The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:1663] From: Mr William Wightman / To: Dr William Cullen (Professor Cullen) / Regarding: Mrs Grieve (Patient) / 29 April 1779 / (Incoming)
Letter from William Wightman giving the case history of Mrs Grieve, who consulted Cullen the previous winter for stomach complaints. She has had various menstrual problems which eventually indicated the menopause, and now has eruptions and pains in the arm. She has a previous history of arm pain and the excision of part of her right breast for suspected cancer in 1777.
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- Normalized Text
- Diplomatic Text
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- People
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Facsimile
There are 4 images for this document.
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Metadata
| Field | Data |
|---|---|
| DOC ID | 1663 |
| RCPE Catalogue Number | CUL/1/2/750 |
| Main Language | English |
| Document Direction | Incoming |
| Date | 29 April 1779 |
| Annotation | None |
| Type | Authorial original |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | No |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Letter from William Wightman giving the case history of Mrs Grieve, who consulted Cullen the previous winter for stomach complaints. She has had various menstrual problems which eventually indicated the menopause, and now has eruptions and pains in the arm. She has a previous history of arm pain and the excision of part of her right breast for suspected cancer in 1777. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:726] |
Case of Mrs Grieve who apparently consulted Cullen in winter of 1778-79 for a stomach ailment. She has a long history of arm pains; in February 1777 underwent a partial mastectomy for suspected breast cancer in 1779 develops respiratory difficulties. |
6 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:2385] | Author | Mr William Wightman |
| [PERS ID:1] | Addressee | Dr William Cullen (Professor Cullen) |
| [PERS ID:2583] | Patient | Mrs Grieve |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:2385] | Patient's Physician / Surgeon / Apothecary | Mr William Wightman |
Places linked to this document
| Role in document | Specific Place | Settlements / Areas | Region | Country | Global Region | Confidence |
|---|---|---|---|---|---|---|
| Place of Writing | Eyemouth (Eymouth) | Borders | Scotland | Europe | certain | |
| Destination of Letter | Cullen's House / Mint Close | Edinburgh | Edinburgh and East | Scotland | Europe | certain |
Normalized Text
I have here sent you a state of the Case of Mrs. Grieve who consulted
you some time in Winter last for some stomach Complaints.
As her present complaints may appear of a doubtful nature, it may
not be improper to begin the History of her case pretty far back.
In June 1776 she first began to complain of a pain in the Joint of
the right shoulder extending down the muscle of the Arm & forearm
to the fingers with a small swellling of the Whole arm, the pain &
swelling I remember were removed in a few Weeks by Blooding,
application of the Volatile Liniment & a blister, only a small
numbness in the Arm, & a slight stiffness remained in the Joint
of the Shoulder for some time after the pain was removed. ––––
In the month of October the same year, she complained of a hard¬
ness & swelling occupying almost the whole of the Apex of the
right breast, attended with very little pain, she did not remem¬
ber of any stroke she received or at least it was so slight as not
to be noticed at the time, a small ulceration appeared soon after
below the Areola, in short after a trial of the Bark & Cicuta
to no purpose, a considerable portion of the Breast was taken
off the 1.st of February 77 before there was any Affection of the Glands
of the Axilla ––––
After this she enjoyed a very good state of health till the middle
of August last when having arrived at that period wherein the
menses were about to leave her, she began to complain of a
sickness at the stomach, a spitting of Insipid watery stuff, & such
other Symptoms as she herself would relate to you formerly
[Page 2]
The symptoms by her own account perfectly resembling what used
to attend a suppression of the Menses from pregnancy. I considered
them more as originating from no other cause than that natural
suppression which occurred, & accordingly they have been considera¬
bly better this some time, the Menses as is ordinarily the case
have continued to be obstructed for several periods & then returned
with greater violence, but now seem to have left her entirely.
About Six Weeks ago she complained of pains in the left & also in the
right Shoulder extending down the muscles on the back part
of the arm to the Elbow, & from that to the Hand with a Coldness
& numbing of the part, they do not seem much affected by the
Heat of the bed, but are rather the better for that, & rubbing which
generally gives a temporary ease, there is not much moisture
appears naturally, neither is there an obstinate dryness, but
frequently there is an Eruption of small red pimples which
seldom advance much without the skin, when this Eruption
is most considerable the pains are always the easiest, it hath
been most plentiful on the left arm which is also the freest
from pain. Pulse is generally about 80, & firm, appetite good
except when the pains are most severe which is generally towards
the Evening, & when they come on they are constant gnawing kind
of pains, not in sharp shooting stitches.
Being uncertain what nature to consider the pains to be of –
I have directed my Intentions of cure to the three following Indications
1st. To lessen the plenitude of the System, in general.
2 To endeavour at amending any fault in the Constitution &
3 To ease the pain.
[Page 3]
In the first Intention Blooding hath been administered twice, & hath
given a short relief the blood exhibited a good deal of the buffy Coat –
Cooling Laxatives repeted frequently. Whey drunk in pretty large
quantities, & on the whole as low a Diet as the stomach complaints
will admit of. A pea issue was put into her arm the beginning
of Winter & still continued. ––
To answer the second Intention the Bark hath been given & also
the Decoction of Woods.
To ease the pain different Remedies have been used, Volatile Liniment
& blisters have been tried with little Effect. Frictions with the
Flesh-brush. Internally Dovers powder hath been given, at first
giving it eased the pains very much & brought on a plentiful
diaphoresis which hath been continued for 10 or 12 hours, the Patient
being clad in flannel, while the Sweat lasted the pains were quite
easy, but returned some hours after it was discontinued ––
As the Patient complained of being very faint I was afraid to conti¬
nue it any longer, she took the Dover's Powder for a good many
nights successively, till at length they made her sick, & appearing
to act merely as anodynes, they were discontinued but in their
stead I have been under the necessity of exhibiting a simple
Opiate at bed-time ––––
Are we to consider the affection of the arm which occurred in
76, & some months after was succeded by a Cancerous tumour
of the breast of the same side, as depending on the same
cause; or are we to reckon both it, & the present affections as
perfectly distinct & unconnected with the other disease?
[Page 4]
I have industriously concealed from the Patient herself, any Suspicion
that the pains are any thing but merely rheumatic, but to her friends
I have hinted the possibility of them being of a different nature
& have urged the propriety of consulting one whose knowledge
and Experience will enable him to direct me in the future mode
of treatment, & to whose Improvements & Corrections I shall always
pay a proper regard.
Your answer in course of post is expected bu the Friends &
your most Obedient humble Servant
Eymouth April 29th
1779
Mr Wightman
Concerning
Mrs Grieve.
April 29. 1779.
Diplomatic Text
I have here sent you a state of the Case of Mrs. Grieve who consulted
you some time in Winter last for some stomach Complaints.
As her present complaints may appear of a doubtful nature, it may
not be improper to begin the History of her case pretty far back.
In June 1776 she first began to complain of a pain in the Joint of
the right shoulder extending down the muscle of the Arm & forearm
to the fingers with a small swellling of the Whole arm, the pain &
swelling I remember were removed in a few Weeks by Blooding,
application of the Volatile Liniment & a blister, only a small
numbness in the Arm, & a slight stiffness remained in the Joint
of the Shoulder for some time after the pain was removed. ––––
In the month of October the same year, she complained of a hard¬
ness & swelling occupying almost the whole of the Apex of the
right breast, attended with very little pain, she did not remem¬
ber of any stroke she received or at least it was so slight as not
to be noticed at the time, a small ulceration appeared soon after
below the Areola, in short after a trial of the Bark & Cicuta
to no purpose, a considerable portion of the Breast was taken
off the 1.st of Febry 77 before there was any Affection of the Glands
of the Axilla ––––
After this she enjoyed a very good state of health till the middle
of August last when having arrived at that period wherein the
menses were about to leave her, she began to complain of a
sickness at the stomach, a spitting of Insipid watery stuff, & such
other Symptoms as she herself would relate to you formerly
[Page 2]
The symptoms by her own account perfectly resembling what used
to attend a suppression of the Menses from pregnancy. I considered
them more as originating from no other cause than that natural
suppression which occurred, & accordingly they have been considera¬
bly better this some time, the Menses as is ordinarily the case
have continued to be obstructed for several periods & then returned
with greater violence, but now seem to have left her entirely.
About Six Weeks ago she complained of pains in the left & also in the
right Shoulder extending down the muscles on the back part
of the arm to the Elbow, & from that to the Hand with a Coldness
& numbing of the part, they do not seem much affected by the
Heat of the bed, but are rather the better for that, & rubbing which
generally gives a temporary ease, there is not much moisture
appears naturally, neither is there an obstinate dryness, but
frequently there is an Eruption of small red pimples which
seldom advance much without the skin, when this Eruption
is most considerable the pains are always the easiest, it hath
been most plentiful on the left arm which is also the freest
from pain. Pulse is generally about 80, & firm, appetite good
except when the pains are most severe which is generally towards
the Evening, & when they come on they are constant gnawing kind
of pains, not in sharp shooting stitches.
Being uncertain what nature to consider the pains to be of –
I have directed my Intentions of cure to the three following Indications
1st. To lessen the plenitude of the System, in general.
2 To endeavour at amending any fault in the Constitution &
3 To ease the pain.
[Page 3]
In the first Intention Blooding hath been administered twice, & hath
given a short relief the blood exhibited a good deal of the buffy Coat –
Cooling Laxatives repeted frequently. Whey drunk in pretty large
quantities, & on the whole as low a Diet as the stomach complaints
will admit of. A pea issue was put into her arm the beginning
of Winter & still continued. ––
To answer the second Intention the Bark hath been given & also
the Decoct. Lignorum.
To ease the pain different Remedies have been used, Volatile Liniment
& blisters have been tried with little Effect. Frictions with the
Flesh-brush. Internally Dovers powder hath been given, at first
giving it eased the pains very much & brought on a plentiful
diaphoresis which hath been continued for 10 or 12 hours, the Patient
being clad in flannel, while the Sweat lasted the pains were quite
easy, but returned some hours after it was discontinued ––
As the Patient complained of being very faint I was afraid to conti¬
nue it any longer, she took the pulvis Doveri for a good many
nights successively, till at length they made her sick, & appearing
to act merely as anodynes, they were discontinued but in their
stead I have been under the necessity of exhibiting a simple
Opiate at bed-time ––––
Are we to consider the affection of the arm which occurred in
76, & some months after was succeded by a Cancerous tumour
of the breast of the same side, as depending on the same
cause; or are we to reckon both it, & the present affections as
perfectly distinct & unconnected with the other disease?
[Page 4]
I have industriously concealed from the Patient herself, any Suspicion
that the pains are any thing but merely rheumatic, but to her friends
I have hinted the possibility of them being of a different nature
& have urged the propriety of consulting one whose knowledge
and Experience will enable him to direct me in the future mode
of treatment, & to whose Improvements & Corrections I shall always
pay a proper regard.
Your answer in course of post is expected bu the Friends &
your most Obed.t humble Serv.t
Eymouth April 29th
1779
Mr Wightman
C
Mrs Grieve.
April 29. 1779.
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