Cullen

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

 

[ID:1078] From: Dr William Cullen (Professor Cullen) / To: Dr Thomas Stephen / Regarding: Mrs Thomson (Patient) / 24 January 1781 / (Outgoing)

Reply 'For Mrs Thomson', in which Cullen thanks Thomas Stephen for 'your usual Precision & Judgement' in conveying the case.

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Metadata

FieldData
DOC ID 1078
RCPE Catalogue Number CUL/1/1/13/132
Main Language English
Document Direction Outgoing
Date24 January 1781
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 Thomson', in which Cullen thanks Thomas Stephen for 'your usual Precision & Judgement' in conveying the case.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1437]
Case of Mrs Thomson at Elgin who has a haemorrhage and severe abdominal pains.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:820]AddresseeDr Thomas Stephen
[PERS ID:3258]PatientMrs Thomson
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:820]Patient's Physician / Surgeon / ApothecaryDr Thomas Stephen

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 Elgin East Highlands Scotland Europe inferred

Normalized Text

[Page 1]

For Mrs. Thomson

Sir


I have taken all the pains I can to Sudy Mrs.
Thomsons Case which you have given me with your usual
precision & Judgement & I have very exactly the same opinion
that you have It is a difficult Case but admitts I hope of relief
For this purpose you have suggested the measures & indeed
all the measures which seem to be most proper and there
is nothing left to me but to give some remarks on the
execution of your indications -


The first for obviating Costiveness is absolutely & constantly
necessary but the repetition of medicines of that kind must
be so frequent that she will probably tire of any one & must
therefore have a Change. The Ol. ricini is what I should have
preferred to any other & I have found the Stomach reconciled to
it by the formula subjoined below which you may try. I would
not put any Rhubarb into her pills, both because it will
increase the bulk in greater proportion than the efficacy, so far
as it is efficacious it leaves an Astrinction. The Jalap is as
better medicine in every View, but it is much improved by
a pretty long triture with Cr. of Tart. as in our pulv: e Jal: comp.
but this preparation renders it unfit for pills & makes it fuller to
be employed in Electuary Sulphur is a good laxative in Such Cases
but it is not easy to introduce it in sufficient quantity into an
Electuary & it does best in a large dose by itself. You will make
use of those hints as your own discretion shall suggest ---


Your 2d. Indication is absolutely necessary, & there is no
Answering of it but by the medicine you now Employ in



[Page 2]

such doses as the frequent repetition absolutely requires. The Cicuta
I must certainly advise with a [valeat?] quantity &c. & I have had
the most remarkable effects from it in such Uterine Cases, but if
her stomach does not bear it to a greater quantity than 10 grains
I should not expect much from it & notwithstanding a little Sickness
I should wish to increase the dose. If I thought you had, or if I
could find you the Extractum Belladonnæ I should advise it in
this case as I have had benefit from it in others. In such a
copious efflux of humors to the Uterus. I think Some Astringents
may be useful & I recommend the following

Take half an ounce of Peruvian Bark powder, half an ounce of Bearberry leaves powder, one drachm of Alumen Rupeum Powder, one ounce of Conserve of Roses and enough Dried Roses Syrup in order to let there be made an Electuary to be taken [mol:?] in the morning and at bed time twice a day.


As the Evacuation is so remarkably foetid I think the
Vagina should be washed out by injection several times a day
the Injection may be a weak infusion of Bark with an eighth part
of the Brandy Tincture of Bark & a little Powdered Myrrh
may be infused along the Bark. A Diet of Milk and
farinacea is the only one I can advise


W.C.

Edinburgh 24th. January 1781.

Diplomatic Text

[Page 1]

For Mrs. Thomson

Sir


I have taken all the pains I can to Sudy Mrs.
Thomsons Case which you have given me with your usual
precision & Judgement & I have very exactly the same opinion
that you have It is a difficult Case but admitts I hope of relief
For this purpose you have suggested the measures & indeed
all the measures which seem to be most proper and there
is nothing left to me but to give some remarks on the
execution of your indications -


The first for obviating Costiveness is absolutely & constantly
necessary but the repetition of medicines of that kind must
be so freqt. that she will probably tire of any one & must
therefore have a Change. The Ol. ricini is what I should have
preferred to any other & I have found the Stomach reconciled to
it by the formula subjoined below which you may try. I would
not put any Rhubarb into her pills, both because it will
increase the bulk in greater proportion than the efficacy, so far
as it is efficacious it leaves an Astrinction. The Jalap is as
better medicine in every View, but it is much improved by
a pretty long triture wt. Cr. of Tart. as in our pulv: e Jal: comp.
but this preparn. renders it unfit for pills & makes it fuller to
be employed in Electy. Sulphur is a good laxative in Such Cases
but it is not easy to introduce it in suffict. quantity into an
Electuary & it does best in a large dose by itself. You will make
use of those hints as your own discretion shall suggest ---


Your 2d. Indication is absolutely necessary, & there is no
Answering of it but by the medicine you now Employ in



[Page 2]

such doses as the freqt. repetition absolutely requires. The Cicuta
I must certainly advise wt. a [valeat?] quantity &c. & I have had
the most remarkable effects from it in such Uterine Cases, but if
her stomach does not bear it to a greater quantity than 10 grains
I should not expect much from it & notwt.standing a little Sickness
I should wish to increase the dose. If I thought you had, or if I
could find you the Extractum Belladonnæ I should advise it in
this case as I have had benefit from it in others. In such a
copious efflux of humors to the Uterus. I think Some Astrings.
may be useful & I recommend the following


pulv: Cort: Peruv:
pulv: fol: Uv: Urs: @℥fs Alum Rup: pulv: ʒj Cons: rosar.
℥j Syr: e ros: sicc: q. s. ut f. Elect. cujus cap. mol: n. m.
bis in die.


As the Evacuation is so remarkably foetid I think the
Vagina should be washed out by injection several times a day
the Injection may be a weak infusion of Bark with an 8th. part
of the Brandy Tincture of Bark & a little Powdered Myrrh
may be infused along the Bark. A Diet of Milk and
farinacea is the only one I can advise


W.C.

Edr. 24th. Jany. 1781.

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