Increase of his Anxiety &
weakness if possible-


Upon the Doctors being sent for &
finding the symtoms before Desscribed, he let some
blood
to the Quantity of six Ounces or thereabouts.
Still his dread of his Distemper becoming ma¬
naicall
, Inflamed every symtom of his Disorder.
The blister was again renewed, as before & he put
to Bed-




[Page 3]

The Doctor ordered him a cordiall mixture which
relieved him much. He had Broken slumbers
untill towards morning sometimes for a quarter
of an hour together, but his intervalls were dread¬
full awaking in the greatest of fright & pain.-


And now it was that his Delerium seemed
to be fixed- more towards Day light (this being
about five oClock) his slumbers seemed to be less
Interrupted & a Breathing sweat broke out all
over his Body when his fever remitted-
He now sleept still with Greater ease & Refresh¬
ment, & this a good deal thro the day- Took also
some sago with a little wine- This Drink Barly
water with Gum Arabic, as he complained of
a Strangury- 20th. His pulse regular and free from
labouring, he had some loose stools which Give
him Great Ease- The Doctor ordered him the
Decoction of the Bark with Snake root- This
evening he Broke wind Downward which was
more than he had done since the Begining of his
Distemper-


21st. Continued to slumber without refreshment. very
frequently Interrupted by Dreaming and Starting-
He continues also very weak- The Food was such
as you had ordered with a small quantity of
wine etcetra. For Drink the Barley water continu¬
ed, with a change of Toast & water rather stronger
than ordinary- This last he liked much-


22d. Much the same as the preceding day-
The cordiall mixture continued on Account of his
depression of spirits- The Deoction of the Bark
also continued.




[Page 4]


23d. The Doctor ordered him the tincture of Rhubarb
which operated very well; This night he sleept well
& Long att a time & was Greatly refreshed af¬
ter it- When he awoke thro the night he took
some sago, Barley &c as before mentioned-


the use of the flannell had an Agreeable Ef¬
fect-


24th, 25th. 26th. Much the same, he continues ↑rather↑ to weaken-


27th. Sleept too much without refreshment in Great
Perturbation of mind- His Blister still open
& runs much-


28th, 29th. & 30th. Very little alteration; & Greatly Distressed-
He seems to Dread his attacks, which now were
fixed by regular Paroxsims, & whose approach
he always predicted, by the utmost dread &
terror- And until he belched, or broke wind
downwards continued ↑also↑ in the greatest Agony-


The Doctor laid aside the use of the tincture
of therhubarb
, & give him stoved prunes in
its stead- which answered well- Takes the
Sago, Barley, &c as above- But nothing
solid- He uses water gruell & frequently which
supports him Greatly-


From the 1st to the 8th continues much the same ↑as to his complaints↑ & not
withstanding his miserable state seem to
get some streinth-


9th. Thro the whole day continued in Great Distress
his fitts being more frequent & violent, than
heretofore, towards Evening & in the night,



[Page 5]

he solicited the Doctor to take some Blood from
him, which he did to the Quantity of six or seven
Ounces- His rest was greatly interrupted
afterwards- and its greatlymuch to be feared. that the
confusion in his head is rather fix't- At least
he Dreads it himself.


Ever since his first attack he conti¬
nues rather costive (as you predict) & which
makes him very unhappy, when he's longer
in that state than he would Incline-


upon this Last {illeg}AttackFitt he being in the above
state the Doctor give him a purging mixture
to be taken occasionally with Tincture of Vale¬
rian
- He also used the Valerian, & Snake
root
by way of pea for a day or two- but
with very little effect- And to conclude this
simple narrative of facts- And which is
transmitted to you for your immediate ans¬
wer, as Mr Ross will be very Impatient.
I must entreat therefore you'll send it as soon
as may be as Im certain nothing can give
[Start of margin text]him[End of margin text] greater pleasure, nor can anything be of
more reall service towards his relief, than
your Excellent Directions, as he's often
Experienced- And I am


Sir-
with the Greatest Esteem
your very humble servant
James Fea



[Page 6]


Mr [Fea]
about Mr Ross
December 10th 1774
Vol. I. p.151

Diplomatic Text

[Page 1]
Kirkll, 10th Decr 1774
Sir --


Your agreeable favours (relating to Mr Ross's
case,) came to his hand in Course of Post.-


But tho the Return was as Desireable to
him as could have been wisht, yet his Disorder
(Before it's arrivall) had taken a very unfavour¬
ble turn.-


His Greate complaint (as formerly mentioned)
was a collection of wind in the stomach & Bowels &
wch att that time, Give him some little respite, but
since has arissen the most alarming hight, & has
now reduced him to the last degree of weakness &
Langour.-


By this Increase of his Disorder he has been
prevented from rest, almost for whole nights- And
if at any time he slumbered he was awaked by
frightfull Dreams, & startings- And in this situ¬
ation (Docr Groat the Physician who attended him
& who has done every thing in his power for his
ease) Greatly feared a Delerium from his Great
Watchings, Breaking of wind &c- Therefore the
Docr judged it necessary to take some Blood from
him more especially as his pulse was rather quick
& strong
- The quantity taken was nearest to eight
ounces, wch when cold appeared to be very ritch
without the appearance of any thin Inflam¬
matory- This anxiety, & dread of the approach¬
ing delerium (as stated above), made him very
unhappy- to ease wch the Docr applyed a blister
to the top of his head more by way of prevention
than otherwise, keeping it open in the ordinary
way- & that for about a fortnight-




[Page 2]

The Blister being thus keept open eased his
mind, & keept the symptoms he so much dread¬
ed greatly att Bay-


You may remember you was wrote to of
his taking the Bark, but it purging him it was left
off, & this renewed for about a week it seemed to be
do him but little good- Therefore was Dropt in
the species, & about three weeks afterwards wch
Docr give it him in Decoction wch answered well
(but this last shall be stated in its proper place).


The above management was previous to his
receiving your Excellent Instructions, wch he's fol¬
lowed as close as possible in Every Instance- On¬
ly exercise wch he's totally deprived off, first
on Acct of his great weakness, & next the cli¬
mate, & season of the year.-


The chewing of the Rhubarb he had
left off & only used the tincture by the Docr's directi¬
on to give him a stool or so-


Matters thus stood on the most distresfull
state with very little alteration untill ye 19th [Att?]
about five o clock in the evening, when he was
all of a sudden seized with Great shiverings like
Aguishfitts, strong & quick pulse, great
Drowth with an Increase of his Anxiety &
weakness if possible-


Upon the Docr's being sent for &
finding the symtoms before Desscribed, he let some
blood
to the Quantity of six Ounces or thereabouts.
Still his dread of his Distemper becoming ma¬
naicall
, Inflamed every symtom of his Disorder.
The blister was again renewed, as before & he put
to Bed-




[Page 3]

The Doctor ordered him a cordiall mixture wch
relieved him much. He had Broken slumbers
untill towards morning sometimes for a quarter
of an hour together, but his intervalls were dread¬
full awaking in the greatest of fright & pain.-


And now it was that his Delerium seemed
to be fixed- more towards Day light (this being
about five oClock) his slumbers seemed to be less
Interrupted & a Breathing sweat broke out all
over his Body when his fever remitted-
He now sleept still wt Greater ease & Refresh¬
ment, & this a good deal thro the day- Took also
some sago with a little wine- This Drink Barly
water with Gum Arabic, as he complained of
a Strangury- 20th. His pulse regular and free from
labouring, he had some loose stools wch Give
him Great Ease- The Docr ordered him the
Decoction of ye Bark wt Snake root- This
evening he Broke wind Downward wch was
more than he had done since the Begining of his
Distemper-


21st. Continued to slumber without refreshmt. very
frequently Interrupted by Dreaming and Starting-
He continues also very weak- The Food was such
as you had ordered with a small quantity of
wine &tc. For Drink the Barley water continu¬
ed, with a change of Toast & water rather stronger
than ordinary- This last he liked much-


22d. Much the same as the preceding day-
The cordiall mixture continued on Account of his
depression of spirits- The Deoction of the Bark
also continued.




[Page 4]


23d. The Doctor ordered him the tincture of Rhubarb
wch operated very well; This night he sleept well
& Long att a time & was Greatly refreshed af¬
ter it- When he awoke thro ye night he took
some sago, Barley &c as before mentioned-


the use of the flannell had an Agreeable Ef¬
fect-


24th, 25th. 26th. Much the same, he continues ↑rather↑ to weaken-


27th. Sleept too much without refreshmt in Great
Perturbation of mind- His Blister still open
& runs much-


28th, 29th. & 30th. Very little alteration; & Greatly Distressed-
He seems to Dread his attacks, wch now were
fixed by regular Paroxsims, & whose approach
he always predicted, by the utmost dread &
terror- And until he belched, or broke wind
downwards continued ↑also↑ in the greatest Agony-


The Docr laid aside the use of the tincture
of therhubarb
, & give him stoved prunes in
its stead- wch answered well- Takes the
Sago, Barley, &c as above- But nothing
solid- He uses water gruell & frequently wch
supports him Greatly-


From ye 1st to ye 8th continues much the same ↑as to his complaints↑ & not
withstanding his miserable state seem to
get some streinth-


9th. Thro the whole day continued in Great Distress
his fitts being more frequent & violent, than
heretofore, towards Evening & in the night,



[Page 5]

he solicited the Docr to take some Blood from
him, wch he did to the Quantity of six or seven
Ounces- His rest was greatly interrupted
afterwards- and its greatlymuch to be feared. that the
confusion in his head is rather fix't- At least
he Dreads it himself.


Ever since his first attack he conti¬
nues rather costive (as you predict) & wch
makes him very unhappy, when he's longer
in that state than he would Incline-


upon this Last {illeg}AttackFitt he being in the above
state the Docr give him a purging mixture
to be taken occasionally wt Tincture of Vale¬
rian
- He also used the Valerian, & Snake
root
by way of pea for a day or two- but
wt very little effect- And to conclude this
simple narrative of facts- And wch is
transmitted to you for your immediate ans¬
wer, as Mr Ross will be very Impatient.
I must entreat therefore you'll send it as soon
as may be as Im certain nothing can give
[Start of margin text]him[End of margin text] greater pleasure, nor can anything be of
more reall service towards his relief, than
your Excellent Directions, as he's often
Experienced- And I am


Sir-
with ye Greatest Esteem
your very humble servt
James Fea



[Page 6]


Mr [Fea]
abt Mr Ross
Decr 10th 1774
Vol. I. p.151

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