Cullen

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

 

[ID:776] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mrs Leith (Patient) / 18 June 1765 / (Outgoing)

Reply by Cullen regarding the case of Mrs Leith, who has suffered from an ailment of the breast and pains in her back. Cullen thinks the breast pain to be most significant, and suggests that remedies should be directed towards that. Addressee unidentified.

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Metadata

FieldData
DOC ID 776
RCPE Catalogue Number CUL/1/2/44
Main Language English
Document Direction Outgoing
Date18 June 1765
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply by Cullen regarding the case of Mrs Leith, who has suffered from an ailment of the breast and pains in her back. Cullen thinks the breast pain to be most significant, and suggests that remedies should be directed towards that. Addressee unidentified.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:209]
Case of Mrs Leith who has an ailment in her back and breast.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1210]PatientMrs Leith
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr 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

[Page 1]
Dear Sir


I have got a very full ↑& exact↑ history of Mrs
Leiths former Ailments & that with your accurate
account of her present state puts me in a pretty
good condition to judge of the Case. After considering
the whole very fully I am heartily sorry to find it very
unfavourable. I am disposed to think the pains of
the back of the Rheumatic kind & tho perhaps aggravated
by the state of her blood I think we might easily get
the better of them but the Ailment in her breast
is by much the most urgent & to that our Remedies
must be directed. Happily some of these are very
↑well↑ adapted to both ailments but except in so far as this
is the Case I would neglect the pains of her ↑back↑
unless it becomes more urgent than at present


The Remedies you have already employed ap¬
pear
viz the Bark & Cicuta appear to me the
most proper possible. For the first I would endea¬
vour to bring it to two drams every day & at
that dose continue it for a fortnight. If in that
time it makes any change on the condition of the
sore & particularly if it brings a better matter it
may be continued longer but if it does ↑not↑ in a fort¬
night



[Page 2]

make some change on the sore it should then be laid
aside at lest for some time.


With regard to the Cicuta I trust to its good
effects but think it must be increased to the Dose
she can bear & I expect nothing from it till it is
brought to shew some sensible effects. Besides a
full dose I find also that a long continuance is
commonly necessary & sometimes the external use
contributes a great deal to the Cure. I would there¬
fore advise a poultice of the Pulv. Cicuta & Farin.
Avenac.
@ p. [8?]. 1 reference with as much of the Ung. Emoll.
sine Terebinth. as is necessary to prevent the poul¬
tice
from drying too much. Thes frequent use
of this application is apt to make the skin tender
& sometimes to spread the excoriation. I would there¬
fore apply it only during the night & at some time
cover the sore with a plaisterwhich may either
be Empl.
commune 2 or the Cereum 3 made with Pix
sicca 4 instead Resin. While the Cerat. e. Lap. Calam. 5
you have very properly applied keeps the sore easy it
should be continued ↑in the day time↑ but if it does not, one of the Lead
Ointments
must be employed or what is sometimes better
a poultice of bread moistened with Acet. Lithargyrites




[Page 3]


So far I have given my Remarks on your practice
& with regard to it I have only to add that the Diaphoretic
Powder seems to have ↑had↑ a good effect & urged further miight
be of great service to the pains of her back but must
think of it hardly safe to urge it at present & would ra¬
ther reserve it till perhaps pains in the breast ↑or great want of sleep may
require it.


Of my own prescription I have only one to offer
which is the Antimonial Wine & which I have found ser¬
viceable in such schirrosities. Of the Mixture pre¬
scribed below let her take a table spoonfull at ten
every Evening & if ↑this does not occasion any sickness &↑ if she lies awake she may take another
at eleven & on the like conditions a third at twelve.
The dose that gives a little sickness & Nausea is to be
persisted in for some weeks, & I need ↑not↑ detail to you the
management either first or last that this requires.


During the use of these medicines it will be pro¬
per that the Belly be kept regular & it may be done by
the use of the Tinct. Rhei you have advised but I think
it may be also proper for Mrs Leith to take during a
great part of the summer season a muchkin ↑or more↑ of of new
drawn Cow Milk Whey every morning.


With regard to Mrs Leiths Diet I have only to
say that without being low it should be light
& cool avoiding salt meats, high seasoning, heavy meats
or much Fish.




[Page 4]


At present I am perswaded that Mrs Leith cannot
bear much Exercise & I should by no means urge but if
she ↑can↑ contrive to get a little fresh air with gentle easy
motion every day it will certainly be of service.


I suppose you understood by ↑my↑ not mentioning it that
I did not intend any application to the right breast & it is
so but ↑I would↑ have her keep it constantly covered with a bit of
very good soft Fur which is the very best means of defending
it from every ruder compression.


When any new Circumstance casts up I shall be
expect to hear from you & it will give me great pleasure
if I can in the least contribute to the relief of a Lady
& family I have a very great regard for. Believe me always

Take eight and a half ounces of Cinnamon Water, half an ounce of Antimonial Wine. Mix. [Label]: The Antimonial Mixture, half a table spoonfull for a dose.

18 June 1765

Notes:

1: This appears to be a page reference but no formula has been traced in the Pharmacopoeia Collegii Regii Medicorum Edinburgensis which is the most obvious source.

2: 'common or ordinary'.

3: Literally means 'blue', but refers to a particular type of medicated plaster usually made with Burgundy Pitch.

4: 'Dry'.

5: This abbreviated ingredient is unclear, but it may refer to Calamus.

Diplomatic Text

[Page 1]
Dr Sir


I have got a very full ↑& exact↑ history of Mrs
Leiths former Ailments & that with your accurate
account of her present state puts me in a pretty
good condition to judge of the Case. After considering
the whole very fully I am heartily sorry to find it very
unfavourable. I am disposed to think the pains of
the back of the Rheumatic kind & tho perhaps aggravated
by the state of her blood I think we might easily get
the better of them but the Ailment in her breast
is by much the most urgent & to that our Remedies
must be directed. Happily some of these are very
↑well↑ adapted to both ailments but except in so far as this
is the Case I would neglect the pains of her ↑back↑
unless it becomes more urgent than at present


The Remedies you have already employed ap¬
pear
viz the Bark & Cicuta appear to me the
most proper possible. For the first I would endea¬
vour to bring it to two drams every day & at
that dose continue it for a fortnight. If in that
time it makes any change on the condition of the
sore & particularly if it brings a better matter it
may be continued longer but if it does ↑not↑ in a fort¬
night



[Page 2]

make some change on the sore it should then be laid
aside at lest for some time.


With regard to the Cicuta I trust to its good
effects but think it must be increased to the Dose
she can bear & I expect nothing from it till it is
brought to shew some sensible effects. Besides a
full dose I find also that a long continuance is
commonly necessary & sometimes the external use
contributes a great deal to the Cure. I would there¬
fore advise a poultice of the Pulv. Cicuta & Farin.
Avenac.
@ p. [8?]. 1 reference with as much of the Ung. Emoll.
sine Terebinth. as is necessary to prevent the poul¬
tice
from drying too much. Thes frequent use
of this application is apt to make the skin tender
& sometimes to spread the excoriation. I would there¬
fore apply it only during the night & at some time
cover the sore with a plaisterwhich may either
be Empl.
commune 2 or the Cereum 3 made with Pix
sicca 4 instead Resin. While the Cerat. e. Lap. Calam. 5
you have very properly applied keeps the sore easy it
should be continued ↑in the day time↑ but if it does not, one of the Lead
Ointments
must be employed or what is sometimes better
a poultice of bread moistened wth Acet. Lithargyrites




[Page 3]


So far I have given my Remarks on your practice
& with regard to it I have only to add that the Diaphoretic
Powder seems to have ↑had↑ a good effect & urged further miight
be of great service to the pains of her back but must
think of it hardly safe to urge it at present & would ra¬
ther reserve it till perhaps pains in the breast ↑or great want of sleep may
require it.


Of my own prescription I have only one to offer
which is the Antimonial Wine & which I have found ser¬
viceable in such schirrosities. Of the Mixture pre¬
scribed below let her take a table spoonfull at ten
every Evening & if ↑this does not occasion any sickness &↑ if she lies awake she may take another
at eleven & on the like conditions a third at twelve.
The dose that gives a little sickness & Nausea is to be
persisted in for some weeks, & I need ↑not↑ detail to you the
management either first or last that this requires.


During the use of these medicines it will be pro¬
per that the Belly be kept regular & it may be done by
the use of the Tinct. Rhei you have advised but I think
it may be also proper for Mrs Leith to take during a
great part of the summer season a muchkin ↑or more↑ of of new
drawn Cow Milk Whey every morning.


With regard to Mrs Leiths Diet I have only to
say that without being low it should be light
& cool avoiding salt meats, high seasoning, heavy meats
or much Fish.




[Page 4]


At present I am perswaded that Mrs Leith cannot
bear much Exercise & I should by no means urge but if
she ↑can↑ contrive to get a little fresh air with gentle easy
motion every day it will certainly be of service.


I suppose you understood by ↑my↑ not mentioning it that
I did not intend any application to the right breast & it is
so but ↑I would↑ have her keep it constantly covered with a bit of
very good soft Fur which is the very best means of defending
it from every ruder compression.


When any new Circumstance casts up I shall be
expect to hear from you & it will give me great pleasure
if I can in the least contribute to the relief of a Lady
& family I have a very great regard for. Believe me always


℞ Aq. Cinnam. s. v. ℥iijſs
Vin. Emetic. Antimon. ℥ſs
ℳ The Antimonial Mixture half a table
spoonfull for a Dose

18 June 1765

Notes:

1: This appears to be a page reference but no formula has been traced in the Pharmacopoeia Collegii Regii Medicorum Edinburgensis which is the most obvious source.

2: 'common or ordinary'.

3: Literally means 'blue', but refers to a particular type of medicated plaster usually made with Burgundy Pitch.

4: 'Dry'.

5: This abbreviated ingredient is unclear, but it may refer to Calamus.

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