Cullen

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

 

[ID:2626] Case Note / Regarding: Mrs Mary Maxwell (Riddell) (of Kirkconnel) (Patient) / May 1785 / (Incoming)

Unsigned case note describing the case of Mrs Maxwell of Kirkconnel (possibly written by her son, the physician William Maxwell, though the hand in this letter and in 2624 does not correspond with that in 2655, which is signed by William Maxwell). Mrs Maxwell suffers from rheumatic complaints and recurring bouts of erysipelas. Has taken the Harrogate waters in the past, from which she never failed to receive benefit.

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Metadata

FieldData
DOC ID 2626
RCPE Catalogue Number CUL/1/2/1671
Main Language English
Document Direction Incoming
DateMay 1785
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Unsigned case note describing the case of Mrs Maxwell of Kirkconnel (possibly written by her son, the physician William Maxwell, though the hand in this letter and in 2624 does not correspond with that in 2655, which is signed by William Maxwell). Mrs Maxwell suffers from rheumatic complaints and recurring bouts of erysipelas. Has taken the Harrogate waters in the past, from which she never failed to receive benefit.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1684]
Case of Mrs. Mary Maxwell of Kirkonnel who suffers from a rheumatic complaint which especially affects her hip.
5
[Case ID:1783]
Case of Mrs Mary Maxwell of Kirkconnel who has various symptoms includings sweats, restlessness and pains in her arms and shoulders.
4


People linked to this document

Person IDRole in documentPerson
[PERS ID:2931]AuthorMr William Maxwell (of Kirkconnel)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:2852]PatientMrs Mary Maxwell (of Kirkconnel)
[PERS ID:2931]Patient's Physician / Surgeon / ApothecaryMr William Maxwell (of Kirkconnel)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:2931]Patient's Relative / Spouse / FriendMr William Maxwell (of Kirkconnel)
[PERS ID:2883]Patient's Relative / Spouse / FriendMr Thomas Riddell (of Swinburne Castle)

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Mentioned / Other Harrogate North-East England Europe certain
Mentioned / Other Kirkconnel Borders Scotland Europe certain
Mentioned / Other Swinburne Castle Swineburn North-East England Europe certain

Normalized Text

[Page 1]


Mrs Maxwell has been for these twenty
years past subject to Rheumatick complaints
to pains at least which have been so called
Is it of use to remark that her Brother Mr Ridd¬
ell of Swinburne Castle has from an early period
of his life been afflicted with a formed Gout?
and that her two sisters have also both been
liable to complaints supposed to be of the same
kind as Mrs Maxwell's, but which have sometimes
given sym probable symptoms of being Goutish
Neither their father or Mother had ever any
appearance of it.


Mrs Maxwell has in every other respect enjoyed
very good health she has been all along in
a full habit of body.


She has been much upon her guard During
her whole life against all manner of high
living this being now about 54th year of her age.
About Six months ago her present Distress
began by pains seizing her as they had usually
done before in the hip joint, whence they



[Page 2]

spread upwards on the Back and Loins which during
the acutest moments seemed contracted as if violently
Cramped. It next extended down the whole
limb fixed a long time in the knee and shin
bone
([Start of margin text]sinew of the leg[End of margin text]) and in the foot.


The foot swelled a little across the Toes but
lost not it's natural color, as did also the knee
The pains gradually abated in this extremity
and also became less severe in the hip bone and back
so that she found her self able to get out of bed
where she had been confined for about two months
it is believed that mustard plaisters which were suc¬
cessively applied to the parts most affected helped
greatly to mitigate the pain no other application
was ever used, nor medcen taken internally other
than bark (Columbo root) magnesia and the Elixir of Guaicum, and
one or two Doses of Dovers' powder which [Start of margin text]which induced profuse sweat for
twelve hours the other medicines[End of margin text]
which free'd her
stomach from sourness and flatulency and procured
her rest.


On former occasions she never had recourse to other
medcins but Mustard Seed, cold ↑and warm↑ sea Bathing and
Harrogate from ↑the last of↑ which she never failed receiving benefit.




[Page 3]


When former attacks seized the hands and feet they
generally swelled in the same manner as now, and
ther remained upon the joints some hard knots ----
One of the most violent attacks she ever had was about
four years ago, when about the beginning of winter
her right arm was violently affected from above
the Elbow to the tops of her fingers, the complaint
seemed particularly fixed in her wrist and hand, and
was attended with so much pain that she could
scarcly use it at all, writing particularly had
the most immediate effect upon it, and in the
space of a few minutes writing occasioned a very
considerable swelling attended with very acute pain
after this complaint had continued for about
Eighteen months it gradually left her, but a
considerable protuberance upon the bone such as
already described upon her fingers and toes remained
upon the bone immediatly above the wrist but
considerably larger which still continues in this same
state from this time till near the end of ↑last↑ autumn she
had not complained so much until the approach of this



[Page 4]

Winter when she began to feel herself growing ill, she was
{illeg} once or twice so much affected as not to be able to turn herself
in bed without help but grew easier towards the middle of
the day when she generally rose.


A few days after when dressing she was seized so violently
as not to be able to support her self, but sunk down upon
her chair, from which she could not move, and was soon
after carried to bed the violence of the pain in her back
loins and belly havin been alleviated by the successive
application of warm cloths from this time the disease continued
for two to confine her to bed for two months as already
mentioned.


She had so far recovered her strength as to sit up for a few
hours every day for several weeks running till at last about
the beginning of february she could sit up the greatest
part of the day whether by trying her strength too far
at so inclement a season or from some latent other cause
the same pains in her back and loins returned and she
relapsed once more to bed where she was confined for
six weeks with the pains.


Her stomach however was freer from the sourness and
flatulency than formerly.




[Page 5]


During the first two months of her Distress she had
been subject to Daly sweatings, after this relapse these
became more profuse and returned pretty regularly
every Day soon about two (↑betwixt 3 and five↑) o'clock at which hour
she had used to have taken her Dinners, which
was generally some animal food ↑and a glass of port wine after it↑ (milk or vegetables
seemed not to agree with her stomach)
her apetite was generally good and her Digestion
easy, She generally drank tea in the afternoon with
which she eat a small bit of bread, took for
Supper a Coddle of two Eggs, Eat an egg at
breakfast She usually at this time drunk ass milk
in the morning, and took in three Dozes about
¼ oz of bark thro the Day and when occasion
required a little magnesia.


Impatient to get out of bed again she attempted to g it
three or four times about a month ago but was
obliged to Desist from the attempt.


She began to grow sick and feverish the fever
increased accompanied with Considerable heat and
severe smarting of the skin for some days when her
left arm swelled grew red and inflamed.




[Page 6]


Large blisters rose upon it which Discharged great quantities
of Water, besides an issue which has long been in this
arm, it was thought propper soon after her first
relapse to apply a blister to her head with intention
to relieve her from a very violent pain in her head
and Neck which had then attacked her the discharges
from it were very considerable ↑yet had no immediate good effect neither had Leeches
[Start of margin text]applyed to the temple
the pain continuing to the full as violent
immediately after as before for
some time after as before[End of margin text]

and before it was suffered
to dry up an other blister was applied betwixt her
shoulders which has still been kept open with issue
ointment
and in effect the pain has now left (↑is not now so constant in↑) the head
there is no pain (↑nor any where↑) so intense as formerly but there is one
diffused over the breast bone whch feels as if it sometimes
entered into the stomach, about a week ago a Vomit had
been was administer'd which had the effect of bringing
up a great quantity of bilious matter (↑her stomach being uneasy more than ordinaryly↑) since which time
her stomach hasnot been so much disordered but the
daly sweatings continue and are every day preceeded by the [Start of margin text]pain in her back and sometimes
her legs growing more intense
by feverish[End of margin text]

heat and ↑painfull↑ smarting of her skin by {illeg} which sometimes also
brings out red spots on different parts of the body ↑which come out and disappear again at short intervals↑ and renews
the inflammation on the Arm where the Eisipe
Erysipelas had been and that kind of pain which it had
occasioned see N 1. next page.



[Page 7]

the Debility occasioned by her complaints and confinements
and Ext is like to affect her spirits.


Her pulse which had been full and strong is
within these few days fallen low
yet she retains her
appetite not ill sleeps soundly, but her anxiety
During the day has now become very uneasy and
almost makes her despair of her recovery. Doubting
that a complication of ills may occasion her complaints
Rheumatism Gout Scurvey


After this Erysipelas she had been prescribed some Dozes
Rochelle salts. and since the vomit has been in use to
take 20 grains of tartar in a spoonful of lemon juice
two or three times Pær Diem


N 1 This was so uncommonly severe the day that her stomach
was so much out of order as to require the vomit that she
compared it to the burning of a blister the vomit was ad¬
ministered on fryday evening and on satturday the inflamm¬
ation
shewed it self on her arm where it still remains in
a lesser degree.


The pain in her head has left a great soreness to the touch
so much that it is with difficulty she can rest it on the pillow




[Page 8]

Case
Mrs. Maxwell
of Kirkconnel
May 1785
V. XVII. P.97. 109.

Diplomatic Text

[Page 1]


Mrs Maxwell has been for these twenty
years past subject to Rheumatick complaints
to pains at least which have been so called
Is it of use to remark that her Brother Mr Ridd¬
ell of Swinburne Castle has from an early period
of his life been afflicted with a formed Gout?
and that her two sisters have also both been
liable to complaints supposed to be of the same
kind as Mrs Maxwell's, but which have sometimes
given sym probable symptoms of being Goutish
Neither their father or Mother had ever any
appearance of it.


Mrs Maxwell has in every other respect enjoyed
very good health she has been all along in
a full habit of body.


She has been much upon her guard During
her whole life against all manner of high
living this being now about 54th year of her age.
About Six months ago her present Distress
began by pains seizing her as they had usually
done before in the hip joint, whence they



[Page 2]

spread upwards on the Back and Loins which during
the acutest moments seemed contracted as if violently
Cramped. It next extended down the whole
limb fixed a long time in the knee and shin
bone
([Start of margin text]sinew of the leg[End of margin text]) and in the foot.


The foot swelled a little across the Toes but
lost not it's natural color, as did also the knee
The pains gradually abated in this extremity
and also became less severe in the hip bone and back
so that she found her self able to get out of bed
where she had been confined for about two months
it is believed that mustard plaisters which were suc¬
cessively applied to the parts most affected helped
greatly to mitigate the pain no other application
was ever used, nor medcen taken internally other
than bark (Columbo root) magnesia and the Elixir of Guaicum, and
one or two Doses of Dovers' powder which [Start of margin text]which induced profuse sweat for
twelve hours the other medicines[End of margin text]
which free'd her
stomach from sourness and flatulency and procured
her rest.


On former occasions she never had recourse to other
medcins but Mustard Seed, cold ↑and warm↑ sea Bathing and
Harrogate from ↑the last of↑ which she never failed receiving benefit.




[Page 3]


When former attacks seized the hands and feet they
generally swelled in the same manner as now, and
ther remained upon the joints some hard knots ----
One of the most violent attacks she ever had was about
four years ago, when about the beginning of winter
her right arm was violently affected from above
the Elbow to the tops of her fingers, the complaint
seemed particularly fixed in her wrist and hand, and
was attended with so much pain that she could
scarcly use it at all, writing particularly had
the most immediate effect upon it, and in the
space of a few minutes writing occasioned a very
considerable swelling attended with very acute pain
after this complaint had continued for about
Eighteen months it gradually left her, but a
considerable protuberance upon the bone such as
already described upon her fingers and toes remained
upon the bone immediatly above the wrist but
considerably larger which still continues in this same
state from this time till near the end of ↑last↑ autumn she
had not complained so much until the approach of this



[Page 4]

Winter when she began to feel herself growing ill, she was
{illeg} once or twice so much affected as not to be able to turn herself
in bed without help but grew easier towards the middle of
the day when she generally rose.


A few days after when dressing she was seized so violently
as not to be able to support her self, but sunk down upon
her chair, from which she could not move, and was soon
after carried to bed the violence of the pain in her back
loins and belly havin been alleviated by the successive
application of warm cloths from this time the disease continued
for two to confine her to bed for two months as already
mentioned.


She had so far recovered her strength as to sit up for a few
hours every day for several weeks running till at last about
the beginning of february she could sit up the greatest
part of the day whether by trying her strength too far
at so inclement a season or from some latent other cause
the same pains in her back and loins returned and she
relapsed once more to bed where she was confined for
six weeks with the pains.


Her stomach however was freer from the sourness and
flatulency than formerly.




[Page 5]


During the first two months of her Distress she had
been subject to Daly sweatings, after this relapse these
became more profuse and returned pretty regularly
every Day soon about two (↑betwixt 3 and five↑) o'clock at which hour
she had used to have taken her Dinners, which
was generally some animal food ↑and a glass of port wine after it↑ (milk or vegetables
seemed not to agree with her stomach)
her apetite was generally good and her Digestion
easy, She generally drank tea in the afternoon with
which she eat a small bit of bread, took for
Supper a Coddle of two Eggs, Eat an egg at
breakfast She usually at this time drunk ass milk
in the morning, and took in three Dozes about
¼ oz of bark thro the Day and when occasion
required a little magnesia.


Impatient to get out of bed again she attempted to g it
three or four times about a month ago but was
obliged to Desist from the attempt.


She began to grow sick and feverish the fever
increased accompanied with Considerable heat and
severe smarting of the skin for some days when her
left arm swelled grew red and inflamed.




[Page 6]


Large blisters rose upon it which Discharged great quantities
of Water, besides an issue which has long been in this
arm, it was thought propper soon after her first
relapse to apply a blister to her head with intention
to relieve her from a very violent pain in her head
and Neck which had then attacked her the discharges
from it were very considerable ↑yet had no immediate good effect neither had Leeches
[Start of margin text]applyed to the temple
the pain continuing to the full as violent
immediately after as before for
some time after as before[End of margin text]

and before it was suffered
to dry up an other blister was applied betwixt her
shoulders which has still been kept open with issue
ointment
and in effect the pain has now left (↑is not now so constant in↑) the head
there is no pain (↑nor any where↑) so intense as formerly but there is one
diffused over the breast bone whch feels as if it sometimes
entered into the stomach, about a week ago a Vomit had
been was administer'd which had the effect of bringing
up a great quantity of bilious matter (↑her stomach being uneasy more than ordinaryly↑) since which time
her stomach hasnot been so much disordered but the
daly sweatings continue and are every day preceeded by the [Start of margin text]pain in her back and sometimes
her legs growing more intense
by feverish[End of margin text]

heat and ↑painfull↑ smarting of her skin by {illeg} which sometimes also
brings out red spots on different parts of the body ↑which come out and disappear again at short intervals↑ and renews
the inflammation on the Arm where the Eisipe
Erysipelas had been and that kind of pain which it had
occasioned see N 1. next page.



[Page 7]

the Debility occasioned by her complaints and confinements
and Ext is like to affect her spirits.


Her pulse which had been full and strong is
within these few days fallen low
yet she retains her
appetite not ill sleeps soundly, but her anxiety
During the day has now become very uneasy and
almost makes her despair of her recovery. Doubting
that a complication of ills may occasion her complaints
Rheumatism Gout Scurvey


After this Erysipelas she had been prescribed some Dozes
Rochell. salts. and since the vomit has been in use to
take 20 grs. of tartar in a spoonful of lemon juice
two or three times Pær Diem


N 1 This was so uncommonly severe the day that her stomach
was so much out of order as to require the vomit that she
compared it to the burning of a blister the vomit was ad¬
ministered on fryday evening and on satturday the inflamm¬
ation
shewed it self on her arm where it still remains in
a lesser degree.


The pain in her head has left a great soreness to the touch
so much that it is with difficulty she can rest it on the pillow




[Page 8]

Case
Mrs. Maxwell
of Kirkconnel
May 1785
V. XVII. P.97. 109.

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