The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:238] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: (x x x x x) (Patient) / 20? December? 1781? / (Outgoing)
Reply - incomplete - 'For x x x x x', a female patient, who has a tumour which needs extirpation by surgery possibly in response to case conveyed by Mr Hutchinson, and mentioning Dr Hunter. The day of the month is notionally given as mid-way between the dates of letters either side in the volume.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 3 images for this document.
[Page 1]
[Page 2]
[Page 3]
Metadata
| Field | Data |
|---|---|
| DOC ID | 238 |
| RCPE Catalogue Number | CUL/1/1/14/124 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 20? December? 1781? |
| Annotation | None |
| Type | Machine copy |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | No |
| Regimen | Yes |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply - incomplete - 'For x x x x x', a female patient, who has a tumour which needs extirpation by surgery possibly in response to case conveyed by Mr Hutchinson, and mentioning Dr Hunter. The day of the month is notionally given as mid-way between the dates of letters either side in the volume. |
| Manuscript Incomplete? | Yes |
| 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:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:4411] | Patient | (x x x x x) |
| [PERS ID:4409] | Patient's Physician / Surgeon / Apothecary | Mr Hutchinson |
| [PERS ID:4410] | Patient's Physician / Surgeon / Apothecary | Dr Hunter |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr 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 |
Normalized Text
For x x x x x
I have very attentively considered the case communi¬
cated by Mr Hutchinson and need not say anything of
the nature of the disease which tho suffered at present
with very little uneasiness is certainty of very dangerous
tendency; as it may not only prove fatal but what is
perhaps worse may become a very painfull disease.
All this was certainly apprehended by Dr Hunter
when he advised the only certain means of preventing both
events and as in spite of any remedies hitherto employed
the disease seems to be constantly advancing and tho other
remedies may still be proposed as there are none of them ab¬
solutely certain I believe that extirpation would still be the
most prudent measure: providing always that the circum¬
stances of the tumour are such as to admit of it, that is that
the tumour can still be easily and entirely separated from
the ribs, that it has sent out no branches towards the arm¬
pit and that there are still no indurated or even [seized?]
[Page 2]
glands in the axilla for in these circumstances the tu¬
mour could not taken away either entirely or to any good
purpose.
The regimen advised for this lady was certainly very
proper, tho it was perhaps more rigorous in diet than ne¬
cessary at first but now she has submitted to it I think
a fuller diet would have a very bad effect
I think the use of the Cicuta was also very properly
prescribed and it has probably kept the Lady more free
from pain than she would otherwise have been but I
think it has hardly at all retarded the progress of the
disease. The use of it therefore would not lead me to su¬
persede the use of the knife for a day if either the Lady
can be reconciled to this or that the circumstances
above mentioned do not forbid it.
If either of these conditions are in the case we
must make the most of medicines we can. The Cicuta
may be continued increasing the doses always so as
to produce sensible effects. But if in spite of the
[Page 3]
Cicuta the ulcerating increase and new ones are formed
or ↑especially↑ if the disease shall become more painfull I would de¬
pend no longer on the Cicuta but try the Belladonna
which tho not absolutely certain has with me been [more?]
commonly more effectual than the Cicuta
You must begin with half a grain of the dried leaf
infused for six hours in two ounces of boiling water
and such an infusion is to be taken twice a day.
This dose may appear small and have no sensible effects
but in that case the dose is to be increased by half a
grain every day till ↑it↑ shews its effects in giving some
sickness at stomach or some confusion of head and
at a such a dose it is to be continued till these effects
disappear, when it may again be a little increased.
It is hoped that this medicine will prove a more
powerful anddyne 1 than the cicuta and that it will
bring the ulcerations to produce a better pus and even
to dispose them to heal. The operation of this
medicine
Notes:
1: A slip of the pen for "Anodyne".
Diplomatic Text
For x x x x x
I have very attentively considered the case communi¬
cated by Mr Hutchinson and need not say anything of
the nature of the disease which tho suffered at present
with very little uneasiness is certainty of very dangerous
tendency; as it may not only prove fatal but what is
perhaps worse may become a very painfull disease.
All this was certainly apprehended by Dr Hunter
when he advised the only certain means of preventing both
events and as in spite of any remedies hitherto employed
the disease seems to be constantly advancing and tho other
remedies may still be proposed as there are none of them ab¬
solutely certain I believe that extirpation would still be the
most prudent measure: providing always that the circum¬
stances of the tumour are such as to admit of it, that is that
the tumour can still be easily and entirely separated from
the ribs, that it has sent out no branches towards the arm¬
pit and that there are still no indurated or even [seized?]
[Page 2]
glands in the axilla for in these circumstances the tu¬
mour could not taken away either entirely or to any good
purpose.
The regimen advised for this lady was certainly very
proper, tho it was perhaps more rigorous in diet than ne¬
cessary at first but now she has submitted to it I think
a fuller diet would have a very bad effect
I think the use of the Cicuta was also very properly
prescribed and it has probably kept the Lady more free
from pain than she would otherwise have been but I
think it has hardly at all retarded the progress of the
disease. The use of it therefore would not lead me to su¬
persede the use of the knife for a day if either the Lady
can be reconciled to this or that the circumstances
above mentioned do not forbid it.
If either of these conditions are in the case we
must make the most of medicines we can. The Cicuta
may be continued increasing the doses always so as
to produce sensible effects. But if in spite of the
[Page 3]
Cicuta the ulcerating increase and new ones are formed
or ↑especially↑ if the disease shall become more painfull I would de¬
pend no longer on the Cicuta but try the Belladonna
which tho not absolutely certain has with me been [more?]
commonly more effectual than the Cicuta
You must begin with half a grain of the dried leaf
infused for six hours in two ounces of boiling water
and such an infusion is to be taken twice a day.
This dose may appear small and have no sensible effects
but in that case the dose is to be increased by half a
grain every day till ↑it↑ shews its effects in giving some
sickness at stomach or some confusion of head and
at a such a dose it is to be continued till these effects
disappear, when it may again be a little increased.
It is hoped that this medicine will prove a more
powerful anddyne 1 than the cicuta and that it will
bring the ulcerations to produce a better pus and even
to dispose them to heal. The operation of this
medicine
Notes:
1: A slip of the pen for "Anodyne".
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