Cullen

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

 

[ID:1391] From: Mr Andrew Liddell (Liddle) / To: Dr William Cullen (Professor Cullen) / Regarding: Miss Alexandrina Dunbar (Lexie) (Patient) / 3 April 1777 / (Incoming)

Letter from Andrew Liddell concerning the case of Miss Lexie Dunbar.

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Metadata

FieldData
DOC ID 1391
RCPE Catalogue Number CUL/1/2/487
Main Language English
Document Direction Incoming
Date3 April 1777
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from Andrew Liddell concerning the case of Miss Lexie Dunbar.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:498]
Case of Miss Alexandria "Lexie" Dunbar (eighteen-year-old daughter of Sir William Dunbar) who has a persistent cough and chest complaint.
6


People linked to this document

Person IDRole in documentPerson
[PERS ID:339]AuthorMr Andrew Liddell (Liddle)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:1509]PatientMiss Alexandrina Dunbar (Lexie)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:339]Patient's Physician / Surgeon / ApothecaryMr Andrew Liddell (Liddle)
[PERS ID:1651]OtherMr George Sinclair

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Wick North Highlands Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain

Normalized Text

[Page 1]
Dear Sir,


Miss Lexie Dunbars Cough, which has
now lasted betwixt 3 & 4 months seems scarcely to have under¬
gone any chance since it began. It differs from common
Coughing in a manner not to be described in words, tho' easily
↑distinguished↑ by any present observer. One difference however can be
mentioned. A fit of the common Cough consists of two or more
successive expirations, without any intervening Inspiration:
but Hers, which for distinction I may call nervous, consists
regularly of 3, 4, or 5 Expirations, with a quick Inspiration
betwixt each of them. The Fit of Coughing returns commonly
after the interval of half a minute. What is remarka¬
ble, for this last fortnight She has had both kinds of
Cough. The nervous continues regularly from morning
till she begins to fall asleep at night, & is never attended
with uneasy breathing, pain, nor expectoration. The
common Cough comes now & then irregular & seldom,
bringing up sometimes a little mucous expectoration,
especially in the morning when she first awakes; but
the patient complains much more of uneasiness from
this Cough, particularly a painful straitness of her Breast breathing,
& it also heightens the colour of her Cheeks, which the
other Cough does not.


Her Pulse thro' the Day is quick, generally 90, sometimes
100; but in the morning before rising, & after she has been
sometime in bed at night, it for most part does not exceed
80 in a minute.


Her skin is often warm, but I observe no regular returns
of heat or cold.


The appetite for food is but weak: there is no remarkable
Thirst.
--




[Page 2]


She has had frequent returns of Pain in her Stomach, &
Intestines, generally attended with some degree of Looseness;
tho' at other times the tendency is to costiveness. These
continue only for a few Days, & the Looseness does not at
any time come to a very great height.


The menses at one time delayed appearing for a
fortnight later than usual, & at the next period returned
in about 3 weeks: at both times were preceeded by great
pains in the belly: in other respects were well enough.


Mis Dunbar for the most part continues to rest very
well thro' the night.


Her looks are a good deal paler than formerly, & She
has also lost some of her Flesh, tho' I cannot say more
than might have been expected from her confinement
and regimen


Every tolerable day she goes abroad in a Chaise for an
hour or two, & I am pretty sure she is no worse of it, either
in respect of her Cough or Pulse. As soon as the weather
is warmer, may she ride on horseback?. --- Upon a notion
that the sea air might promote her cough, she was car¬
ried about 6 miles from the seaside into the country
for 10 or 12 Days; but I could perceive no advantage from
the tryal.


The Diet has been such as was directed, only that
some Days she is permitted a piece of Fowl to dinner.
I suppose She may take Asses Milk freely. -------


Neither the Oleous nor Mucilaginous medicines seem to
have any effect in her Cough. The Opiates were tryed
only 2 or 3 times at the beginning, without any effect.
The foetid Pills were used as directed night & morning for
a fortnight, but then given up as no sensible effect ap¬
peared from them in that time. Emetics have not
been given since your Letter, which expressed some doubts



[Page 3]

of their propriety in regard to the complaint of her Stomach.


Bleeding has been repeated very frequently, to which I
was led partly by the frequency of the Pulse, & particularly
by the appearance of the Blood, which continues remark¬
ably sizy, with a white viscid crust to the last; but the propor¬
tion of serum seems a good deal increased. I cannot
however say that the Bleedings were attended hitherto
with any apparent advantage; & for two or three Days
after this evacuation, Miss Dunbar generally complains
of a Dizziness in her head; & twice she was affected the
day after bleeding with three violent fits of Coughing which
last unremitted for an hour or two, as described in a former
Letter.


The Irritation of the perpetual Blister was so great,
& sometimes occasioning Strangury, that it was healed up,
& Miss Dunbar with some difficulty has allowed a Pea Issue
to be put into her arm. --------------------


I should have answered your Letter sooner, but delayed
till I had some farther Observations to make on Miss Dun¬
bars state of Health. --


Your kindness in sending me a copy of your Practice
of Physic I have still to thank you for. It is an addi¬
tional mark of your Friendship, & I prize it accordingly.


Mr. George Sinclair will forward your return to this
Letter, & I hope it will be ready as soon as your conve¬
niency can allow.


With best Compliments & highest
regard I am Dear Sir
your most obedient humble
Servant
Andrew Liddell
Wick 3d. April 1777



[Page 4]


Doctor William Cullen
Physician
at Edinburgh

Diplomatic Text

[Page 1]
Dr. Sir,


Miss Lexie Dunbars Cough, which has
now lasted betwixt 3 & 4 months seems scarcely to have under¬
gone any chance since it began. It differs from common
Coughing in a manner not to be described in words, tho' easily
↑distinguished↑ by any present observer. One difference however can be
mentioned. A fit of the common Cough consists of two or more
successive expirations, without any intervening Inspiration:
but Hers, which for distinction I may call nervous, consists
regularly of 3, 4, or 5 Expirations, with a quick Inspiration
betwixt each of them. The Fit of Coughing returns commonly
after the interval of half a minute. What is remarka¬
ble, for this last fortnight She has had both kinds of
Cough. The nervous continues regularly from morning
till she begins to fall asleep at night, & is never attended
with uneasy breathing, pain, nor expectoration. The
common Cough comes now & then irregular & seldom,
bringing up sometimes a little mucous expectoration,
especially in the morning when she first awakes; but
the patient complains much more of uneasiness from
this Cough, particularly a painful straitness of her Breast breathing,
& it also heightens the colour of her Cheeks, which the
other Cough does not.


Her Pulse thro' the Day is quick, generally 90, sometimes
100; but in the morning before rising, & after she has been
sometime in bed at night, it for most part does not exceed
80 in a minute.


Her skin is often warm, but I observe no regular returns
of heat or cold.


The appetite for food is but weak: there is no remarkable
Thirst.
--




[Page 2]


She has had frequent returns of Pain in her Stomach, &
Intestines, generally attended with some degree of Looseness;
tho' at other times the tendency is to costiveness. These
continue only for a few Days, & the Looseness does not at
any time come to a very great height.


The menses at one time delayed appearing for a
fortnight later than usual, & at the next period returned
in about 3 weeks: at both times were preceeded by great
pains in the belly: in other respects were well enough.


Mis Dunbar for the most part continues to rest very
well thro' the night.


Her looks are a good deal paler than formerly, & She
has also lost some of her Flesh, tho' I cannot say more
than might have been expected from her confinement
and regimen


Every tolerable day she goes abroad in a Chaise for an
hour or two, & I am pretty sure she is no worse of it, either
in respect of her Cough or Pulse. As soon as the weather
is warmer, may she ride on horseback?. --- Upon a notion
that the sea air might promote her cough, she was car¬
ried about 6 miles from the seaside into the country
for 10 or 12 Days; but I could perceive no advantage from
the tryal.


The Diet has been such as was directed, only that
some Days she is permitted a piece of Fowl to dinner.
I suppose She may take Asses Milk freely. -------


Neither the Oleous nor Mucilaginous medicines seem to
have any effect in her Cough. The Opiates were tryed
only 2 or 3 times at the beginning, without any effect.
The foetid Pills were used as directed night & morning for
a fortnight, but then given up as no sensible effect ap¬
peared from them in that time. Emetics have not
been given since your Letter, which expressed some doubts



[Page 3]

of their propriety in regard to the complaint of her Stomach.


Bleeding has been repeated very frequently, to which I
was led partly by the frequency of the Pulse, & particularly
by the appearance of the Blood, which continues remark¬
ably sizy, with a white viscid crust to the last; but the propor¬
tion of serum seems a good deal increased. I cannot
however say that the Bleedings were attended hitherto
with any apparent advantage; & for two or three Days
after this evacuation, Miss Dunbar generally complains
of a Dizziness in her head; & twice she was affected the
day after bleeding with three violent fits of Coughing which
last unremitted for an hour or two, as described in a former
Letter.


The Irritation of the perpetual Blister was so great,
& sometimes occasioning Strangury, that it was healed up,
& Miss Dunbar with some difficulty has allowed a Pea Issue
to be put into her arm. --------------------


I should have answered your Letter sooner, but delayed
till I had some farther Observations to make on Miss Dun¬
bars state of Health. --


Your kindness in sending me a copy of your Practice
of Physic I have still to thank you for. It is an addi¬
tional mark of your Friendship, & I prize it accordingly.


Mr. George Sinclair will forward your return to this
Letter, & I hope it will be ready as soon as your conve¬
niency can allow.


With best Compliments & highest
regard I am Dr. Sir
your most obt. humble
Servt.
Andrew Liddell
Wick 3d. April 1777



[Page 4]


Doctor William Cullen
Physician
at Edinburgh

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