Cullen

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

 

[ID:4284] From: Dr William Cullen (Professor Cullen) / To: Mr Thomas Bushby / Regarding: Mrs Bushby (in Dumfries) (Patient) / 29 July 1778 / (Outgoing)

Reply 'For Mrs Bushby - Dumfries'. This is a casebook copy of [DOC ID:1537].

Facsimile

There are 3 images for this document.

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Metadata

FieldData
DOC ID 4284
RCPE Catalogue Number CUL/1/1/11/22
Main Language English
Document Direction Outgoing
Date29 July 1778
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply 'For Mrs Bushby - Dumfries'. This is a casebook copy of [DOC ID:1537].
Manuscript Incomplete? No
Evidence of Commercial Posting No

Draft versions for this document exist:

1. [DOC ID:1537]

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:785]
Case of Mrs Bushby who has a bad chest, vomiting and various other complaints generally associated with multiple child-bearing.
7


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:2194]AddresseeMr Thomas Bushby
[PERS ID:2197]PatientMrs Bushby (in Dumfries)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:2112]Patient's Physician / Surgeon / ApothecaryDr William Hamilton (in Dumfries)
[PERS ID:2194]Patient's Relative / Spouse / FriendMr Thomas Bushby

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 Dumfries Borders Scotland Europe inferred

Normalized Text

[Page 1]

For Mrs Bushby - Dumfries

Dear Sir


I find it very difficult to treat a Constitution of so much Laxity
sensibility & irritability & which has been so long & so often deranged
as Mr Bushbys but shall do the best I can. -- The pain of her side
& throwing up of blood at times might seem to mark a breast
Complaint, & I cannot declare her absolutely secure against it, but
while there is no cough no constant spitting, no difficult breathing
nor hectic steadily established I must think any breast ailment
has ↑made↑ no progress & need not be much considered at present. Whatever be
in this own attention must now be directed to the general state
of the system, to the delicacy & irritability of that & to the symptoms
of too abundant Menstruation & fluor, for these continuing
increase the weakness & irritability more & more, & it is from
such increase that we are to apprehend the danger of her breast
Complaints. It would be my plan therefore to restore by



[Page 2]

every safe means the tone of the system. She should be often in
the fresh air & in gentle exercise, but walking except in the more
gentle manner is not admissable, & it is going on horseback
or in a Carriage which can only be safe & of service & even then
must not be pushed to fatigue, & be laid aside entirely at the
time of menstruation. At this period even an erect posture
should be avoided as much as it possibly can. Warm Chambers
Soft Beds & many bed Cloaths should at all times be carefully
avoided. But all this may not be enough & I am for her
returning to cold bathing but with this management that one
part of boiling water, be always part to four parts of cold.
taken from a well or a spring that is of an uniform temperature
& with a view to this the water must not be taken from a river which
is changing every day. The mixed water I propose will give a
sufficient cold shock that has on many occasions been of service
& as it is very moderate it is very safe; but the execution of it in
employing a bathing tub is troublesome & servants are liable
to be negligent in the execution & I would therefore recommend the
use of a shower bath Machine, with which the execution is much more
easy & therefore ↑may be↑ more exact. The bathing should be employd
every morning except during the very days of menstruation. It should
not be employd till an hour after the patient is out of bed & the
skin free from any moisture she should always go to
bed betimes in the Evening & never lay long in the morning. That is
any time after her sound sleep is over -- I would have her
abstain almost entirely from animal food & at the same
time to take very sparingly of roots greens or garden things.


[Page 3]

Her diet should consist almost entirely of Milk & farinacea.
If her stomach do (↑should↑) not digest plain Milk easily, she must take it
mixed with an equal part of water gruel & well sweetened with sugar.
& use this mixture with bread barley rice sago &c as she would do
plain Milk. - I would wish to employ some tonic Medicines but
Chalybeats are of doubtful use & Bark her stomach refuses
I would therefore avoid both for the present & try to correct the Laxity
of the uterine system by the Medicines ordered below.


I would supose that for her hysteric complaints & sleep less nights
you would have sometimes employed an anodyne, & unless you
found that the heated her ↑too much↑ I would wish to try if they might
obviate those with fits wich have so once distressed her in the
night time. But I wish you were upon the spot with her a little
time that you might mark more exactly the circumstances of a
very changeable state & the effects of Medicines. I am &c


W C

Edinburgh July 29th. 1778


I have taken no notice of Piles because I suppose they will
amend with other things in consequence of what is advised. but if
at any time either diet medicines or other cause produce any
costiveness it should be carefully obviated or removed and
F.l. sulph. or Oleum Ricini are the medicines I would employ.

Take two drachms of Alumen rupeum, two drachms of Cinnamon, one and a half ounce of conserve of roses and a sufficient quantity of syrup obtained from dried roses in order to make an electuary. Label as Strengthening Electuary of which the bigness of a horsebean to be taken twice a day an hour before dinner & supper washing it down with a small cupfull of the following infusion.

Take one drachm of flowers of pomegranate, one drachm of red roseand one pound of boiling water. Let it digest for one night and then add to the strained liquid one ounce of spirituous cinnamon water, one of syrup obtained from dried roses and a sufficient quantity of Spiritus vitroli tenuis to obtain an agreeable acidity. Label as Strengthening Infusion. A small tea cupful after every dose of the Electuary.


W C

Diplomatic Text

[Page 1]

For Mrs Bushby - Dumfries

Dr Sir


I find it very difficult to treat a Constitution of so much Laxity
sensibility & irritability & which has been so long & so often deranged
as Mr Bushbys but shall do the best I can. -- The pain of her side
& throwing up of blood at times might seem to mark a breast
Complaint, & I cannot declare her absolutely secure against it, but
while there is no cough no constant spitting, no difficult breathing
nor hectic steadily established I must think any breast ailment
has ↑made↑ no progress & need not be mc considd at present. Whatever be
in this own attention must now be directed to ye general state
of the system, to ye delicacy & irritability of that & to ye symptoms
of too abundant Menstruation & fluor, for these continuing
increase the weakness & irritability more & more, & it is from
such increase that we are to apprehend ye danger of her breast
Complaints. It would be my plan therefore to restore by



[Page 2]

every safe means ye tone of ye system. She should be often in
ye fresh air & in gentle exercise, but walking except in ye more
gentle manner is not admissable, & it is going on horseback
or in a Carriage wc can only be safe & of service & even then
must not be pushed to fatigue, & be laid aside entirely at ye
time of menstruation. At this period even an erect posture
should be avoided as much as it possibly can. Warm Chambers
Soft Beds & many bed Cloaths should at all times be carefully
avoided. But all this may not be enough & I am for her
returning to cold bathing but wt ys management that one
part of boiling water, be always part to four parts of cold.
taken from a well or a spring that is of an uniform temperature
& wt a view to this ye water must not be taken from a river wc
is changing every day. The mixed water I propose will give a
sufficient cold shock that has on many occasions been of service
& as it is very moderate it is very safe; but ye execution of it in
employing a bathing tub is troublesome & servts are liable
to be negligent in ye execution & I wd theree recommend ye
use of a shower bath Machine, wt wc ye execution is mc more
easy & therefore ↑may be↑ more exact. The bathing should be employd
every morng except during ye very days of menstruation. It shd
not be employd till an hour after ye patient is out of bed & ye
skin free from any moisture she should always go to
bed betimes in ye Evening & never lay long in ye morng. That is
any time after her sound sleep is over -- I wd have her
abstain almost entirely from animal food & at ye same
time to take very sparingly of roots greens or garden things.


[Page 3]

Her diet should consist almost entirely of Milk & farinacea.
If her stomach do (↑should↑) not digest plain Milk easily, she must take it
mixed wt an equal part of water gruel & well sweetened wt sugar.
& use this mixture wt bread barley rice sago &c as she wd do
plain Milk. - I wd wish to employ some tonic Medicines but
Chalybeats are of doubtful use & Bark her stomach refuses
I wd therefore avoid both for ye present & try to correct ye Laxity
of ye uterine system by ye Medicines ordered below.


I wd supose yt for her hysteric complaints & sleep less nights
you wd have sometimes employed an anodyne, & unless you
found that ye heated her ↑too mc↑ I would wish to try if they might
obviate those with fits wc have so one distressed her in ye
night time. But I wish you were upon ye spot wt her a little
time that you might mark more exactly ye circumstances of a
very changeable state & ye effects of Medicines. I am &c


W C

Edinr July 29th. 1778


I have taken no notice of Piles because I suppose they will
amend wt other things in consequence of what is advised. but if
at any time either diet medicines or other cause produce any
costiveness it should be carefully obviated or removed and
F.l. sulph. or Oleum Ricini are ye medicines I wd employ.


Alum. rup. Cinnam. @ ʒij Conserv. Ros. ℥jss Syr. e ros. sicc.
q. s. ut f. Electar. S. Strengtheng Elec. of which the bigness of a
horsebean to be taken twice a day and hour before dinner & supper
washing it down with a small cupfull of the following infusion.


Balaust. Ros. rubr. @ ʒj Aq. bull. ℔ij Digere per noctem
& colaturæ adde Aq. cinnam. spir. Syr. e ros. sicc. @ ℥j sp. vitriol
ten.
q.s. ad grat. acidit. S. Strengtheng Infusion a small tea cup¬
ful after every dose of the Electuary.


W C

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