Cullen

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

 

[ID:3769] From: Dr William Cullen (Professor Cullen) / To: Dr James Kenneth Saunders / Regarding: Lady Abercrombie (Abercromby) (Patient) / 18 January 1775 / (Outgoing)

Reply 'To Dr [James] Saunders about Lady Abercrombie', largely concerned with purging and the continued use of an issue and other treatments. Identification of addressee as Dr James Saunders of Banff manifest from his other letters concerning the Abercromby family.

Facsimile

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[Page 2]


 
 

Metadata

FieldData
DOC ID 3769
RCPE Catalogue Number CUL/1/1/5/32
Main Language English
Document Direction Outgoing
Date18 January 1775
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply 'To Dr [James] Saunders about Lady Abercrombie', largely concerned with purging and the continued use of an issue and other treatments. Identification of addressee as Dr James Saunders of Banff manifest from his other letters concerning the Abercromby family.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:314]
Case of Lady Abercrombie [Abercromby] who is pale and short of breath; she believes she may be jaundiced.
4


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:596]AddresseeDr James Kenneth Saunders
[PERS ID:1522]PatientLady Abercrombie (Abercromby)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:596]Patient's Physician / Surgeon / ApothecaryDr James Kenneth Saunders

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Edinburgh Edinburgh and East Scotland Europe certain
Destination of Letter Banff (Bamf) East Highlands Scotland Europe inferred

Normalized Text

[Page 1]
Smeaton
To Dr Saunders about Lady Abercrombie
Dear Dr

Edinburgh
January 18
1775
Leucophlegmalia

I have received your account of L. As case drawn with
your usual accuracy & judgement. I have no doubt about
the nature of it. It is a Leukophlegmasia in a high degree
with effusions into the Pericardium and probably into the
cavity of the Thorax. It is founded in a ↑very↑ general loss of tone &
therefore attended with so much failure of strength. This can
not be easily recovered and especially if it has been preceeded
as may suspected by some considerable obstruction in the abdo¬
minal
viscera.


The measures you have already pursued were extremely
proper but as they have not been so efficacious as we could
wish we must try some others. I am persuaded that L. As -
present state will not bear any great evacuation by stool.
and therefore will not bear any of the Hydrogogue Purga¬
tives,
but some evacuation by stool may be usefull &
the medicine I would recommend is one which operates
commonly both by stool and urine. This is the Cream
of Tartar
given in Syrup. & par reprises so that she
may take from two drachms to perhaps eight in a day and if small
doses are admissable they may be taken every day. The
dose is to be determined by its purging just so much &
no more than she seems to bear easily. Even in small doses
long continued it has proved an effectual diuretic with little




[Page 2]


or no purging. While this Medicine is employed I would en¬
deavour at the same time to restore the tone of the system.
& I find nothing better for that purpose than the
prepared Limat Martis given from two to ten grams as
the stomach bears it once or twice a day. Thestomach
bears it better for being mixed with a little powdered
cinnamon and sugar. With the Chalybeate you may
give as another Tonic the Peruvian Bark in any form that
is most agreable, but you neednot strain this
matter because I dont expect that any quantity that
may be very so usefull can be taken. In advising
these Medicines I do not mean to exclude you from
using any other Diuretics which you have found usefull
or shall here of after here after find suited n
to the circumstances of the case or the Patients Stomach
I would have the Lady continue to take what Rhe¬
nish wine she can bear without Heat or thirst .
& let her take as little other liquid as possible
Her diet may be suited to her appetite & stomach
without much niciety in any other respect. Let the
rubbing with flannel be continued by all means. I cannot
advise the repetition of Blister., but a pea Issue put in
a little below the knee has often been of signal service
& if the viscera of the thorax be not absolutely over poured
& irrecoverable the Isue may be of Service

Diplomatic Text

[Page 1]
Smeaton
To Dr Saunders about Lady Abercrombie
Dr Dr

Edinburgh
Janry 18
1775
Leucophlegmalia

I have recd your account of L. As case drawn with
your usual accuracy & judgement. I have no doubt about
the nature of it. It is a Leukophlegmasia in a high degree
with effusions into the Pericardium and probably into the
cavity of the Thorax. It is founded in a ↑very↑ general loss of tone &
therefore attended with so much failure of strength. This can
not be easily recovered and especially if it has been preceeded
as may suspected by some considerable obstruction in the abdo¬
minal
viscera.


The measures you have already pursued were extremely
proper but as they have not been so efficacious as we could
wish we must try some others. I am persuaded that L. As -
present state will not bear any great evacuation by stool.
and therefore will not bear any of the Hydrogogue Purga¬
tives,
but some evacuation by stool may be usefull &
the medicine I would recommend is one which operates
commonly both by stool and urine. This is the Cream
of Tartar
given in Syrup. & par reprises so that she
may take from ʒij to perhaps viij in a day and if small
doses are admissable they may be taken every day. The
dose is to be determined by its purging just so much &
no more than she seems to bear easily. Even in small doses
long cont,d it has proved an effectual diuretic with little




[Page 2]


or no purging. While this Med is employed I would en¬
deavour at the same time to restore the tone of the system.
& I find nothing better for that purpose than the
Limat. mart. præparat. given from ij to x gr. as
the stomach bears it once or twice a day. Thestomach
bears it better for being mixed with a little powdered
cinnamon and sugar. With the Chalybeate you may
give as another Tonic the Per. B. in any form yt
is most agreable, but you neednot strain this
matter because I dont expect that any qty that
may be very so usefull can be taken. In advising
these Meds I do not mean to exclude you from
using any other Diuretics wc you have found usefull
or shall here of after here after find suited n
to the circumstances of the case or the Patients Stomh
I would have the Lady cont to take what Rhe¬
nish wine she can bear without Heat or thirst .
& let her take as little other liquid as possible
Her diet may be suited to her appetite & stomach
witht much niciety in any other respect. Let the
rubbing with flannel be contd by all means. I cannot
advise the repetition of Blister., but a pea Issue put in
a little below the knee has often been of signal service
& if the viscera of the thorax be not absolutely over poured
& irrecoverable the Isue may be of Service

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