Cullen

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

 

[ID:2133] From: Dr Alexander Taylor (Sanders) / To: Dr William Cullen (Professor Cullen) / Regarding: Mr William Orr ((later) of Ingliston, then Ralston) (Patient) / 14 January 1782 / (Incoming)

Letter from Alexander Taylor concerning the case of a Paisley merchant, William Orr, whose eyes have become very sensitive to the light, and has also had a skin rash. He is a thin, delicate young man of 32, and has had a badly sprained ankle, severe toothache, requiring extraction, and problems with digestion after eating a lobster.

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Metadata

FieldData
DOC ID 2133
RCPE Catalogue Number CUL/1/2/1208
Main Language English
Document Direction Incoming
Date14 January 1782
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from Alexander Taylor concerning the case of a Paisley merchant, William Orr, whose eyes have become very sensitive to the light, and has also had a skin rash. He is a thin, delicate young man of 32, and has had a badly sprained ankle, severe toothache, requiring extraction, and problems with digestion after eating a lobster.
Manuscript Incomplete? No
Evidence of Commercial Posting Yes

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:554]
Case of William Orr who has an eye condition.
13


People linked to this document

Person IDRole in documentPerson
[PERS ID:207]AuthorDr Alexander Taylor (Sanders)
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:211]PatientMr William Orr ((later) of Ingliston, then Ralston)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:207]Patient's Physician / Surgeon / ApothecaryDr Alexander Taylor (Sanders)

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Paisley Glasgow and West Scotland Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain
Place of Handstamp Paisley Glasgow and West Scotland Europe certain

Normalized Text

[Page 1]
Paisley 14 January 1782
Sir


It is fully 2 months
since Mr. Willm. Orr, merchant in this
place felt from no apparent cause
his eyes uneasy – it was at first an uneasi¬
ness as if full of motes
– then soon after¬
wards became impatient of light and felt
as if there were a weight or load upon the
upper eye-lids and the upper and fore part
of the balls of the eyes
corresponding to them
When there was any light he found it very
uneasy to lift up
his eye-lids; but in darkness
this was done easily; he likewise could move
in darkness could move the eyeballs them¬
selves without increasing the weight or un¬
easiness – soon after he Complained I saw
him but could observe no external inflamma¬
tion
– he himself thought the outer Angles of
the eye-lids
inflamed, but I cannot say this was



[Page 2]

perceptible to me – it was with difficulty
I got a moments time to look into them but
I observed the Pupil to be much Contracted &
his eyes had a wearied appearance like in
one who had long wanted sleep; and he Com¬
plained that his eyes were dry and that
his nose never watered –– his pulse was re¬
gular and slow and soft
; and he was
otherwise in perfect health –– fearing an
inflammation of
the Retina I applied a dozen
of leeches
to the brow and temples – I likewise
prescribed a very low Regimen and gave
him a weak solution of the Sugar of Lead
to bathe his eyes and the Lead Ointment to anoint
them
–– the leeches bled freely but 24 hours
after a pale redish swelling appeared above
his left eye and this continued for two days
extending itself so as to swell the adjacent
eye-lid
and the part betwixt the eyebrows
This swelling did not appear to be occasioned by the
leeches
for, besides that it was full 24 hours
before it appeared, it had never any appearance


[Page 3]

of extravasation – upon this symptom I too
took a full pound of blood from the jugular
but without benefit – in a day or 2 the
leeches were applied again
and afterwards
much against his inclination a blister to the
neck
for he had formerly from a blister
suffered much by a strangury – but this ap¬
plication was followed by a very distress¬
ing Circumstance, for he did not get two (↑one↑) hours
sleep in one night for ten nights afterwards

– whether this was owing to apprehension
(for the blister gave no Considerable Pain)
putting him out of his usual Course as
he himself suspected; or to what other Cause
I do not determine; but his eyes remained
&c. remained exactly as before nor
was he so much hurt in this respect as one
would have expected – but he felt
himself faintish and weak and his pulse
became still more slow and feeble
; and it
was then thought proper to try if a Diet
a little more solid and a glass of Wine


[Page 4]

and some exercise in a darkened Chaise
would not bring about an alteration – this
{illeg} was attended with success and
he has ↑since↑ been restored to his rest but his
eyes
tho' likewise better remain still
far from well – he can now look up
longer at a time and when he does look
he sees as distinctly as ever but they
are still very impatient of light – with
these few days an eruption has appeared,
over his hands and different parts of
his body, of little clear pimples much
like the miliary but harder
; but from
this no effect has been produced on his
eyes
–––– All along he has been
kept in a darkened room and the air
around kept cool, and his eyes have not
been tied up or Confined – his belly
has been kept easy with small doses of
salts; and he twice or thrice has got a
Dose so as to purge him more freely


[Page 5]

and since this eruption two grains
of Calomel have for two night successive
nights been given and a purge after
of
Jalap and Cream of Tartar.


Sometimes tho' not often he has
Complained of a pain of his fore-head
but it never continued long nor has
his stomach ever been affected with
squeamishness –– he is a thin made
man of 32 years of age and delicate
so that a slight Cause disorders ↑him↑ and he
has therefore always been regular
and temperate ––


There are some other particu¬
lars which it is perhaps necessary
you should be informed of – five years
since he strained his ankle which re¬
mained weak for a very long time
; it
was upwards of a year before he had the use
of it – and it is a year and a half since



[Page 6]

he had an attack of the tooth ache
in the backmost tooth of the Upper Jaw
which affected that side of his head with
excessive Pain shooting upwards to
the temple and backwards to the
ear
with intolerable shootings.
The tooth after different and severe
attempts was at last fully extracted
piece-meal
; but gave not the smallest
alleviation – he was blistered and
blooded but all in Vain. And
it was not till after many weeks
that he got any tolerable sleep
or
ease; yet all this time his Pulse
was perfectly regular, Calm and slow
soft and slow
–– I forgot to mention
that a fortnight before his eyes


[Page 7]

became uneasy, after having disordered
his stomach with eating of a Lobster
he had a severe Vomiting and Purging
but he at the time felt no straining
nor uneasiness in his eyes nor for 2
weeks after and I can therefore
scarce think the two Conne[cted.]



I have been as particular as
possible in this account but if you
think Mr. Orr's Presence necessary
he will attend you in Edinburgh.

I am Sir
your most humble servant
Alexr. Taylor

Mr. Orr wishes to have
your advice as soon as
possible.




[Page 8]


Dr. Willm. Cullen
Professor of Medicine
Edinburgh


Mr Taylor
Concerning Mr Orr.
January 1782
Vol. XIII p 256

Diplomatic Text

[Page 1]
Paisley 14 Janr. 1782
Sir


It is fully 2 months
since Mr. Willm. Orr, mercht. in this
place felt from no apparent cause
his eyes uneasy – it was at first an uneasi¬
ness as if full of motes
– then soon after¬
wards became impatient of light and felt
as if there were a weight or load upon the
upper eye-lids and the upper and fore part
of the balls of the eyes
corresponding to them
When there was any light he found it very
uneasy to lift up
his eye-lids; but in darkness
this was done easily; he likewise could move
in darkness could move the eyeballs them¬
selves without increasing the weight or un¬
easiness – soon after he Complained I saw
him but could observe no external inflamma¬
tion
– he himself thought the outer Angles of
the eye-lids
inflamed, but I cannot say this was



[Page 2]

perceptible to me – it was with difficulty
I got a moments time to look into them but
I observed the Pupil to be much Contracted &
his eyes had a wearied appearance like in
one who had long wanted sleep; and he Com¬
plained that his eyes were dry and that
his nose never watered –– his pulse was re¬
gular and slow and soft
; and he was
otherwise in perfect health –– fearing an
inflammation of
the Retina I applied a dozen
of leeches
to the brow and temples – I likewise
prescribed a very low Regimen and gave
him a weak solution of the Sacch. Saturn.
to bathe his eyes and the Ungt Saturn. to anoint
them
–– the leeches bled freely but 24 hours
after a pale redish swelling appeared above
his left eye and this continued for two days
extending itself so as to swell the adjacent
eye-lid
and the part betwixt the eyebrows
This swelling did not appear to be occasioned by the
leeches
for, besides that it was full 24 hours
before it appeared, it had never any appearance


[Page 3]

of extravasation – upon this symptom I too
took a full pound of blood from the jugular
but without benefit – in a day or 2 the
leeches were applied again
and afterwards
much against his inclination a blister to the
neck
for he had formerly from a blister
suffered much by a strangury – but this ap¬
plication was followed by a very distress¬
ing Circumstance, for he did not get two (↑one↑) hours
sleep in one night for ten nights afterwards

– whether this was owing to apprehension
(for the blister gave no Considerable Pain)
putting him out of his usual Course as
he himself suspected; or to what other Cause
I do not determine; but his eyes remained
&c. remained exactly as before nor
was he so much hurt in this respect as one
would have expected – but he felt
himself faintish and weak and his pulse
became still more slow and feeble
; and it
was then thought proper to try if a Diet
a little more solid and a glass of Wine


[Page 4]

and some exercise in a darkened Chaise
would not bring about an alteration – this
{illeg} was attended with success and
he has ↑since↑ been restored to his rest but his
eyes
tho' likewise better remain still
far from well – he can now look up
longer at a time and when he does look
he sees as distinctly as ever but they
are still very impatient of light – with
these few days an eruption has appeared,
over his hands and different parts of
his body, of little clear pimples much
like the miliary but harder
; but from
this no effect has been produced on his
eyes
–––– All along he has been
kept in a darkened room and the air
around kept cool, and his eyes have not
been tied up or Confined – his belly
has been kept easy with small doses of
salts; and he twice or thrice has got a
Dose so as to purge him more freely


[Page 5]

and since this eruption two grains
of Calomel have for two night successive
nights been given and a purge after
of
Jalap and Crem. tart..


Sometimes tho' not often he has
Complained of a pain of his fore-head
but it never continued long nor has
his stomach ever been affected with
squeamishness –– he is a thin made
man of 32 years of age and delicate
so that a slight Cause disorders ↑him↑ and he
has therefore always been regular
and temperate ––


There are some other particu¬
lars which it is perhaps necessary
you should be informed of – five years
since he strained his ankle which re¬
mained weak for a very long time
; it
was upwards of a year before he had the use
of it – and it is a year and a half since



[Page 6]

he had an attack of the tooth ache
in the backmost tooth of the Upper Jaw
which affected that side of his head with
excessive Pain shooting upwards to
the temple and backwards to the
ear
with intolerable shootings.
The tooth after different and severe
attempts was at last fully extracted
piece-meal
; but gave not the smallest
alleviation – he was blistered and
blooded but all in Vain. And
it was not till after many weeks
that he got any tolerable sleep
or
ease; yet all this time his Pulse
was perfectly regular, Calm and slow
soft and slow
–– I forgot to mention
that a fortnight before his eyes


[Page 7]

became uneasy, after having disordered
his stomach with eating of a Lobster
he had a severe Vomiting and Purging
but he at the time felt no straining
nor uneasiness in his eyes nor for 2
weeks after and I can therefore
scarce think the two Conne[cted.]



I have been as particular as
possible in this acct. but if you
think Mr. Orr's Presence necessary
he will attend you in Edinr..

I am Sir
your most humble servt.
Alexr. Taylor

Mr. Orr wishes to have
your advice as soon as
possible.




[Page 8]


Dr. Willm. Cullen
Professor of Medicine
Edinr.


Mr Taylor
C Mr Orr.
Janry. 1782
Vol. XIII p 256

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