Cullen

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

 

[ID:47] From: Dr William Cullen (Professor Cullen) / To: Dr Menzies / Regarding: Mr Murray (of Ayton) (Patient) / 27 February 1769 / (Outgoing)

Letter, 'To Doctor Menzies concerning Mr Murray of Ayton'

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[Page 2]


 

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Metadata

FieldData
DOC ID 47
RCPE Catalogue Number CUL/1/1/1/42
Main Language English
Document Direction Outgoing
Date27 February 1769
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 Letter, 'To Doctor Menzies concerning Mr Murray of Ayton'
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:215]
Case of Mr Murray of Ayton who has a hernia.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:54]AddresseeDr Menzies
[PERS ID:1045]PatientMr Murray (of Ayton)
[PERS ID:54]Patient's Physician / Surgeon / ApothecaryDr Menzies
[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
Mentioned / Other Ayton House Aberargie Mid Scotland Scotland Europe certain

Normalized Text

[Page 1]

To Doctor Menzies concerning Mr Murray of Ayton


I am favoured with yours concerning Mr Murray of
Ayton & have considered your full & distinct account of the Case
with all the attention I can bestow


You are right in informing me concerning the ailments
he has formerly been liable to or is now occasionally but there
is at present nothing but the Circumstances of the Hirnea that we
can to any purpose attend to


As for a long time past the intestine has never been
entirely reduced it has now formed a sac in the Growth with
adhesions that make it impossible to be reduced In this situation
the intestine may continue long to propell its contents but
more imperfectly & in any case of costiveness the feculent
matter is especially in danger stagnating here of & of giving
occasion to spasm & at length to inflammation &c &c


The management necessary is especially to obviate costi¬
veness
or when it comes on to remove it as quickly as possible
& at same time to obviate its effects - For obviating costive¬
ness
I think the Andersons Pills was very proper while there
was no particular fear of Irritation or if [in?] that case the
Pill was given often enough - But as by frequent repeti¬
tion it may have become less effectual or require a dose that
maybe too acrid I have presented below an Electuary
that I trust to for obviating Costiveness without any irritation


At first it requires to be given very frequently perhaps both night
& evening & for some days successively but when it has once established



[Page 2]

the course of the belly much less frequent repetition will serve but it should
be managed so as to give a motion once a day or every second day according
to the former habits of the patient. If after trying it two or three days
you think it too weak you may add to the quantity here ordered Radix Jallappa pulvis ʒj which is a milder medecine than commonly imagined. When
there is no heat nor suspicion of it I have no objection to the Elixir Salutis
But it requires some caution. When by any means a costiveness has
come on & a pain arises in the Groin you must then depend chiefly upon
Glysters. I have great faith in these of simple water if the patient can
retain them easily to the bulk of a pound or two thrown up well with a
syringe. When another stimulus is necessary I find nothing better or
safer than Common Salt from ℥ſs to ℥ij. If these prove ineffectual as
they sometimes do by irritating & therefore returning too soon what I find
most effectual is Turpentine from ℥ſs to ℥j but it requires great pains
in mixing it well & some attention in the exhibition that it continues
mixed & does not remain in the [boger?] Syringe.


When Glysters fail to remove the stricture of the Intestine the most
effectual remedy is Tobacco smoke if you are provided [&?] with the
proper apparatus for throwing it in. I doubt you may not at all for tho
we are in some measure here, we have it not in the best & most com¬
plete form


These are the remedies I depend upon for Mr Murray but
your Liniment may also upon occasions to be useful & the obviating all
coldness in the feet is a very necessary attention. With regards to the
Bark I suppose you know it to have no tendency to bind his belly &
if it has with him as with many others a contrary tendency it may
be very useful to him. The Saline Mixture cannot on any sup¬
position be improper.


The accident that happened ten days days ago seemed to threa¬
ten inflammation. You managed it very properly but if such
an accident & should happen again you may judge if his pulse &



[Page 3]

strength would bear taking a little blood from his arm.
Many old people bear it well & with great advantage as people
that are so entire at Mr Murray's time of day have been very
robust & are still liable to the Inflammatory Diathesis

Take one ounce of flowers of sulphur, half an ounce of crystal tartar, one drachm of Russian nutmeg, lenitive electuary either [two drachms?] of {illeg} a sufficient quantity of syrup of roses as required to make an electuary of which the patient is to take an ample amount for a dose either in the morning or night.

27 February 1769
W.C.

Diplomatic Text

[Page 1]

To Doctor Menzies concerning Mr Murray of Ayton


I am favoured with yours concerning Mr Murray of
Ayton & have considered your full & distinct account of the Case
with all the attention I can bestow


You are right in informing me concerning the ailments
he has formerly been liable to or is now occasionally but there
is at present nothing but the Circumstances of the Hirnea that we
can to any purpose attend to


As for a long time past the intestine has never been
entirely reduced it has now formed a sac in the Growth with
adhesions that make it impossible to be reduced In this situation
the intestine may continue long to propell its contents but
more imperfectly & in any case of costiveness the feculent
matter is especially in danger stagnating here of & of giving
occasion to spasm & at length to inflammation &c &c


The management necessary is especially to obviate costi¬
veness
or when it comes on to remove it as quickly as possible
& at same time to obviate its effects - For obviating costive¬
ness
I think the Andersons Pills was very proper while there
was no particular fear of Irritation or if [in?] that case the
Pill was given often enough - But as by frequent repeti¬
tion it may have become less effectual or require a dose that
maybe too acrid I have presented below an Electuary
that I trust to for obviating Costiveness without any irritation


At first it requires to be given very frequently perhaps both night
& evening & for some days successively but when it has once established



[Page 2]

the course of the belly much less frequent repetition will serve but it should
be managed so as to give a motion once a day or every second day according
to the former habits of the patient. If after trying it two or three days
you think it too weak you may add to the quantity here ordered Rad. Jallap.
pulv. ʒj which is a milder medecine than commonly imagined. When
there is no heat nor suspicion of it I have no objection to the Elix. Salat.
But it requires some caution. When by any means a costiveness has
come on & a pain arises in the Groin you must then depend chiefly upon
Glysters. I have great faith in these of simple water if the patient can
retain them easily to the bulk of a pound or two thrown up well with a
syringe. When another stimulus is necessary I find nothing better or
safer than Common Salt from ℥ſs to ℥ij. If these prove ineffectual as
they sometimes do by irritating & therefore returning too soon what I find
most effectual is Turpentine from ℥ſs to ℥j but it requires great pains
in mixing it well & some attention in the exhibition that it continues
mixed & does not remain in the [boger?] Syringe.


When Glysters fail to remove the stricture of the Intestine the most
effectual remedy is Tobacco smoke if you are provided [&?] with the
proper apparatus for throwing it in. I doubt you may not at all for tho
we are in some measure here, we have it not in the best & most com¬
plete form


These are the remedies I depend upon for Mr Murray but
your Liniment may also upon occasions to be useful & the obviating all
coldness in the feet is a very necessary attention. With regards to the
Bark I suppose you know it to have no tendency to bind his belly &
if it has with him as with many others a contrary tendency it may
be very useful to him. The Saline Mixture cannot on any sup¬
position be improper.


The accident that happened ten days days ago seemed to threa¬
ten inflammation. You managed it very properly but if such
an accident & should happen again you may judge if his pulse &



[Page 3]

strength would bear taking a little blood from his arm.
Many old people bear it well & with great advantage as people
that are so entire at Mr Murray's time of day have been very
robust & are still liable to the Inflammatory Diathesis


℞ flor. sulphur. ℥j Grystall Tartar ℥ſs
Nuc. Mosch rus. ʒj Elect. Lenetic. vel [Pulp. Prun. Gall.?] [ʒiij?]
syr. Rosar pall. q.s.ut. f. Electuarium cujus capiat molem N.M. vel
amplius pro dosi

27 Febry 1769
W.C.

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