Cullen

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

 

[ID:2554] From: Dr John Alves / To: Dr William Cullen (Professor Cullen) / Regarding: Mrs Jane Fraser (of Relick) (Patient) / 8 January 1785 / (Incoming)

Letter from John Alves, concerning the case of Mrs Fraser. Upon being exposed to cold, Mrs Fraser's former complaints return. These include shortness of breath, spitting blood, cough, and a persistent pain in her side.

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Metadata

FieldData
DOC ID 2554
RCPE Catalogue Number CUL/1/2/1603
Main Language English
Document Direction Incoming
Date8 January 1785
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 John Alves, concerning the case of Mrs Fraser. Upon being exposed to cold, Mrs Fraser's former complaints return. These include shortness of breath, spitting blood, cough, and a persistent pain in her side.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:788]
Case of Mrs [Jane] Fraser of Relict [Relig/Reelig], who suffers from breathlessness and pain in her side; she subsequently falls down stairs, becomes pregnant and is then dissuaded from suckling her child for fear of her catching milk fever and a cold.
21


People linked to this document

Person IDRole in documentPerson
[PERS ID:148]AuthorDr John Alves
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:857]PatientMrs Jane Fraser (of Relick)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:148]Patient's Physician / Surgeon / ApothecaryDr John Alves
[PERS ID:4571]Patient's Relative / Spouse / FriendMr Fraser
[PERS ID:858]Patient's Relative / Spouse / FriendMr Fraser (of Relick)

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Inverness North Highlands Scotland Europe certain
Destination of Letter Cullen's House / Mint Close Edinburgh Edinburgh and East Scotland Europe certain

Normalized Text

[Page 1]
Inverness 8th. January 1785
Dear Sir


Since our Patient Mrs Fraser of Relicks reco¬
very from Child bed till lately she enjoy'd tolerable health,
that is, The pain of her side tho continual in some degree, yet
was so slight in general as to give her very little trouble.
The spitting of blood had altogether left her; she seldom
had any cough or difficult breathing;- her Appetite was
[g]ood;- she slept well;- was chearfull & in good spirits
and in most respects was as well as in her ordinary health;
[y]et I cannot say that she pick'd up any flesh.


About three weeks ago she went out in the Chaise two or
[th]ree times & made some Visits in the Neighbourhood while the
[A]ir was very cold, frosty & foggy. It is probable she got cold
[u]pon these occasions, for immediatly thereafter the pain of
[h]er side increas'd, the blood spitting return'd in its former
[s]hape, that is, a bloody slime came in to her mouth and was
[ha]wk'd up from her throat in the mornings without any Cough¬
ing
; her breathing was sometimes short & oppress'd, & she
[h]ad some short dry Cough. While in this situation, the
[M]enses, which had made a very slight appearance, once
or twice before since her delivery, came on & Continued the
[us]ual time & rather more Copiously than in her ordinary
health.
This circumstance however made no alteration



[Page 2]

in her Complaints which notwithstanding continued as usua[l]
some days better & some days worse. There happened to be
a small blister in the house and she Apply'd it to the pain'd
part. It did not ly on a sufficient time to have its full
effect, but there was some discharge & next day the pain was
pretty much gone; it returnd however the day following
& has continued more or less ever since accompanied fre¬
quently with the other symptoms above mention'd.


I did not see Mrs Fraser ↑for 2 months↑ (tho I had occasionally notices
from Relick how she went on) till yesterday. I find tha[t]
a fit of short breathing generally comes on in the morning
about eight oclock & continues till she gets up after nine.
It returns again about two oclock and goes Off after
dinner, and she is pretty free from it for the rest of the
evening, unless she brings it on by too much motion in
the room, or by going up stairs, and then it only lasts
for a few minutes. When this Asthmatick fit is upon
her, she feels a kind of Constriction in her neck, or, as
if a hand pressing upon her neck & upper part of her
breast
prevented her breathing freely. This sensation sh[e]
says is different from that of the Globus Hystericus
which she has experienced formerly. - The pain o[f]
her side which is seated along the interior edge of the



[Page 3]

Cartilages of the two or three lowest false ribs on the left side
extending a little backwards along the last of them & two or
three finger breadths upwards upon the ribs, never leaves
her altogether. It is sometimes very troublesome with a
kind of pricking sensation in the skin; sometimes it is
attended with a sense of heat in the part; at other times
she can bear it without much uneasiness. Turning
suddenly in bed will increase the pain, as will holding
the Child upon her left arm & moving him. She is most
uneasy when she lyes upon the right side, and put¬
ting a pillow under the pain'd part when she lyes upon
it she finds give some ease when she is much pain'd.


The short Cough she has is always dry without the
least expectoration - she is most dispos'd to have it
when the Breathless fit is upon her; but she has had this
and all the other Complaints, without any Cough at all
and she thinks it is generally after catching cold that
she has a Cough. The Blood spitting is not regular
or Constant. This morning there was none of it.


Her Pulse yesterday afternoon & evening was from 70 to
80, and this morning I think under 70 but I could not
be certain as I had not my pulse glass with me. It was
soft & not full. There was no unnatural heat in her
skin. Her Appetite is pretty good: no thirst; belly -



[Page 4]

regular. Her Diet Consists chiefly of Bread, White Meat,
fruit, Vegetables & Milk. Her Drink Toast Water.
When she is easy & breaths freely, she is chearfull &
amuses herself at her Harpsicord, but a return of her
Complaints sometimes makes her low spirited and
Apprehensive. I believe it would be a great Comfort
to her to be near you, but a journey at present is
impracticable.


I shall be glad to have your Opinion upon her pre¬
sent situation & what is proper to be sone with her.
Meantime I have desir'd another blister should be
applyd to her side.


Relick demes me present his Compliments to you & beg
your Acceptance of the inclos'd five Guineas.


I always am with much regard


Dear Sir
Your most obedient Servant
John Alves


Mrs F. generally sleeps well - she is
extremely sensible of the Cold air
in her breast when she goes thro'
the passages from one room to another
& even in bed in the morning when the doors are opened and the
Cold Air advanced into the Room.

Diplomatic Text

[Page 1]
Inverness 8th. Janr 1785
Dear Sir


Since our Patient Mrs Fraser of Relicks reco¬
very from Child bed till lately she enjoy'd tolerable health,
that is, The pain of her side tho continual in some degree, yet
was so slight in general as to give her very little trouble.
The spitting of blood had altogether left her; she seldom
had any cough or difficult breathing;- her Appetite was
[g]ood;- she slept well;- was chearfull & in good spirits
and in most respects was as well as in her ordinary health;
[y]et I cannot say that she pick'd up any flesh.


About three weeks ago she went out in the Chaise two or
[th]ree times & made some Visits in the Neighbourhood while the
[A]ir was very cold, frosty & foggy. It is probable she got cold
[u]pon these occasions, for immediatly thereafter the pain of
[h]er side increas'd, the blood spitting return'd in its former
[s]hape, that is, a bloody slime came in to her mouth and was
[ha]wk'd up from her throat in the mornings without any Cough¬
ing
; her breathing was sometimes short & oppress'd, & she
[h]ad some short dry Cough. While in this situation, the
[M]enses, which had made a very slight appearance, once
or twice before since her delivery, came on & Continued the
[us]ual time & rather more Copiously than in her ordinary
health.
This circumstance however made no alteration



[Page 2]

in her Complaints which notwithstanding continued as usua[l]
some days better & some days worse. There happened to be
a small blister in the house and she Apply'd it to the pain'd
part. It did not ly on a sufficient time to have its full
effect, but there was some discharge & next day the pain was
pretty much gone; it returnd however the day following
& has continued more or less ever since accompanied fre¬
quently with the other symptoms above mention'd.


I did not see Mrs Fraser ↑for 2 months↑ (tho I had occasionally notices
from Relick how she went on) till yesterday. I find tha[t]
a fit of short breathing generally comes on in the morning
about eight oclock & continues till she gets up after nine.
It returns again about two oclock and goes Off after
dinner, and she is pretty free from it for the rest of the
evening, unless she brings it on by too much motion in
the room, or by going up stairs, and then it only lasts
for a few minutes. When this Asthmatick fit is upon
her, she feels a kind of Constriction in her neck, or, as
if a hand pressing upon her neck & upper part of her
breast
prevented her breathing freely. This sensation sh[e]
says is different from that of the Globus Hystericus
which she has experienced formerly. - The pain o[f]
her side which is seated along the interior edge of the



[Page 3]

Cartilages of the two or three lowest false ribs on the left side
extending a little backwards along the last of them & two or
three finger breadths upwards upon the ribs, never leaves
her altogether. It is sometimes very troublesome with a
kind of pricking sensation in the skin; sometimes it is
attended with a sense of heat in the part; at other times
she can bear it without much uneasiness. Turning
suddenly in bed will increase the pain, as will holding
the Child upon her left arm & moving him. She is most
uneasy when she lyes upon the right side, and put¬
ting a pillow under the pain'd part when she lyes upon
it she finds give some ease when she is much pain'd.


The short Cough she has is always dry without the
least expectoration - she is most dispos'd to have it
when the Breathless fit is upon her; but she has had this
and all the other Complaints, without any Cough at all
and she thinks it is generally after catching cold that
she has a Cough. The Blood spitting is not regular
or Constant. This morning there was none of it.


Her Pulse yesterday afternoon & evening was from 70 to
80, and this morning I think under 70 but I could not
be certain as I had not my pulse glass with me. It was
soft & not full. There was no unnatural heat in her
skin. Her Appetite is pretty good: no thirst; belly -



[Page 4]

regular. Her Diet Consists chiefly of Bread, White Meat,
fruit, Vegetables & Milk. Her Drink Toast Water.
When she is easy & breaths freely, she is chearfull &
amuses herself at her Harpsicord, but a return of her
Complaints sometimes makes her low spirited and
Apprehensive. I believe it would be a great Comfort
to her to be near you, but a journey at present is
impracticable.


I shall be glad to have your Opinion upon her pre¬
sent situation & what is proper to be sone with her.
Meantime I have desir'd another blister should be
applyd to her side.


Relick demes me present his Compts to you & beg
your Acceptance of the inclos'd five Guineas.


I always am with much regard


Dear Sir
Your most obd Sert
John Alves


Mrs F. generally sleeps well - she is
extremely sensible of the Cold air
in her breast when she goes thro'
the passages from one room to another
& even in bed in the morning when the doors are opened and the
Cold Air advanced into the Room.

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