Cullen

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

 

[ID:1138] From: Dr / To: Dr William Cullen (Professor Cullen) / Regarding: Mrs Blackburn (Patient) / 12 May 1775 / (Incoming)

Case note on a 61-year-old married woman [Mrs Blackburn: see Cullen's reply - Letter ID 304] who has 'been subject for several years at intervals to violent spasmodic pains, bilious vomitings and other symptoms of a distempered Gall'. She has passed a 'bilious concretion'.

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Metadata

FieldData
DOC ID 1138
RCPE Catalogue Number CUL/1/2/239
Main Language English
Document Direction Incoming
Date12 May 1775
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Case note on a 61-year-old married woman [Mrs Blackburn: see Cullen's reply - Letter ID 304] who has 'been subject for several years at intervals to violent spasmodic pains, bilious vomitings and other symptoms of a distempered Gall'. She has passed a 'bilious concretion'.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:507]
Case of Mrs Blackburn who is diagnosed with 'obstruction of bile'.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:1434]AuthorDr
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:1433]PatientMrs Blackburn
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:1434]Patient's Physician / Surgeon / ApothecaryDr
[PERS ID:1435]Patient's Physician / Surgeon / ApothecaryMr

Places linked to this document

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

Normalized Text

[Page 1]
May. 12. 1775.


A ↑married↑ Gentlewoman of the age of sixty one, having been subject
for several years at intervals to violent spasmodic pains, bili¬
ous
vomiting and other symptoms of a distempered Gall (from which
she recovered by the use of soap pills, neutral draughts, clysters,
and the application of bladders with hot water, opiates &c) was
after an interval of tolerable Health for near nine months,
seized with pain in her ri right side & stomach, and more parti¬
cularly in the lower belly, on the 17th. of March last; which was
immediately succeeded by almost continual bilious vomitings
without any motion downwards, in so much that the Apothecary
fearing an inflammation, from the continual pains in the lower
belly
, feverish heats, intermitting pulse &c thought it proper
to take away ounces of blood
; which carried off (↑abated↑) the fever, but
did not relieve the other symptoms, viz. nausea & vomiting or
the costiveness.


OnThe Symptoms continuing for five or six days, it was
thought proper to give her Pil. Ruffi gradually and increasing
the doses as there should be occasion. This in about 48 hours, opend
the passage by stool, and on the 30th. of March the patient voided
a Bilious concretion of the size of a large Walnut. This substance
has been sawn through, and appears to have a ↑calcareous↑ nucleus about
as large as a middling pea, & to have been covered with strata
one above another of a gritty crumbling nature, much like rotten
wood.


From this time the patient has been better and worse, some
times quite easy, got out in a chaise, recovered her appetite in some
tolerable measure, but seldom ↑entirely↑ free from oppression at her stomach
a general uneasiness, with a nauseous taste in her mouth, and
Eructations which hardly gave reliefany material relief.


Sometimes towards evening, she has been seized with shi
violent coldness & shivering, exactly like the cold fit of an ague
and always succeeded by a pretty brisk fever, which went off towards
morning and left the patient pretty easy; These fits of shivering &c
did not come on periodically, but sometimes for two or three
days successively, sometimes after an interval of 3 or 4 days.


The Person who attended her, was induced (but not from his own
judgment) to try the Bark, which unfortunately brought on
a spasmodic paroxysm of the pain in her side, to a most violent
degree, which after being alleviated by some drops of Laudanum
and the hot bladder, ended in a trembling followed by the hot fit
as before. This happened on Friday May. 5. when a Physician
being called in, he prescribed only a neutral - composed of spirit of
Nitre
, Sal Ammoniac, Penny royal water & Fennel water, together with
the Soap pills, which have kept the body open, but produced only
clayey, or ash coloured stools, extremely offensive, attended with Nausea



[Page 2]

or sickness
, but not with vomiting. Otherwise pretty easy days, and
no shiverings &c. since [11?] Sunday 9.th. N.B. The pulse very good
The water various, sometimes pale & thin, ↑and in plenty↑ at other times extremely
turbid and high coloured almost the colour of Grumous blood or
Coffee with a pretty copious sediment, but in small quantities , and
chiefly after exercise. No remarkable diminuation of strength, but
bears exercise very well hitherto.

Diplomatic Text

[Page 1]
May. 12. 1775.


A ↑married↑ Gentlewoman of the age of sixty one, having been subject
for several years at intervals to violent spasmodic pains, bili¬
ous
vomiting and other symptoms of a distempered Gall (from wch
she recovered by the use of soap pills, neutral draughts, clysters,
and the application of bladders with hot water, opiates &c) was
after an interval of tolerable Health for near nine months,
seized with pain in her ri right side & stomach, and more parti¬
cularly in the lower belly, on the 17th. of March last; which was
immediately succeeded by almost continual bilious vomitings
without any motion downwards, in so much that the Apothecary
fearing an inflammation, from the continual pains in the lower
belly
, feverish heats, intermitting pulse &c thought it proper
to take away ounces of blood
; which carried off (↑abated↑) the fever, but
did not relieve the other symptoms, viz. nausea & vomiting or
the costiveness.


OnThe Symptoms continuing for five or six days, it was
thought proper to give her Pil. Ruffi gradually and increasing
the doses as there shd be occasion. This in about 48 hours, opend
the passage by stool, and on the 30th. of March the patient voided
a Bilious concretion of the size of a large Walnut. This substance
has been sawn through, and appears to have a ↑calcareous↑ nucleus about
as large as a middling pea, & to have been covered with strata
one above another of a gritty crumbling nature, much like rotten
wood.


From this time the patient has been better and worse, some
times quite easy, got out in a chaise, recovered her appetite in some
tolerable measure, but seldom ↑entirely↑ free from oppression at her stomach
a general uneasiness, with a nauseous taste in her mouth, and
Eructations which hardly gave reliefany material relief.


Sometimes towards evening, she has been seized with shi
violent coldness & shivering, exactly like the cold fit of an ague
and always succeeded by a pretty brisk fever, which went off towds
morning and left the patient pretty easy; These fits of shivering &c
did not come on periodically, but sometimes for two or three
days successively, sometimes after an interval of 3 or 4 days.


The Person who attended her, was induced (but not from his own
judgment) to try the Bark, which unfortunately brought on
a spasmodic paroxysm of the pain in her side, to a most violent
degree, which after being alleviated by some drops of Laudanum
and the hot bladder, ended in a trembling followed by the hot fit
as before. This happened on Friday May. 5. when a Physician
being called in, he prescribed only a neutral - composed of spirit of
Nitre
, Sal Ammoniac, Penny royal water & Fennel water, together with
the Soap pills, which have kept the body open, but produced only
clayey, or ash coloured stools, extremely offensive, attended with Nausea



[Page 2]

or sickness
, but not with vomiting. Otherwise pretty easy days, and
no shiverings &c. since [11?] Sunday 9.th. N.B. The pulse very good
The water various, sometimes pale & thin, ↑and in plenty↑ at other times extremely
turbid and high coloured almost the colour of Grumous blood or
Coffee with a pretty copious sediment, but in small quantities , and
chiefly after exercise. No remarkable diminuation of strength, but
bears exercise very well hitherto.

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