Cullen

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

 

[ID:5192] From: Dr William Cullen (Professor Cullen) / To: Mr Malcolm MacLaurin (of Barcaldine) / Regarding: Mrs Campbell (of Barcaldine) (Patient) / 3 January 1786 / (Outgoing)

Reply, 'For Mrs Campbell of Barcaldine'

Facsimile

There are 8 images for this document.

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Metadata

FieldData
DOC ID 5192
RCPE Catalogue Number CUL/1/1/19/4
Main Language English
Document Direction Outgoing
Date3 January 1786
Annotation None
TypeMachine scribal copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply, 'For Mrs Campbell of Barcaldine'
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1857]
Case of Mrs Campbell of Barcaldine with a complex history of complaints including episodes of headaches, vertigo and vomiting, but most recently swollen legs. Symptoms are attributed to a menstrual disorder.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:5881]AddresseeMr Malcolm MacLaurin (of Barcaldine)
[PERS ID:5723]PatientMrs Campbell (of Barcaldine)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:5881]Patient's Physician / Surgeon / ApothecaryMr Malcolm MacLaurin (of Barcaldine)

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
Destination of Letter Barcaldine Glasgow and West Scotland Europe inferred

Normalized Text

[Page 1]

For Mrs. Campbell of Barcaldine


I have attentively considered the Case which
is very distinctly and seemingly very fully descri¬
bed by Mr. McLaurin.


I have no doubt that the Ailments were
begun by the sudden stopping of the Menses and
though this did not show any considerable
disorder for many years after I have no doubt
that it laid the foundation of visceral obstru¬
ctions
which have occasioned the effects which
have appeared since Summer last.


As the symptoms now appearing depend
upon Visceral Obstruction they must be of
difficult cure but despair is never to be
admitted and I shall advise what I think
most probable to be of relief.


{illeg} this I have little regard to the
{illeg} I believe they have



[Page 2]

{illeg} removing by accidental cold [wine?] I am to {illeg}
chiefly the {illeg} if the
Cough and Dyspnea depend upon the [same?]
{illeg} they will be relieved by the same remedies
and I would therefore advise no other remedy
for the Cough but the continuance of the Opiate
at bed time, so much and so far as Cough and
restlessness may seem to require, for I do not
think that the Opiate will interfere with
any other plan I have to offer


I must own that the Practitioners who
have treated her case before followed probable
{illeg} they employed Emetics and
Purgatives if they {illeg} them with [obstinacy?]
but both because they have been ineffectual
and because the patient is ↑probably↑ now too much
weakened to bear them I shall not now
advise any repetition of such remedies and
only say with respect to purgatives that as



[Page 3]

far as Costiveness requires, some laxative, may
from time to time be necessary, and I would
especially advise the Cream of Tartar and Jalap
which if the Jalap be previously well
triturated with a portion of the Cream of Tartar
the mixture may be made sufficiently mild
or sufficiently strong as circumstances may
seem to demand.


As the indication which in this Case
presents itself to me is the resolving obstruc¬
ted Viscera and evacuating collected water
I would proceed in this manner. Let the
Diuretic pills prescribed ↑at↑ A in the inclosed
paper be entered upon immediately and let
her take one pill every three or four hours
through the course of the day, and the
management is intended to carry the
medicine to the kidneys without offending



[Page 4]

the Stomach or {illeg} preventing the conti¬
nuance of the medicine, but if it shall be
found that a single piece does not at all
affect the stomach, two pills may be taken
for a dose, or in renewing the composition
instead of a quarter, half a grain of the
properly dried Squill may be put into every
pill, or indeed the dose of the squill may
be carried as far as it can be without
disturbing the stomach while by separating
the doses a considerable quantity of it may
be upon the whole introduced. At the Same
time with these diuretic pills let the ape¬
rient
pill also prescribed ↑at B↑ on the same paper
be employed, giving one every night at bed time
and I hope they may be continued for two
weeks together and then being intermitted
for a week they may be taken again for two
weeks more, but as I do not know what
may be the Lady's particular condition (↑situation↑)


[Page 5]

in this respect let care be taken during the
use of the Aperient pill that neither it
run off by stool nor touch the mouth.


Every night let the aperient pill
be washed down with four Ounces of the aperient de¬
coction prescribed also ↑at C↑ on the inclosed paper
I have prescribed it in small quantity
because I would have it made fresh every
second day.


When an Anodyne is taken, it may be
taken an hour before the Ladys lying down
and the aperient pill and decoction may be
taken just when she is going to lie down, or
when she is laid down, or if it happens that
the Lady chuses, or is obliged to lie down
before she takes other of her medicines
it will be enough if there is an hour left
be taken the Anodye and aperient medicines


During the use of these medicines



[Page 6]

I shall be glad to find the Lady able to take daily
some Exercise in her Carriage. I am not indeed advising
it in the present State of the weather, but when
the frost and snow shall be gone I think it
would be of great service.


In diet I have no Nicety to advise and
would leave it to the Ladys own discretion
to take what her appetite suggests providing
only she knows at the same time that her
digestion is suitable to the {illeg}.


In drinking I would not have her indulge
much in Tea or other such watery liquor
neither would I enjoy much abstemiousness
in drinking and I think two or three glasses of
any white wine that she likes best may be
taken every day, partly with and partly without
water, and if the wine shows any tendency to
become sour, she may take some Gin and water
as she has done before.


I take no notice of the discharge of



[Page 7]

water
from her legs and thighs, as the ma¬
nagement of it must be left to the discretion
of a surgeon upon the spot who can see the
daily seat of it. I am surprised to find that
though the discharge is said to be copious it
has no effect of in taking down the swelling.


The above is all that occurs
to me to be said at present, but as
the Case may take different turns
I shall be ready upon a further account
to advise as occasion may require


William Cullen

Edinburgh 3d. January
1786



[Page 8]

For Mrs. Campbell of Barcaldine

Take ten grains of powder of squills well {illeg}, twenty grains of powder of millipedes, and enough syrup of squills in order to obtain a mass to be divided into sixty pills. Label: Diuretic Pills; one, two, or three to be taken several times every day.

Tale ten grains of Calomel and one drachm of Extract of liquorice. After having divided the extract into small pieces, pour over it enough boiling water in order to let it soften and reduced into a pulp, to which you add the Calomel, and divide in fourteen pills. Label: Aperient pills; one to be taken every evenong.

Take two drachms of {illeg} gum guaiacum, and one drachm of will carrot seeds. Cook in one pound of water until it reduces to half a pound, adding towards the end two drachms of crushed berries of Juniper. Add, to the strained liquid, half an ounce of compounded Water of Juniper and Syrup of {illeg} Label: Aperient decoction; four ounces to be taken with the aperient pill every evening.


W.C.

3rd. January 1786

Diplomatic Text

[Page 1]

For Mrs. Campbell of Barcaldine


I have attentively considered the Case which
is very distinctly and seemingly very fully descri¬
bed by Mr. McLaurin.


I have no doubt that the Ailments were
begun by the sudden stopping of the Menses and
though this did not show any considerable
disorder for many years after I have no doubt
that it laid the foundation of visceral obstru¬
ctions
which have occasioned the effects which
have appeared since Summer last.


As the symptoms now appearing depend
upon Visceral Obstruction they must be of
difficult cure but despair is never to be
admitted and I shall advise what I think
most probable to be of relief.


{illeg} this I have little regard to the
{illeg} I believe they have



[Page 2]

{illeg} removing by accidental cold [wine?] I am to {illeg}
chiefly the {illeg} if the
Cough and Dyspnea depend upon the [same?]
{illeg} they will be relieved by the same remedies
and I would therefore advise no other remedy
for the Cough but the continuance of the Opiate
at bed time, so much and so far as Cough and
restlessness may seem to require, for I do not
think that the Opiate will interfere with
any other plan I have to offer


I must own that the Practitioners who
have treated her case before followed probable
{illeg} they employed Emetics and
Purgatives if they {illeg} them with [obstinacy?]
but both because they have been ineffectual
and because the patient is ↑probably↑ now too much
weakened to bear them I shall not now
advise any repetition of such remedies and
only say with respect to purgatives that as



[Page 3]

far as Costiveness requires, some laxative, may
from time to time be necessary, and I would
especially advise the Cream of Tartar and Jalap
which if the Jalap be previously well
triturated with a portion of the Cream of Tartar
the mixture may be made sufficiently mild
or sufficiently strong as circumstances may
seem to demand.


As the indication which in this Case
presents itself to me is the resolving obstruc¬
ted Viscera and evacuating collected water
I would proceed in this manner. Let the
Diuretic pills prescribed ↑at↑ A in the inclosed
paper be entered upon immediately and let
her take one pill every three or four hours
through the course of the day, and the
management is intended to carry the
medicine to the kidneys without offending



[Page 4]

the Stomach or {illeg} preventing the conti¬
nuance of the medicine, but if it shall be
found that a single piece does not at all
affect the stomach, two pills may be taken
for a dose, or in renewing the composition
instead of a quarter, half a grain of the
properly dried Squill may be put into every
pill, or indeed the dose of the squill may
be carried as far as it can be without
disturbing the stomach while by separating
the doses a considerable quantity of it may
be upon the whole introduced. At the Same
time with these diuretic pills let the ape¬
rient
pill also prescribed ↑at B↑ on the same paper
be employed, giving one every night at bed time
and I hope they may be continued for two
weeks together and then being intermitted
for a week they may be taken again for two
weeks more, but as I do not know what
may be the Lady's particular condition (↑situation↑)


[Page 5]

in this respect let care be taken during the
use of the Aperient pill that neither it
run off by stool nor touch the mouth.


Every night let the aperient pill
be washed down with four Ounces of the aperient de¬
coction prescribed also ↑at C↑ on the inclosed paper
I have prescribed it in small quantity
because I would have it made fresh every
second day.


When an Anodyne is taken, it may be
taken an hour before the Ladys lying down
and the aperient pill and decoction may be
taken just when she is going to lie down, or
when she is laid down, or if it happens that
the Lady chuses, or is obliged to lie down
before she takes other of her medicines
it will be enough if there is an hour left
be taken the Anodye and aperient medicines


During the use of these medicines



[Page 6]

I shall be glad to find the Lady able to take daily
some Exercise in her Carriage. I am not indeed advising
it in the present State of the weather, but when
the frost and snow shall be gone I think it
would be of great service.


In diet I have no Nicety to advise and
would leave it to the Ladys own discretion
to take what her appetite suggests providing
only she knows at the same time that her
digestion is suitable to the {illeg}.


In drinking I would not have her indulge
much in Tea or other such watery liquor
neither would I enjoy much abstemiousness
in drinking and I think two or three glasses of
any white wine that she likes best may be
taken every day, partly with and partly without
water, and if the wine shows any tendency to
become sour, she may take some Gin and water
as she has done before.


I take no notice of the discharge of



[Page 7]

water
from her legs and thighs, as the ma¬
nagement of it must be left to the discretion
of a surgeon upon the spot who can see the
daily seat of it. I am surprised to find that
though the discharge is said to be copious it
has no effect of in taking down the swelling.


The above is all that occurs
to me to be said at present, but as
the Case may take different turns
I shall be ready upon a further account
to advise as occasion may require


William Cullen

Edinr. 3d. Janry.
1786



[Page 8]

For Mrs. Campbell of Barcaldine


A ℞ pulv {illeg} scill rite {illeg} gr. X
--- milliped. gr. XX
Syr. Scill. q. s. f. massa dividenda
in pil. №. XL
Sig. Diuretic Pills, one two, or three to be taken
several times every day.


B ℞ Calomel gr. X
Extract. glycyrrh ʒj
Extracto in frustula conciso affunde aquæ ferventis
q. s. ut mollescat et contundatur in pulpam
cui adde Calomelos et divide in pil. № XIV
Sig. Aperient pills one to be taken every Evening.


C ℞ {illeg} lign. guaiac. ʒij
Sem. dauc. sylv. ʒj
Coque ex aquæ ℔j ad ℔ſs addendo sub finem
Bacc. Junip. contus. ʒij
colaturæ adde
Aq. Junip. comp.
Syr {illeg} @ ℥ſs
Sig Aperient decoction four ounces to be taken
with the aperient pill every Evening


W.C.

3rd. Janry. 1786

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