The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:2121] Case Note / Regarding: Anonymous (Patient) / December 1781 / (Incoming)
Unsigned case note describing the case of an unnamed female patient, aged 52 who has a schirrous breast (a tumour) and has been under the care of Drs Warren and Hunter in London. She refuses surgery but has been taking Hemlock to uncertain effect.
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- Normalized Text
- Diplomatic Text
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Facsimile
There are 4 images for this document.
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Metadata
Field | Data |
---|---|
DOC ID | 2121 |
RCPE Catalogue Number | CUL/1/2/1196 |
Main Language | English |
Document Direction | Incoming |
Date | December 1781 |
Annotation | None |
Type | Authorial original |
Enclosure(s) | No enclosure(s) |
Autopsy | No |
Recipe | No |
Regimen | No |
Letter of Introduction | No |
Case Note | No |
Summary | Unsigned case note describing the case of an unnamed female patient, aged 52 who has a schirrous breast (a tumour) and has been under the care of Drs Warren and Hunter in London. She refuses surgery but has been taking Hemlock to uncertain effect. |
Manuscript Incomplete? | No |
Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
Case ID | Description | Num Docs |
---|---|---|
[Case ID:1443] |
Case of an unnamed female patient who requires surgery to remove a tumour in her breast. |
2 |
People linked to this document
Person ID | Role in document | Person |
---|---|---|
[PERS ID:4582] | Author | |
[PERS ID:1] | Addressee | Dr William Cullen (Professor Cullen) |
[PERS ID:4581] | Patient | |
[PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
[PERS ID:531] | Patient's Physician / Surgeon / Apothecary | Dr Richard? Warren |
[PERS ID:4580] | Patient's Physician / Surgeon / Apothecary | Dr Hunter |
[PERS ID:4582] | Patient's Physician / Surgeon / Apothecary |
Places linked to this document
Role in document | Specific Place | Settlements / Areas | Region | Country | Global Region | Confidence |
---|---|---|---|---|---|---|
Destination of Letter | Edinburgh | Edinburgh and East | Scotland | Europe | certain | |
Mentioned / Other | London | London and South-East | England | Europe | certain |
Normalized Text
A Lady in the fifty second year of her age, middle sized,
of a full corpulent habit, & tho remarkably healthy & of strong
constitution, is not without evident symptoms of a scorbutic
tendency; who's menstrual discharge continued regular to her
fiftieth year and then ceased without trouble or inconvenience:
In the month of August 1780 first discover'd a hard Schirrous tumor
under her right Breast almost close to the ribs, but unattended
with the least degree of pain. The Breast was naturally so large
that the size of the lu{illeg} (↑m↑)p cou'd not then be ascertained, but was
thought to be about the bigness of a hens egg. On raising the Breast
its surface appeared the breadth of a halfpenny firmly connected
[wi]th the skin. In the month of February 1781 she went to London &
consulted Doctors Warren & Hunter. At that time a red speck
appeared in the middle of its surface. Both the Doctors look'd upon
it as not immediately dangerous, at the same time Dr. Hunter
was inclinable to recommend an extirpation of the lump either
by caustic, or what he thought more eligible by the point of a Knife.
The Lady was much averse to an operation, so was advised to
leave Town, and from a full generous diet and much exercise
which she had always been accustom'd to, was order'd to keep still
and quiet, & to live very low, chiefly upon pudding & vegetables.
abstaining from Wine and animal food, & to take ʒij of Sal. Rochel.
twice a week. In June last she was further advised to drink
twice a day, a strong decoction of Veronica mas, which she complied
with for a month, but it operated so much physically that it
was thought advisable to discontinue it. From the end of
[Page 2]
April the time of her leaving Town till the latter end of July, she
enjoy'd good health, excepting now & then a sudden darting pain
in the lump, & from the change of diet was reduced considerably.
thin etc.. The Breast altogether was considerably wasted, the tumor
more perceptible & at that time appeared to be as large as a Swans
egg. The external surface & redness was likewise extended to the
breadth of a crown piece or larger. At that time, being the latter
end of July, she was advised to try Extract of Hemlock. She began
with two grains three times a day, increasing the dose gradually
so that now she is taking about sixty grains a day. The Tumor
for the last three months certainly does not appear to have in¬
creased, if any thing it is rather diminished. The Lady has
enjoy'd perfect health & has been quite free from pain -
The secretions & excretions are natural & unaffected by the use
of Hemlock, nor has it any sensible effect further than occasi¬
oning a little giddiness, the common criterion of the sufficiency
of its dose. The external surface of the lump is now increased
to about three inches diameter, nearly circular, several red pro¬
tuberances appearing on its surface from which a little
serous humour has ouzed at times for three Weeks or a month
past. Ten days since one of these protuberances burst & dis¬
charg'd a little Blood, Since which time, the serous discharge
is increased, & a small ulcer is form'd attended with some degree
of foetor. No outward application has be used further than
washing the part with Sea Water two or three times a day,
and afterwards covering it with a piece of soft cambrick, &
[Page 3]
for the last two or three days a Poultice of Bread & Milk with a
a little of the Extract. Cicut. in it. The Lady continues in good
health, only her Spirits at times are a little agitated with (↑from↑) the
apprenhension of danger. She Sleeps well, sees company,
walks out at times and frequently rides in a Carriage and
without the least degree of pain, or even a sensation of weight
in the Breast or the least uneasiness in the lump. -----
As she will with the utmost reluctance submit to an operation
Your authority is requested, to know how far and in what
manner the use of Hemlock, or any other medicine you can
propose, may be persisted in without risqueing the chances
of a radical cure by means of the Knife ----------
[Page 4]
Doctor C[ulle]n
Case of a Lady.
a Schirrhous Breast.
December 1781.
V.XIII p .243.
Diplomatic Text
A Lady in the fifty second year of her age, middle sized,
of a full corpulent habit, & tho remarkably healthy & of strong
constitution, is not without evident symptoms of a scorbutic
tendency; who's menstrual discharge continued regular to her
fiftieth year and then ceased without trouble or inconvenience:
In the month of Augt. 1780 first discover'd a hard Schirrous tumor
under her right Breast almost close to the ribs, but unattended
with the least degree of pain. The Breast was naturally so large
that the size of the lu{illeg} (↑m↑)p cou'd not then be ascertained, but was
thought to be about the bigness of a hens egg. On raising the Breast
its surface appeared the breadth of a halfpenny firmly connected
[wi]th the skin. In the month of Feby 1781 she went to London &
consulted Docts. Warren & Hunter. At that time a red speck
appeared in the middle of its surface. Both the Docts. look'd upon
it as not immediately dangerous, at the same time Dr. Hunter
was inclinable to recommend an extirpation of the lump either
by caustic, or what he thought more eligible by the point of a Knife.
The Lady was much averse to an operation, so was advised to
leave Town, and from a full generous diet and much exercise
which she had always been accustom'd to, was order'd to keep still
and quiet, & to live very low, chiefly upon pudding & vegetables.
abstaining from Wine and animal food, & to take ʒij of Sal. Rochel.
twice a week. In June last she was further advised to drink
twice a day, a strong decoction of Veronica mas, which she complied
with for a month, but it operated so much physically that it
was thought advisable to discontinue it. From the end of
[Page 2]
April the time of her leaving Town till the latter end of July, she
enjoy'd good health, excepting now & then a sudden darting pain
in the lump, & from the change of diet was reduced considerably.
thin et.. The Breast altogether was considerably wasted, the tumor
more perceptible & at that time appeared to be as large as a Swans
egg. The external surface & redness was likewise extended to the
breadth of a crown piece or larger. At that time, being the latter
end of July, she was advised to try Extract of Hemlock. She began
with two grains three times a day, increasing the dose gradually
so that now she is taking about sixty grains a day. The Tumor
for the last three months certainly does not appear to have in¬
creased, if any thing it is rather diminished. The Lady has
enjoy'd perfect health & has been quite free from pain -
The secretions & excretions are natural & unaffected by the use
of Hemlock, nor has it any sensible effect further than occasi¬
oning a little giddiness, the common criterion of the sufficiency
of its dose. The external surface of the lump is now increased
to about three inches diameter, nearly circular, several red pro¬
tuberances appearing on its surface from which a little
serous humour has ouzed at times for three Weeks or a month
past. Ten days since one of these protuberances burst & dis¬
charg'd a little Blood, Since which time, the serous discharge
is increased, & a small ulcer is form'd attended with some degree
of foetor. No outward application has be used further than
washing the part with Sea Water two or three times a day,
and afterwards covering it with a piece of soft cambrick, &
[Page 3]
for the last two or three days a Poultice of Bread & Milk with a
a little of the Extract. Cicut. in it. The Lady continues in good
health, only her Spirits at times are a little agitated with (↑from↑) the
apprenhension of danger. She Sleeps well, sees company,
walks out at times and frequently rides in a Carriage and
without the least degree of pain, or even a sensation of weight
in the Breast or the least uneasiness in the lump. -----
As she will with the utmost reluctance submit to an operation
Your authority is requested, to know how far and in what
manner the use of Hemlock, or any other medicine you can
propose, may be persisted in without risqueing the chances
of a radical cure by means of the Knife ----------
[Page 4]
Doctr. C[ulle]n
Case of a Lady.
a Schirrhous Breast.
Decr. 1781.
V.XIII p .243.
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