The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:6288] From: Dr William Cullen (Professor Cullen) / To: Dr Gilbert Blane / Regarding: Mrs (Blane) (Patient) / July? 1772? / (Outgoing)
Reply, in the form of a neatly copied retained response concerning an unnamed female patient (a 'sister' of the recipient). Undated and no names mentioned but internal evidence implies that this almost certainly is a neat copy of Cullen's reply to Gilbert Blane concerning his sister (not only do the symptoms match, but Cullen response very closely echoes Blane's very professional diagnostic account of the case). Dated accordingly.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 4 images for this document.
[Page 1]
[Page 2]
[Page 3]
[Page 4]
Metadata
| Field | Data |
|---|---|
| DOC ID | 6288 |
| RCPE Catalogue Number | CUL/1/2/2538 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | July? 1772? |
| Annotation | None |
| Type | Scribal copy ( includes Casebook Entry) |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | No |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply, in the form of a neatly copied retained response concerning an unnamed female patient (a 'sister' of the recipient). Undated and no names mentioned but internal evidence implies that this almost certainly is a neat copy of Cullen's reply to Gilbert Blane concerning his sister (not only do the symptoms match, but Cullen response very closely echoes Blane's very professional diagnostic account of the case). Dated accordingly. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:348] |
Case of the sister of Gilbert Blane who suffers from stomach paroxysms. |
2 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:352] | Addressee | Dr Gilbert Blane |
| [PERS ID:1006] | Patient | Mrs |
| [PERS ID:1007] | Patient's Physician / Surgeon / Apothecary | Mr Logan |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:352] | Patient's Physician / Surgeon / Apothecary | Dr Gilbert Blane |
| [PERS ID:352] | Patient's Relative / Spouse / Friend | Dr Gilbert Blane |
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 | inferred | |
| Destination of Letter | Maybole | Glasgow and West | Scotland | Europe | inferred |
Normalized Text
I'll have considered the full and distinct account
you have been pleased to give me of your sisters
case and Im sorry to find it a difficult one and indeed
threatening a very unfavourable event.
The symptoms are certainly spasmodic and
if I had been advised more early in the case I should
certainly have considered it as entirely of that
kind but when such symptoms continue and in¬
crease both, with (↑in↑)frequency and violence there is
reason to suspect as you do some topical and
organic affection and probably somewhat of the
Schirr↑o↑us kind. This is in general probably but
the particular circumstances are very much in
the dark and I am quite at a loss in judging
where the affection may be seated. The Intestines
are certainly affected and it appears especially by
the present state of the pain about the navel but
I can hardly believe that the Intestines are in any
part under any fixt (↑ed↑) construction or compression
while there is less constant costiveness than before
and the stools are often loose sometimes natural
The liver seems also affected and the colour of the
present vomitings might give a Suspicion of the
redundancy and ↑as↑ the whiteness of the Stools former¬
ly
[Page 2]
formerly might have made you there suppose
a deffect of bile. But all this is precarious, an
interrupted Secretion is very uncommon and an
interrupted excretion should have only
given white stools but a yellow skin which is
not mentioned in the case and the present appear¬
ances may depend entirely upon spasmodic
affections of the alimentary Canal communi¬
cated to the biliary Ducts without the Livers
being farther concerned. In short I am still un¬
determined in fixing the seal of this disorder
but am inclined to suppose it in the uterus or
ovaria rather than any where else. The menses
suppressed so easily ↑in the Case↑ encourage this supposition and
the extraordinary Effects of pregnancy on the ali¬
mentary Canal allow us to suppose any thing
on this subject
I↑a↑m afraid I have entered into thus discussion
to very little purpose but my regard for you engaged
me to consider your hints and I think myself
bound not only to cure your Sister but to give you
what instruction I can. After what I have said
I'm afraid you'll expect little instruction for your
Sisters benefite. The view of Schorrosity or any others
organic affection is to me a very desperate Case
[Page 3]
and I think it to very little purpose to say even
what may probably be done for it. However well
founded the supposition may be I think it ne¬
cessary to neglect it entirely and to take up
with some view that admits of practice. My
Plan at present therefore is to leave the organic
affection to nature and to employ our art in
relieving the spasmodic Symptoms. To this
purpose I would employ very opiates very freely
and largely. You say she sleeps tolerably well
by which I will (↑ould↑) understand that the Paroxysms
are especially in the day time and therefore
I would give the opiate a little before the expected
attack. You mention celetives (↑Sedatives↑) having been
employed and given a temporary palliation
but I find most practitioners too Cautious both
in the dose and repetition of these remedies
but let (↑and↑) it ↑should↑ be observed that in spasmodic affections
a person will bear six times larger dozes of opium
than they would do in ordinary health let the
opiate therefore be pushed pretty boldly in your
sisters Case. It is somewhat to be relieved from
pain and whatever is at bottom in (↑of↑) spasmodic
affections it is certainly always rendered worse
by the repetition of paroxysms. In short I can
[Page 4]
advise no other practice at present except
it may be what is necessary along with
the opiate to prevent the Costiveness which opia[tes?]
commonly produce. Mr Logan as acquainted
with your Sisters Constitution should know
best what will answer the purpose. He may
employ aliethecks (↑aleotics↑) magnesia or cream of
Tartar as he thinks best. If it can be had
and your Sister can take it, I have a great
favour for Castor oil. In the way of injection
I prefer warm water alone to most other things
but it must be given in large quantity
from one pound to two. and It answers
other purposes as well as opening the belly
and may be repeated at pleasure. If warm
bathing or fomentations have not been formerly
employed they might probably be now with
advantage. When you have made any trial of
this Course I beg you will let me know the effect
of it and every new circumstance as exactly [as?]
you can and you may depend upon every atten¬
tion in the power of
yours etc
Diplomatic Text
I'll have considered the full and distinct account
you have been pleased to give me of your sisters
case and Im sorry to find it a difficult one and indeed
threatening a very unfavourable event.
The symptoms are certainly spasmodic and
if I had been advised more early in the case I should
certainly have considered it as entirely of that
kind but when such symptoms continue and in¬
crease both, with (↑in↑)frequency and violence there is
reason to suspect as you do some topical and
organic affection and probably somewhat of the
Schirr↑o↑us kind. This is in general probably but
the particular circumstances are very much in
the dark and I am quite at a loss in judging
where the affection may be seated. The Intestines
are certainly affected and it appears especially by
the present state of the pain about the navel but
I can hardly believe that the Intestines are in any
part under any fixt (↑ed↑) construction or compression
while there is less constant costiveness than before
and the stools are often loose sometimes natural
The liver seems also affected and the colour of the
present vomitings might give a Suspicion of the
redundancy and ↑as↑ the whiteness of the Stools former¬
ly
[Page 2]
formerly might have made you there suppose
a deffect of bile. But all this is precarious, an
interrupted Secretion is very uncommon and an
interrupted excretion should have only
given white stools but a yellow skin which is
not mentioned in the case and the present appear¬
ances may depend entirely upon spasmodic
affections of the alimentary Canal communi¬
cated to the biliary Ducts without the Livers
being farther concerned. In short I am still un¬
determined in fixing the seal of this disorder
but am inclined to suppose it in the uterus or
ovaria rather than any where else. The menses
suppressed so easily ↑in the Case↑ encourage this supposition and
the extraordinary Effects of pregnancy on the ali¬
mentary Canal allow us to suppose any thing
on this subject
I↑a↑m afraid I have entered into thus discussion
to very little purpose but my regard for you engaged
me to consider your hints and I think myself
bound not only to cure your Sister but to give you
what instruction I can. After what I have said
I'm afraid you'll expect little instruction for your
Sisters benefite. The view of Schorrosity or any others
organic affection is to me a very desperate Case
[Page 3]
and I think it to very little purpose to say even
what may probably be done for it. However well
founded the supposition may be I think it ne¬
cessary to neglect it entirely and to take up
with some view that admits of practice. My
Plan at present therefore is to leave the organic
affection to nature and to employ our art in
relieving the spasmodic Symptoms. To this
purpose I would employ very opiates very freely
and largely. You say she sleeps tolerably well
by which I will (↑ould↑) understand that the Paroxysms
are especially in the day time and therefore
I would give the opiate a little before the expected
attack. You mention celetives (↑Sedatives↑) having been
employed and given a temporary palliation
but I find most practitioners too Cautious both
in the dose and repetition of these remedies
but let (↑and↑) it ↑should↑ be observed that in spasmodic affections
a person will bear six times larger dozes of opium
than they would do in ordinary health let the
opiate therefore be pushed pretty boldly in your
sisters Case. It is somewhat to be relieved from
pain and whatever is at bottom in (↑of↑) spasmodic
affections it is certainly always rendered worse
by the repetition of paroxysms. In short I can
[Page 4]
advise no other practice at present except
it may be what is necessary along with
the opiate to prevent the Costiveness which opia[tes?]
commonly produce. Mr Logan as acquainted
with your Sisters Constitution should know
best what will answer the purpose. He may
employ aliethecks (↑aleotics↑) magnesia or cream of
Tartar as he thinks best. If it can be had
and your Sister can take it, I have a great
favour for Castor oil. In the way of injection
I prefer warm water alone to most other things
but it must be given in large quantity
from one pound to two. and It answers
other purposes as well as opening the belly
and may be repeated at pleasure. If warm
bathing or fomentations have not been formerly
employed they might probably be now with
advantage. When you have made any trial of
this Course I beg you will let me know the effect
of it and every new circumstance as exactly [as?]
you can and you may depend upon every atten¬
tion in the power of
yours etc
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