Cullen

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

 

[ID:3035] From: Dr Andrew Bain / To: Dr William Cullen (Professor Cullen) / Regarding: Governor George Johnstone (Johnston) (Patient) / 30 May 1787 / (Incoming)

Letter from A. Bain, writing from Hotwells, near Bristol, reporting the post mortem on Governor George Johnstone, which found diseased enlargement of the maxillary and adjacent glands, and the schirrosity and erosion of the tongue and pharynx. He finds the disease was 'indisputably of a cancerous nature'. He also asks Cullen to send him Dr Irving's letter, and sends his compliments to one of his sons (unnamed).

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Metadata

FieldData
DOC ID 3035
RCPE Catalogue Number CUL/1/2/2068
Main Language English
Document Direction Incoming
Date30 May 1787
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 A. Bain, writing from Hotwells, near Bristol, reporting the post mortem on Governor George Johnstone, which found diseased enlargement of the maxillary and adjacent glands, and the schirrosity and erosion of the tongue and pharynx. He finds the disease was 'indisputably of a cancerous nature'. He also asks Cullen to send him Dr Irving's letter, and sends his compliments to one of his sons (unnamed).
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1930]
Case of Governor George Johnstone (Johnston) who has a maxillary gland tumour and diseased tongue, which prove fatal.
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:5445]AuthorDr Andrew Bain
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:99]PatientGovernor George Johnstone (Johnston)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:5445]Patient's Physician / Surgeon / ApothecaryDr Andrew Bain
[PERS ID:5446]Patient's Physician / Surgeon / ApothecaryDr Ralph Irving
[PERS ID:1967]OtherMr Cullen (Probably one of Cullen's sons, but no first name given.)

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Hotwells South-West England Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe inferred
Mentioned / Other Bristol South-West England Europe certain

Normalized Text

[Page 1]
Dear Sir


As the late Governor Johnstone was
once your patient and as he always
mentioned your name with the greatest
veneration, permit me to inform you
that according to his direction, his body
was opened after his death, that the
seat and nature of his complaints
might be ascertained. The following is
a state of the morbid appearances which
presented on dissection.


Immediately under the coronal process of the
lower jaw
, on the right side of the neck, was
situate a hard and conspicuous tumor, which
on examination proved to be a diseased en¬
largement of
the inferior maxillary gland.
It had been tender to the touch, and in
general troublesomely painful, owing to its
lying under a partial portion of the mastoid
muscle
, which necessarily compressed its surface
whenever put into action by the motion of



[Page 2]

the head. This gland weighed about two ounces
& a half, measured an inch & a half in thick¬
ness, and a trifle more in its diameter.
There can be no doubt but the pressure form¬
ed by
this tumor on the blood vessels of the
neck
, whereby the return of the blood ↑was↑ una¬
voidably interrupted, occasioned the incessant
pain complained of
by the Patient on the
upper and back part of the head
. ––


Besides this, on dissecting away the integu¬
ments, two smaller diseased glands were
found lying under the same muscle, the
largest of which was about the size
of an oblong nutmeg. The lymphatic glands
in general of the neck, (but particularly
the Thyroid) were diseased. The tongue
& pharynx appeared to be the chief (and
probably {illeg} the primary) seat of the
disease. Every natural vestige was obli¬
terated, except a small remnant of the Tonsils
which were in an extremely schirrous state
Every muscle belonging to the tongue was



[Page 3]

annihilated, and formed an entire schirrous
mass
. The back part of the tongue had been
consumed in great part by erosion, which
had formed a contraction that altered its
whole natural appearance, and left it of an
irregular triangular form, of a watery aspect
and by no means a bad resemblance to
a turtle's heart. From a general
review of the disease, it will perhaps
appear from its first attack to have
been unhappily incurable, & indisputably
of a cancerous nature
.


There were no ulcers to be found in
any of the diseased parts. ––––


If you can put your hand on Dr
Irvine's letter to you concerning the
Governor just before he put himself
under my care last Autumn, might I
beg the favor of you to send it here?
There were some circumstances we wished



[Page 4]

to ascertain, which we found it difficult
to do, as the Governor had lost his notes
of the case.


It always gives me the greatest pleasure
to hear that you are well.


I beg you will present my best
Compliments to your son, and
believe me with best wishes
for you my dear sir

Your very faithful and
ever obliged humble servant
A.Bain
Hotwells near Bristol
30 May 1787 –

Dissection
Governor Johnston
May 1787

Diplomatic Text

[Page 1]
Dear Sir


As the late Governor Johnstone was
once your patient and as he always
mentioned your name with the greatest
veneration, permit me to inform you
that according to his direction, his body
was opened after his death, that the
seat and nature of his complaints
might be ascertained. The following is
a state of the morbid appearances which
presented on dissection.


Immediately under the coronal process of the
lower jaw
, on the right side of the neck, was
situate a hard and conspicuous tumor, which
on examination proved to be a diseased en¬
largement of
the inferior maxillary gland.
It had been tender to the touch, and in
general troublesomely painful, owing to its
lying under a partial portion of the mastoid
muscle
, which necessarily compressed its surface
whenever put into action by the motion of



[Page 2]

the head. This gland weighed about two ounces
& a half, measured an inch & a half in thick¬
ness, and a trifle more in its diameter.
There can be no doubt but the pressure form¬
ed by
this tumor on the blood vessels of the
neck
, whereby the return of the blood ↑was↑ una¬
voidably interrupted, occasioned the incessant
pain complained of
by the Patient on the
upper and back part of the head
. ––


Besides this, on dissecting away the integu¬
ments, two smaller diseased glands were
found lying under the same muscle, the
largest of which was about the size
of an oblong nutmeg. The lymphatic glands
in general of the neck, (but particularly
the Thyroid) were diseased. The tongue
& pharynx appeared to be the chief (and
probably {illeg} the primary) seat of the
disease. Every natural vestige was obli¬
terated, except a small remnant of the Tonsils
which were in an extremely schirrous state
Every muscle belonging to the tongue was



[Page 3]

annihilated, and formed an entire schirrous
mass
. The back part of the tongue had been
consumed in great part by erosion, which
had formed a contraction that altered its
whole natural appearance, and left it of an
irregular triangular form, of a watery aspect
and by no means a bad resemblance to
a turtle's heart. From a general
review of the disease, it will perhaps
appear from its first attack to have
been unhappily incurable, & indisputably
of a cancerous nature
.


There were no ulcers to be found in
any of the diseased parts. ––––


If you can put your hand on Dr
Irvine's letter to you concerning the
Governor just before he put himself
under my care last Autumn, might I
beg the favor of you to send it here?
There were some circumstances we wished



[Page 4]

to ascertain, which we found it difficult
to do, as the Governor had lost his notes
of the case.


It always gives me the greatest pleasure
to hear that you are well.


I beg you will present my best
Compliments to your son, and
believe me with best wishes
for you my dear sir

Yr very faithful and
ever obliged humle servt
A.Bain
Hotwells near Bristol
30 May 1787 –

Dissection
Govr. Johnston
May 1787

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