Cullen

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

 

[ID:42] From: Dr William Cullen (Professor Cullen) / To: Dr James Kenneth Saunders / Regarding: Anonymous (Patient) / 23 December 1768 / (Outgoing)

For Dr Saunders at Bamf. Cullen opens 'Struggling with bad health & uncommon hurry I have been obliged to delay this letter longer than I ought'.

Facsimile

There are 2 images for this document.

[Page 1]


 

[Page 2]


 
 

Metadata

FieldData
DOC ID 42
RCPE Catalogue Number CUL/1/1/1/37
Main Language English
Document Direction Outgoing
Date23 December 1768
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary For Dr Saunders at Bamf. Cullen opens 'Struggling with bad health & uncommon hurry I have been obliged to delay this letter longer than I ought'.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:277]
Case of an unnamed patient of Dr Saunders's who has an inflammation of the breast (could be male or female).
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:596]AddresseeDr James Kenneth Saunders
[PERS ID:1183]Patient
[PERS ID:596]Patient's Physician / Surgeon / ApothecaryDr James Kenneth Saunders
[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 Banff (Bamf) East Highlands Scotland Europe certain

Normalized Text

[Page 1]

To Dr Saunders at Bamf.
Dear Sir


Struggling with bad health & uncommon hurry I have been
obliged to delay this letter longer than I ought. You give me a difficult case
that required some thought & I wish I could now make a favourable
prognistic but I dare not. You have in my opinion employed the most
proper measures all along & particularly of late the avoiding & preventing
the inflammation of left breast was a judicious & happy practice
I hope the tendency to inflammation is gone & we are now to consider
matters as they stood before the Inflammatory symptoms appeared
that is a Schirrosity threatening & in some measures occupying the breasts


You will no doubt continue the fomentation till all Inflammatory
Symptoms
have dissappeared but when that happens I would lay it
aside as the warm & humid applications sometimes render the
Skin liable to fret & become very troublesome. The Solution of Sacch.
Satturni
is not so liable to do this but I use it as a lotion hardly warm
two or three times a day & for the rest avoid Poultice & keep the breasts
dry by a piece of fur laid upon them. For internal medicines if the Cicuta
is such as to have a Sensible Operation it may have good effects in resolving
Schirrosity but where it has no Sensible Operation it will do nothing



[Page 2]

I have more faith in the Solution of Subliniate but I know that it
must ↑be↑ employed in a very slow alterative way otherwise I think it
favours Inflammation. I find the Calomel precipatated by the
Volatile Alkali as Willie has proposed a very convenient & usefull
p↑r↑eparation & think it might answer well in the present ease
when there is no tendency to inflammation the bark will do a great
deal to prevent it but it does not agree very well with the Mercurial
Course & I would alternate them by a fortnight of the one & t'other by
twins. Nothing Seems to one more usefull in Such Cases than avoiding
irritation by a diet entirely of milk & Vegetables avoiding all kinds
of Strong drink even small beer avoiding external heat & all but the
very gentlest Exercise, Upon the same plan it is necessary to keep
the belly always easy but by the most cooling means. I think an Issue
may be usefull but I would put ↑it↑ into the thigh or leg. You take notice
that the axilla is not affected & perhaps you have a meaning in it
but I must say that after the appearance in the right breast I thinke
there is nothing to be expected from extirpation. If in Spite of all our
precautions an Inflammation should come on & an ulcer be formed
I shall tell you that I kept {illeg} one of a very bad kind not only
at bay but nearly healed up for two years past by the use of Bella¬
dona
but more of this when there is occasion

For Dr S.
{illeg} Edi Edinburgh 23. December 1768

Diplomatic Text

[Page 1]

To Dr Saunders at Bamf.
Dr Sir


Struggling with bad health & uncommon hurry I have been
obliged to delay this letter longer than I ought. You give me a difficult case
that required some thought & I wish I could now make a favourable
prognistic but I dare not. You have in my opinion employed the most
proper measures all along & particularly of late the avoiding & preventing
the inflammation of left breast was a judicious & happy practice
I hope the tendency to inflammation is gone & we are now to consider
matters as they stood before the Inflammatory symptoms appeared
that is a Schirrosity threatening & in some measures occupying the breasts


You will no doubt continue the fomentation till all Inflammatory
Symptoms
have dissappeared but when that happens I would lay it
aside as the warm & humid applications sometimes render the
Skin liable to fret & become very troublesome. The Solution of Sacch.
Satturni
is not so liable to do this but I use it as a lotion hardly warm
two or three times a day & for the rest avoid Poultice & keep the breasts
dry by a piece of fur laid upon them. For internal medicines if the Cicuta
is such as to have a Sensible Operation it may have good effects in resolving
Schirrosity but where it has no Sensible Operation it will do nothing



[Page 2]

I have more faith in the Solution of Subliniate but I know that it
must ↑be↑ employed in a very slow alterative way otherwise I think it
favours Inflammation. I find the Calomel precipatated by the
Volatile Alkali as Willie has proposed a very convenient & usefull
p↑r↑eparation & think it might answer well in the present ease
when there is no tendency to inflammation the bark will do a great
deal to prevent it but it does not agree very well with the Mercurial
Course & I would alternate them by a fortnight of the one & t'other by
twins. Nothing Seems to one more usefull in Such Cases than avoiding
irritation by a diet entirely of milk & Vegetables avoiding all kinds
of Strong drink even small beer avoiding external heat & all but the
very gentlest Exercise, Upon the same plan it is necessary to keep
the belly always easy but by the most cooling means. I think an Issue
may be usefull but I would put ↑it↑ into the thigh or leg. You take notice
that the axilla is not affected & perhaps you have a meaning in it
but I must say that after the appearance in the right breast I thinke
there is nothing to be expected from extirpation. If in Spite of all our
precautions an Inflammation should come on & an ulcer be formed
I shall tell you that I kept {illeg} one of a very bad kind not only
at bay but nearly healed up for two years past by the use of Bella¬
dona
but more of this when there is occasion

For Dr S.
{illeg} Edi Edinr 23. Decr 1768

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