The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:827] From: Dr Gilbert Blane / To: Dr William Cullen (Professor Cullen) / Regarding: Mrs (Blane) (Patient) / 30 June 1772 / (Incoming)
Letter from Gilbert Blane concerning the case of his sister who suffers from stomach paroxysms (Blane suspects an intestinal tumour), and containing additional information from her surgeon, Mr Logan. Blane, who had studied under Cullen, went on to become one of the leading military physicians of the later eighteenth century.
- 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 | 827 |
| RCPE Catalogue Number | CUL/1/2/94 |
| Main Language | English |
| Document Direction | Incoming |
| Date | 30 June 1772 |
| 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 Gilbert Blane concerning the case of his sister who suffers from stomach paroxysms (Blane suspects an intestinal tumour), and containing additional information from her surgeon, Mr Logan. Blane, who had studied under Cullen, went on to become one of the leading military physicians of the later eighteenth century. |
| 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:352] | Author | Dr Gilbert Blane |
| [PERS ID:1] | Addressee | Dr William Cullen (Professor Cullen) |
| [PERS ID:1006] | Patient | Mrs |
| [PERS ID:352] | Patient's Physician / Surgeon / Apothecary | Dr Gilbert Blane |
| [PERS ID:1007] | Patient's Physician / Surgeon / Apothecary | Mr Logan |
| [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 | Maybole | Glasgow and West | Scotland | Europe | certain |
Normalized Text
The respect I entertain for you and the duty I owe
to the person who is the subject of the following case has determined
me to lay it before you. I have attempted to state it with all the
precision I can, begging you will forgive innaccuracies or omissions
in a work of which I have no experience. As the patient is my sister
I have had an opportunity of observing her case minutely, for the few
days I have been with her. I derive many circumstances from
the information of Mr. Logan the surgeon who has attended her.
She is aged about 26 of a middling plump habit, had
enjoyed a very uninterrupted state of health, except some slight
heartburns and indigestions to which she was now and then subject.
In the beginning of February last she was siezed with a pain
in her stomach and sour belching, which after the use of some
stomachic medecines were relieved.
But about the end of March she was attacked with
short but violent fits of pain in her stomach, accompanied with a
distension in the umbilical and epigastric region, and borborygmos
from the navel along the left side upwards forwards the stomach.
These paroxisms were at first attended with eructations and retching
and after a few attacks with violent vomiting which gave a respite
from the pain, and was succeeded by an interval of nearly ordinary
health which was at first of several days continuance. She conti¬
nued much in this way for about nine weeks, only the duration of the
intervals of ease growing shorter. On the twelth of June the
[Page 2]
frequency of the paroxysms was greatly encreased, occurring six or
seven times in the hour with very little intermission. The region of the
stomach and along the extremities of the false ribs feells almost always
hard and tense, and the distension of the belly is like that of a woman
some months advanced in pregnancy, never diminishing since the
late exacerbation. The seat of the pain which used to be between the
scrobiculus cordis and navel has since that time seemed settled in
the navel. The vomiting occurs about once a day since this encreased
frequency of the fits and is not succeeded with that durable relief it was
formerly. - The stuff she vomited had in the first stage of the ill¬
ness nothing uncommon in its appearance or qualities, and was never
bitter as she recollects. But since the great exacerbation it consists
of a yellow and green stuff not bitter but of a disagreeable taste
and a smell which she compares to that of raw flesh - While
the frequency of the attacks was moderate she was subject to constant
costiveness for which had aloeticks, bitters and injections. The colour
of the stoolls was white. But the exacerbation gave also a diffe¬
rent turn to this symptom; for she has since been at different
times costive, loose, and natural - Before this she preserved her
looks and strength, but has now become much emaciated and
considerably weaker. A swelling of her legs came on yesterday
about the ankles, which pits upon being pressed - No menses
since a fourth night after the first attack which was the usual
time of their return - The urine was natural till the late
exacerbation when it became very high-coloured and deposited
a lateritious sediment - There have been no febril symptoms
all along nor any complaint but what has been represented.
[Page 3]
The pulse has been of late somewhat accelerated. - Appetite tolerable -
Sleeps for the most part tolerably - Skin cooll and dry - Tongue
a little white.
As the disease was at first taken for hysterical, all the
medicines were directed against it on this supposition, and with a view
to restore the menses: fetids, bitters, chalybeates, hot gums 1 No good
effects have been operated but the temporary palliations of sedatives
and laxatives. Since the very very great frequency of the paroxysm
and the symptoms attending it, it has been viewed in a different light
and nothing is applied at present but a light infusion of bitters
with elixir of vitriol - A milk diet recommended, as also exercise
on horseback which she, has been able to take till within these
two days.
I suspect some organic affection and that the proximate
cause is a constriction of some part of the intestinal canal arising
from a tumour, probably of the schirrous kind, in the intestine itself
or the neighbouring parts. Does there not seem to concur an affec¬
tion of the liver, and may not some of the symptoms ↑have↑ proceeded from
an absence and afterwards a degenerate state of the bile? I pro¬
pose these things with the diffidence that becomes me.
Sir
With the utmost Respect
Your Most Obedient Servant
[Page 4]
✍[Start of margin text]1772[End of margin text]
Notes:
1: This could refer to several commonly employed medicinal gums, as listed in the ingredients table for this edition.
Diplomatic Text
The respect I entertain for you and the duty I owe
to the person who is the subject of the following case has determined
me to lay it before you. I have attempted to state it with all the
precision I can, begging you will forgive innaccuracies or omissions
in a work of which I have no experience. As the patient is my sister
I have had an opportunity of observing her case minutely, for the few
days I have been with her. I derive many circumstances from
the information of Mr. Logan the surgeon who has attended her.
She is aged about 26 of a middling plump habit, had
enjoyed a very uninterrupted state of health, except some slight
heartburns and indigestions to which she was now and then subject.
In the beginning of February last she was siezed with a pain
in her stomach and sour belching, which after the use of some
stomachic medecines were relieved.
But about the end of March she was attacked with
short but violent fits of pain in her stomach, accompanied with a
distension in the umbilical and epigastric region, and borborygmos
from the navel along the left side upwards forwards the stomach.
These paroxisms were at first attended with eructations and retching
and after a few attacks with violent vomiting which gave a respite
from the pain, and was succeeded by an interval of nearly ordinary
health which was at first of several days continuance. She conti¬
nued much in this way for about nine weeks, only the duration of the
intervals of ease growing shorter. On the twelth of June the
[Page 2]
frequency of the paroxysms was greatly encreased, occurring six or
seven times in the hour with very little intermission. The region of the
stomach and along the extremities of the false ribs feells almost always
hard and tense, and the distension of the belly is like that of a woman
some months advanced in pregnancy, never diminishing since the
late exacerbation. The seat of the pain which used to be between the
scrobiculus cordis and navel has since that time seemed settled in
the navel. The vomiting occurs about once a day since this encreased
frequency of the fits and is not succeeded with that durable relief it was
formerly. - The stuff she vomited had in the first stage of the ill¬
ness nothing uncommon in its appearance or qualities, and was never
bitter as she recollects. But since the great exacerbation it consists
of a yellow and green stuff not bitter but of a disagreeable taste
and a smell which she compares to that of raw flesh - While
the frequency of the attacks was moderate she was subject to constant
costiveness for which had aloeticks, bitters and injections. The colour
of the stoolls was white. But the exacerbation gave also a diffe¬
rent turn to this symptom; for she has since been at different
times costive, loose, and natural - Before this she preserved her
looks and strength, but has now become much emaciated and
considerably weaker. A swelling of her legs came on yesterday
about the ankles, which pits upon being pressed - No menses
since a fourth night after the first attack which was the usual
time of their return - The urine was natural till the late
exacerbation when it became very high-coloured and deposited
a lateritious sediment - There have been no febril symptoms
all along nor any complaint but what has been represented.
[Page 3]
The pulse has been of late somewhat accelerated. - Appetite tolerable -
Sleeps for the most part tolerably - Skin cooll and dry - Tongue
a little white.
As the disease was at first taken for hysterical, all the
medicines were directed against it on this supposition, and with a view
to restore the menses: fetids, bitters, chalybeates, hot gums 1 No good
effects have been operated but the temporary palliations of sedatives
and laxatives. Since the very very great frequency of the paroxysm
and the symptoms attending it, it has been viewed in a different light
and nothing is applied at present but a light infusion of bitters
with elixir of vitriol - A milk diet recommended, as also exercise
on horseback which she, has been able to take till within these
two days.
I suspect some organic affection and that the proximate
cause is a constriction of some part of the intestinal canal arising
from a tumour, probably of the schirrous kind, in the intestine itself
or the neighbouring parts. Does there not seem to concur an affec¬
tion of the liver, and may not some of the symptoms ↑have↑ proceeded from
an absence and afterwards a degenerate state of the bile? I pro¬
pose these things with the diffidence that becomes me.
Sir
With the utmost Respect
Your Most Obedt. Sert.
[Page 4]
✍[Start of margin text]1772[End of margin text]
Notes:
1: This could refer to several commonly employed medicinal gums, as listed in the ingredients table for this edition.
XML
XML file not yet available.
Feedback
Send us specfic feeback about this document [DOC ID:827]
Please note that the Cullen Project team have now disbanded but your comments will be logged in our system and we will look at them one day...
