Cullen

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

 

[ID:152] From: Dr William Cullen (Professor Cullen) / To: Dr Richard Story / Regarding: Mrs Wyvil (Wyvill) (Patient) / 20 June 1781 / (Outgoing)

Reply, 'For Mrs Wyvil'. Directions for Mrs Wyvil regarding a disease of the breast. This letter is closely related to letter 1335. Letter 1335 appears to be an incomplete, scribal draft. Letter 152 appears to be a composite, comprised of an incomplete scribal copy (pp. 1-4) and a machine copy of a complete version of the same letter in Cullen's hand (pp. 5-7).

Facsimile

There are 7 images for this document.

[Page 1]


 

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[Page 7]


 
 

Metadata

FieldData
DOC ID 152
RCPE Catalogue Number CUL/1/1/14/38
Main Language English
Document Direction Outgoing
Date20 June 1781
Annotation None
TypeMachine copy
Enclosure(s) Enclosure(s) present
Autopsy No
Recipe Yes
Regimen Yes
Letter of Introduction No
Case Note No
Summary Reply, 'For Mrs Wyvil'. Directions for Mrs Wyvil regarding a disease of the breast. This letter is closely related to letter 1335. Letter 1335 appears to be an incomplete, scribal draft. Letter 152 appears to be a composite, comprised of an incomplete scribal copy (pp. 1-4) and a machine copy of a complete version of the same letter in Cullen's hand (pp. 5-7).
Manuscript Incomplete? No
Evidence of Commercial Posting No

Draft versions for this document exist:

1. [DOC ID:1335]

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:301]
Case of Mrs Wyvill who has a disease of the breast.
6


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:118]AddresseeDr Richard Story
[PERS ID:119]PatientMrs Wyvil (Wyvill)
[PERS ID:118]Patient's Physician / Surgeon / ApothecaryDr Richard Story
[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 Penrith North-West England Europe inferred

Normalized Text

[Page 1]
For Mrs Wyvill


The ailment in Mrs Wyvills breast had formerly
a very untoward appearance but since the discharge from
about the
Nipple has come on, it seems to be in a much
better way, the pains are relieved the hardness is in part
dissolved & the rest seems to follow the same course.
We are therefore in hopes that the whole ailment may be
in time discussed & for favouring this we propose the
following measures


1 Let the places excoriated be dressed with the white Liniment spread on a bit of linnen twice a day.
If this melts & runs off so as to allow the Cloth to stick in
the parts, you must apply a Cloth dipped in the white Cerate. If the parts should become more tender and
inflamed you must anoint them with a fourth part of
Unguentum Saturninum to three parts of the white Liniment. If this proportion of the Unguentum Saturninum gives [any]
much pain or smarting it must be omitted but if it
gives no pain or smarting it may be increased to one



[Page 2]

third, or one half but no more


2 These directions proceed upon the supposition that no
Pultice is applied, & at present we are of opinion, that its
application may be delayed, while the discharge about
the
nipple continues to dissolve the hardness & while
the excoriation does not spread. But if the excoriation
spreads or becomes more inflamed let a Carrot pultice
be applied. It is to be made by grating down some
fresh Carrot & putting that into a wooden or Marble
Mortar let it be well bruised with a timber Pestle
till it is a smooth Pulp adding a little water to it if
necessary to make it of a soft consistence. Let a
Pultice of this be applied round the Nipple, so as to
cover the whole of the excoriated part & let the pultice be
changed twice a day. At first it will not be necessary
to add any thing to this Pultice. But if it should
happen that the breast or sores should become painful
a small quantity of the fresh leaves of the Cicuta
boiled till they are soft & tender may be pounded
with the Carrot, or if the fresh leaves are not to be had
a small quantity of the Powder may be used for
the same purpose.




[Page 3]


3 While these applications are made Mrs Wyvill should
continue the use of the Hemlock inwardly while the fresh
leaves
are to be got we think she takes it very properly
but we are of opinion that she does not take quite enough
& we would wish her to increase the Dose gradually till
she finds it affect her head & nerves a little with some
giddiness & tremor. The fresh leaves will do for some
time but when the Plants grow rank & proceed to flower
they grow much weaker & at last become quite inert.
It will be necessary therefore to prepare a quantity of
the leaves dried, so as to be used in Powder. Here follows
the method of preparing the dried leaves


She is to begin with a small dose of not more than
five grains twice a day & increasing the dose by five
grains every day till it affects her head even after
the dose affects her head it will by repetition fail to
Do so, & if it does she should again increase it till
till it does affect her head &c.


4 Mrs. Wyvill should still continue to take the
Malt Infusion every day & if it keeps her belly
regular it is the fittest medicine for this purpose



[Page 4]

she can employ but if it fails to do this, she must employ
some other medicine, so as to give her one Stool every day
& for this purpose she may take Magnesia Flowers of
Sulphur
or Cream of Tartar.


These should keep her belly regular to one Stool
a day but it may be proper once a week to go a little
further by giving a table Spoonful or two of the Medi¬
cine prescribed on the Paper apart to be taken in
half a Pint or more of new drawn Cow milk Whey
On the days she takes this she should omitt the
Malt Infusion.




[Page 5]


5. Mrs Wyvils diet has hitherto been very properly ordered
and we think the Same Should Still be continued. She may
have frequently a light Soup or Beef tea and sometimes a
little of the lighter kinds of animal food but She Should live
very entirely on milk and vegetables avoiding at the Same
time all fermented or Spirituous liquors.


6. Mrs Wyvil may be much better for being frequently
in the fresh Air and in gentle exercise in a carriage,
but the motion ought to be always gentle and She ought
to avoid being in the Sun and more Still the being exposed
to cold.


7. It appears that Mrs Wyvil has been threatened with
some obstruction inwardly in her chest which occasions
some difficulty of breathing upon her walking uphill and
↑she↑ frequently feels Some uneasiness in her throat all of which
we Suppose to depend very much upon her being readily af¬
fected with cold. This therefore requires her Studying more
carefully to avoid cold and She will also be mended in this



[Page 6]

respect by being frequently in gentle exercise in a carriage
and we hope that all considerable obstruction will be preven¬
ted by the use of the pectoral pills prescribed in the paper
apart. She Should take them only for four or five evenings
following but then lay them aside and return to them
again only when She is troubled either with Some uneasiness
↑either↑ in her throat
or in her breathing

William Cullen



[Page 7]
For Mrs Wyvil

Take one ounce of soluble Tartar, half an ounce of Glauber's Salts, one drachm each of polychrest salts and Spanish sea-salts, and two ounces each of Simple cinnamon Water and strong Cinnamon Water. Dissolve and strain. Label: Aperient Solution a table Spoonfull more or less to be taken in the morning in half a pint of new drawn Cow milk whey.

Take three drachms of Extract of Licorice. Pour small amounts of hot water onto the crumbs - just enough to soften it - and pound it into a pulp, to which add one drachm of powdered Myrrh and enough hot water to make a mass to be divided into single pills of five grains each. Label: Pectoral Pills three to be taken for a dose at bedtime


20th June
1781
W. C.

Diplomatic Text

[Page 1]
For Mrs Wyvill


The ailment in Mrs Wyvills breast had formerly
a very untoward appearance but since the discharge from
about the
Nipple has come on, it seems to be in a much
better way, the pains are relieved the hardness is in part
dissolved & the rest seems to follow the same course.
We are therefore in hopes that the whole ailment may be
in time discussed & for favouring this we propose the
following measures


1 Let the places excoriated be dressed with the Lini¬
mentum album
spread on a bit of linnen twice a day.
If this melts & runs off so as to allow the Cloth to stick in
the parts, you must apply a Cloth dipped in the Ceratum
album
. If the parts should become more tender and
inflamed you must anoint them with a fourth part of
Ungt. Saturninum to three parts of the Linimentum
album
. If this proportion of the Ungt. Sat. gives [any]
much pain or smarting it must be omitted but if it
gives no pain or smarting it may be increased to one



[Page 2]

third, or one half but no more


2 These directions proceed upon the supposition that no
Pultice is applied, & at present we are of opinion, that its
application may be delayed, while the discharge about
the
nipple continues to dissolve the hardness & while
the excoriation does not spread. But if the excoriation
spreads or becomes more inflamed let a Carrot pultice
be applied. It is to be made by grating down some
fresh Carrot & putting that into a wooden or Marble
Mortar let it be well bruised with a timber Pestle
till it is a smooth Pulp adding a little water to it if
necessary to make it of a soft consistence. Let a
Pultice of this be applied round the Nipple, so as to
cover the whole of the excoriated part & let the pultice be
changed twice a day. At first it will not be necessary
to add any thing to this Pultice. But if it should
happen that the breast or sores should become painful
a small quantity of the fresh leaves of the Cicuta
boiled till they are soft & tender may be pounded
with the Carrot, or if the fresh leaves are not to be had
a small quantity of the Powder may be used for
the same purpose.




[Page 3]


3 While these applications are made Mrs Wyvill should
continue the use of the Hemlock inwardly while the fresh
leaves
are to be got we think she takes it very properly
but we are of opinion that she does not take quite enough
& we would wish her to increase the Dose gradually till
she finds it affect her head & nerves a little with some
giddiness & tremor. The fresh leaves will do for some
time but when the Plants grow rank & proceed to flower
they grow much weaker & at last become quite inert.
It will be necessary therefore to prepare a quantity of
the leaves dried, so as to be used in Powder. Here follows
the method of preparing the dried leaves


She is to begin with a small dose of not more than
five grains twice a day & increasing the dose by five
grains every day till it affects her head even after
the dose affects her head it will by repetition fail to
Do so, & if it does she should again increase it till
till it does affect her head &c.


4 Mrs. Wyvill should still continue to take the
Malt Infusion every day & if it keeps her belly
regular it is the fittest medicine for this purpose



[Page 4]

she can employ but if it fails to do this, she must employ
some other medicine, so as to give her one Stool every day
& for this purpose she may take Magnesia Flowers of
Sulphur
or Cream of Tartar.


These should keep her belly regular to one Stool
a day but it may be proper once a week to go a little
further by giving a table Spoonful or two of the Medi¬
cine prescribed on the Paper apart to be taken in
half a Pint or more of new drawn Cow milk Whey
On the days she takes this she should omitt the
Malt Infusion.




[Page 5]


5. Mrs Wyvils diet has hitherto been very properly ordered
and we think the Same Should Still be continued. She may
have frequently a light Soup or Beef tea and sometimes a
little of the lighter kinds of animal food but She Should live
very entirely on milk and vegetables avoiding at the Same
time all fermented or Spirituous liquors.


6. Mrs Wyvil may be much better for being frequently
in the fresh Air and in gentle exercise in a carriage,
but the motion ought to be always gentle and She ought
to avoid being in the Sun and more Still the being exposed
to cold.


7. It appears that Mrs Wyvil has been threatened with
some obstruction inwardly in her chest which occasions
some difficulty of breathing upon her walking uphill and
↑she↑ frequently feels Some uneasiness in her throat all of which
we Suppose to depend very much upon her being readily af¬
fected with cold. This therefore requires her Studying more
carefully to avoid cold and She will also be mended in this



[Page 6]

respect by being frequently in gentle exercise in a carriage
and we hope that all considerable obstruction will be preven¬
ted by the use of the pectoral pills prescribed in the paper
apart. She Should take them only for four or five evenings
following but then lay them aside and return to them
again only when She is troubled either with Some uneasiness
↑either↑ in her throat
or in her breathing

William Cullen



[Page 7]
For Mrs Wyvil


Tartar. solubil. ℥j
Sal. Glauber. ℥ſs
-- polychrest.
-- marin. Hisp. @ ʒj
Aquæ cinnam. Simpl.
--- fort. @ ℥ij
Solve et cola Sig. Aperient Solution, a table Spoonfull
more or less to be taken in the morning in half a pint of
new drawn Cow milk whey.


Extract. Glycyrrhiz. ʒiij
In frustula conciso affunde aquæ fervent. q. s. ut mollescat
et contundatur in pulpam cui admisce
Myrrh. in pulverem tritæ ʒj
et cum aq. fervent. q. s. fiat massa dividenda in pilulas
Sing. gr. V
Sig. Pectoral Pills three to be taken for a dose at bedtime


20th June
1781
W. C.

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