Cullen

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

 

[ID:2136] From: Dr Alexander Taylor (Sanders) / To: Dr William Cullen (Professor Cullen) / Regarding: Mr Robert Neilson (Nielson, of Paisley) (Patient), Mr William Orr ((later) of Ingliston, then Ralston) (Patient), Miss Margaret Neilson (Peggy) (Patient) / 23 January 1782 / (Incoming)

Letter from Alexander Taylor, concerning the case of Mr Orr, who is undergoing treatment for his sensitive and sore eyes. He mentions that there is a hereditary disposition towards scrofula in the family. He also reports on Mr Neilson's post-mortem, on the econdition of the stomach, heart and blood-vessels: 'Can grief be supposed to have been a remote Cause here?' on account of his daughter, he asks.

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Metadata

FieldData
DOC ID 2136
RCPE Catalogue Number CUL/1/2/1211
Main Language English
Document Direction Incoming
Date23 January 1782
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy Yes
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from Alexander Taylor, concerning the case of Mr Orr, who is undergoing treatment for his sensitive and sore eyes. He mentions that there is a hereditary disposition towards scrofula in the family. He also reports on Mr Neilson's post-mortem, on the econdition of the stomach, heart and blood-vessels: 'Can grief be supposed to have been a remote Cause here?' on account of his daughter, he asks.
Manuscript Incomplete? No
Evidence of Commercial Posting Yes

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:316]
Case of Mr Robert Neilson with a chronic, progressive illness, probably pulmonary (consumption) but possible cardiac. After a gap, in early January 1782, Cullen confirms that Neilson's condition is terminal. An autopsy soon follows.
22
[Case ID:363]
Case of Miss Peggy Neilson seriously ill with sores, breathing problems and a 'hectic', which eventually proves fatal.
7
[Case ID:554]
Case of William Orr who has an eye condition.
13


People linked to this document

Person IDRole in documentPerson
[PERS ID:207]AuthorDr Alexander Taylor (Sanders)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:211]PatientMr William Orr ((later) of Ingliston, then Ralston)
[PERS ID:2092]PatientMiss Margaret Neilson (Peggy)
[PERS ID:206]PatientMr Robert Neilson (Nielson, of Paisley)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:207]Patient's Physician / Surgeon / ApothecaryDr Alexander Taylor (Sanders)
[PERS ID:2092]Patient's Relative / Spouse / FriendMiss Margaret Neilson (Peggy)

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Paisley Glasgow and West Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain
Place of Handstamp Paisley Glasgow and West Scotland Europe certain

Normalized Text

[Page 1]
Paisley 23 January 1782
Sir


Your approbation gives
me great pleasure, and I return my warm¬
est thanks for the very kind manner in which
you have exprest it ––––


In Cases of Absolute Sensibility unaccom¬
panied by inflammation I clearly see from
what you have said the necessity of accustoming
the eyes to bear light. The less accustomed to it
the more powerful and intolerable must the
stimulus of light be; and I have been at Pains
to habituate Mr. Orr's eyes to more light; but
he finds it very difficult, and I see the Change
must be very gradual –– he has in every thing
followed your directions, and thought himself
rather better; but his eyes became considerably
more uneasy yesterday – it is very painful the
slightest pressure upon the eye-ball gives great
pain; and even the motion of the eyes is uneasy –



[Page 2]

When he bathes ought he to open his eyes in the
water? He has tried this but always feels more
uneasy for some time afterwards –– He does not
now Complain of Pain in his head and the e¬
ruption
is quite gone – he has besides a good
stomach
and sleeps well and is in every other
respect in perfect health –––– I was exceedingly
hurried when I wrote last in trying to overtake
the post; and neglected to take notice that there
is good reason to suspect an hereditary scro¬
phulous seminium
to be lurking in his Con¬
stitution – a brother of his died of the Scrofula
and others of his Relations have suffered severely
from the same disease ––


Owing to the same hurry too I got nothing
said of Mr. Nielson; and I have since delayed
to trouble you till I could say how things
went on with Mr. Orr –––– I got liberty to
open Mr. Nielson and the following were the
appearances –––– Upon the outside of the
stomach
near the Pylorus was a deep Coloured
inflammation
of the extent of an half Crown;
and this no doubt had been the Cause of the flatulence



[Page 3]

and of a Vomiting which distressed him before his
death –– there was bloody Water in both sides of
the breast
, but most in the right, amounting in all
to betwixt 2 and 3 pints –––– the Aorta from
about an inch from the heart till two inches
or more below the left Subclavian was enlarged.
Upon slitting open the artery as nearly in a
straight line as I could and comparing the
breadth of the sound part of the artery next
the heart and the greatest breadth of the en¬
largement the difference was not more
than half an inch – the Coats of this enlarged
Part were a little but not much thicker
than those of the sound artery; and on the inside
in different places there were it was ossi¬
fied in different places
, the intervals of these
bony Concretions being (↑appearing↑) inflamed and red –
this enlargement was loosely Connected with
the neighbouring parts by Cellular membrane
– it contained some blood; but this likewise was
not adhereing – the aorta thro' the rest of it's
Course and all the Chief Viscera both of the
breast
and lower belly were perfectly sound;


[Page 4]

and I say this after having made a careful exa¬
mination –– the heart was large but likewise
strong and muscular – the Valves of the heart as
well as those of the arteries were soft and pliable
the right Ventricle was empty almost empty
but the left turgid with blood ––


Thus from inspection we see your
opinion was too well founded –– I wish I knew
what particular symptoms made up your
Diagnosis and their Reason! – There was a
remarkable hardness of Pulse
which I dare
say proceeded from the inflamed and irritable
state of the aorta suddenly checking the jetts
of blood
from the heart and Communicating the
same sudden jerk to the rest of it's branches –
Can grief be supposed to have been a remote
Cause here? I know he suffered much anxiety
on account of his Daughter –––– If you judge
it necessary Mr. Orr will attend you personally –

I am sir, with Reverence and great Respect
Your most humble servant
Alexr. Taylor



[Page 5]


Mr. Nielson a little for a little
before his death spat up some blood
but in no great quantity; but I do
not see how this was connected with
the Aneurism




[Page 6]


Dr. William Cullen
Professor of Medicine
Edinburgh


Mr Taylor
Concerning Mr Orr.
January 1782.
Vol. XIII p 271

Diplomatic Text

[Page 1]
Paisley 23 Janr. 1782
Sir


Your approbation gives
me great pleasure, and I return my warm¬
est thanks for the very kind manner in which
you have exprest it ––––


In Cases of Absolute Sensibility unaccom¬
panied by inflammation I clearly see from
what you have said the necessity of accustoming
the eyes to bear light. The less accustomed to it
the more powerful and intolerable must the
stimulus of light be; and I have been at Pains
to habituate Mr. Orr's eyes to more light; but
he finds it very difficult, and I see the Change
must be very gradual –– he has in every thing
followed your directions, and thought himself
rather better; but his eyes became considerably
more uneasy yesterday – it is very painful the
slightest pressure upon the eye-ball gives great
pain; and even the motion of the eyes is uneasy –



[Page 2]

When he bathes ought he to open his eyes in the
water? He has tried this but always feels more
uneasy for some time afterwards –– He does not
now Complain of Pain in his head and the e¬
ruption
is quite gone – he has besides a good
stomach
and sleeps well and is in every other
respect in perfect health –––– I was exceedingly
hurried when I wrote last in trying to overtake
the post; and neglected to take notice that there
is good reason to suspect an hereditary scro¬
phulous seminium
to be lurking in his Con¬
stitution – a brother of his died of the Scrofula
and others of his Relations have suffered severely
from the same disease ––


Owing to the same hurry too I got nothing
said of Mr. Nielson; and I have since delayed
to trouble you till I could say how things
went on with Mr. Orr –––– I got liberty to
open Mr. Nielson and the following were the
appearances –––– Upon the outside of the
stomach
near the Pylorus was a deep Coloured
inflammation
of the extent of an half Crown;
and this no doubt had been the Cause of the flatulence



[Page 3]

and of a Vomiting which distressed him before his
death –– there was bloody Water in both sides of
the breast
, but most in the right, amounting in all
to betwixt lb ij and lb iij –––– the Aorta from
about an inch from the heart till two inches
or more below the left Subclavian was enlarged.
Upon slitting open the artery as nearly in a
straight line as I could and comparing the
breadth of the sound part of the artery next
the heart and the greatest breadth of the en¬
largement the difference was not more
than half an inch – the Coats of this enlarged
Part were a little but not much thicker
than those of the sound artery; and on the inside
in different places there were it was ossi¬
fied in different places
, the intervals of these
bony Concretions being (↑appearing↑) inflamed and red –
this enlargement was loosely Connected wt.
the neighbouring parts by Cellular membrane
– it contained some blood; but this likewise was
not adhereing – the aorta thro' the rest of it's
Course and all the Chief Viscera both of the
breast
and lower belly were perfectly sound;


[Page 4]

and I say this after having made a careful exa¬
mination –– the heart was large but likewise
strong and muscular – the Valves of the heart as
well as those of the arteries were soft and pliable
the right Ventricle was empty almost empty
but the left turgid with blood ––


Thus from inspection we see your
opinion was too well founded –– I wish I knew
what particular symptoms made up your
Diagnosis and their Reason! – There was a
remarkable hardness of Pulse
which I dare
say proceeded from the inflamed and irritable
state of the aorta suddenly checking the jetts
of blood
from the heart and Communicating the
same sudden jerk to the rest of it's branches –
Can grief be supposed to have been a remote
Cause here? I know he suffered much anxiety
on account of his Datr. –––– If you judge
it necessary Mr. Orr will attend you personally –

I am sir, with Reverence and great Respect
Your most humble servant
Alexr. Taylor



[Page 5]


Mr. Nielson a little for a little
before his death spat up some blood
but in no great quantity; but I do
not see how this was connected with
the Aneurism




[Page 6]


Dr. William Cullen
Professor of Medicine
Edinr.


Mr Taylor
C Mr Orr.
Janry 1782.
Vol. XIII p 271

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