The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:1050] From: Dr William Cullen (Professor Cullen) / To: Dr James Vaughan / Regarding: Anonymous (Patient) / 8 November 1780 / (Outgoing)
Reply 'Dr Vaughan C[oncerning an unnamed female patient]', whose disease Cullen believes 'is no doubt one of those Anomalous Spasmodic affections which have their chief seat in the Nervous System'. Dr James Vaughan had sent Cullen his 1778 publication on Hydrophobia.
- 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 | 1050 |
| RCPE Catalogue Number | CUL/1/1/13/104 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 8 November 1780 |
| Annotation | None |
| Type | Scribal copy ( includes Casebook Entry) |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | No |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply 'Dr Vaughan C[oncerning an unnamed female patient]', whose disease Cullen believes 'is no doubt one of those Anomalous Spasmodic affections which have their chief seat in the Nervous System'. Dr James Vaughan had sent Cullen his 1778 publication on Hydrophobia. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:30] |
Case of an unnamed patient, a 'young Lady 23 years old' suffering from sleeplessness, fits of breathlessness, sickness and muscle spasms. |
3 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:1191] | Addressee | Dr James Vaughan |
| [PERS ID:1192] | Patient | |
| [PERS ID:1191] | Patient's Physician / Surgeon / Apothecary | Dr James Vaughan |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr 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 |
| Destination of Letter | Leicester | Midlands | England | Europe | inferred |
Normalized Text
Dr Vaughan Concerning
The Disease is no doubt one of those Anomalous spas¬
modic affections which have their chief seat in the Nervous
System. But I consider the whole body as such a system, &
this disorder had its first rise from an affection of the san¬
guiferous & I am well persuaded that this young Lady cannot
be entirely relieved till the catamenia have taken their usual
flow both in time & quantity & to obtain this we must I
think chiefly direct your practice, & as she knows her
usual periods, it is only upon the approach of these that you
can employ remedies to any good purpose . You ask my
opinion of Electricity, & I must say that it may possibly be
of use in discussing Paroxysms, but whether or not it
will answer that purpose, I am well persuaded that it
is the most powerful Emmenagogue that we know of &
if we can find any other means of relieving Paroxysms
I should wish always to defer Electricity till within 2
or 3 days of the expected period, & when also the Paroxysms
are likely to be the most frequent ---
I cannot suggest a new remedy to you
in this Case & can only give you my opinion about the
Conduct of these which you have either employed or
speak of Employing --
As the case has nothing febrile I hold no
Evacuations to be necessary or even proper. I hold vomiting
to be altogether unnecessary, & tho a regular Belly is
very proper, I hold purging to be superfluous & possibly
hurtful. You have employed some very proper Antispas¬
modics & I leave you to Employ them again as your
[Page 2]
past Experience shall direct, but I hold Opium
to be the most certain & powerful, But large doses
will be necessary, & I suspect that by joining the
Laudanum with asafotida Volatile Salt or other
Antispasmodics, you have shortened the dose
of Laudanum & thereby missed of its Effects. Please
try it entirely by itself & in sufficient doses. The only
times proper for its use is a little before a Paroxysm
is expected if you have either by the time of day or
other Circumstances means of foreseeing that. When the
Paroxysm comes on it is commonly too late to give the
Laudanum except it is in an uncommonly large dose
& then too, it commonly does no more than shorten the
Paroxysm. When a fit is actually come on I know
no Antispasmodic more powerful than the Vitriolic Aether
which you do not mention to have been employed. Take care
to have it pure & free from any sulphureous taint & give it
in the quantity of a Tea spoonful or two, properly mixed with
a little water. Take a Phial of an Ounce or an Ounce & a half
size, fill this nearly with water, then add the Aether, cork
it close & let the Phial inverted upon the Cork stand till
the time of using it, when a little shaking & pouring
out from the inverted Phial will render it fit to be
swallowed & it should be swallowed immediately - This
young Ladies fits should be in some measure prevented
or moderated by the use of Tonic, but Bark & Steel are
commonly too slow in such cases & their Continuance
in the necessary quantity is commonly hurtful to the
stomach. I would expect more from the flowers of Zinc
or Cuprum Ammon. & most from the later, but it is so ↓ready↓
[Page 3]
to move the stomach that I doubt if your Patient will
bear it. If you try it, you must begin with one Eight of a
grain & increase the dose by degrees to what the stomach
will just bear, for I hold some degree of nausea, however
small to be a necessary test of the Action of the medicine
Of all Tonics, I hold cold bathing to be one of the
best, but the present Season is extremely inconvenient
for the use of it, unless you can begin with washing with
tempered water & very slowly increase the Coldness every
day or two, till you can bring it to the temperature of
50 in Farenheit. This however is a troublesome & tedious
Operation & I would have you in the mean time, instead
of Cold water employ Cold air - You have not mentioned
any trial of exercise of any kind, but I am persuaded
that it might be a remedy both for diverting the spasmodic
fits & promoting the menses. If it had been more early
in the Season I should have advised riding on horseback
but at present I would only propose going in a carriage
suiting it as well as possible to what she bears, but
the more the better & always with the admission of as much
fresh air as she can safely bear ---
Her Diet is probably very well suited & as
her appetite is bad, there is probably little nicity
necessary in the choice of her food. However if I was
to make a Choice, I would say that Animal food is
generally improper in all cases of mobility & I would
prefer a Diet of Milk & Farinacea alone. Roots Greens
& Garden things are generally hurtful. I take notice
of what you say concerning liquid food & I leave you to
judge by trial how far it extends to milk & milk meats
[Page 4]
To conclude the subject I need not say, that the remote
& Exciting Causes are to be carefully studied obviated
& removed as without pains taken in that way, all
our labour may be in vain.
I was much obliged to you for your Cases
on the Hydrophobia, & 1 I was resolved to have thanked
you for it, but my numerous Avocations put it out of
my head, I should do it now, but I hope you will
perceive that I have bestowed some attention upon
this Case & indeed as much as at present my time
can possibly allow
Notes:
1: See James Vaughan, Two Cases of the Hydrophobia; with observations on that disease. By J. Vaughan, M.D. To the above cases and observations annexed, an account of the cæsarian section; as it was lately performed at Leicester (London: 1778), which was revised the same year for a second-edition as Cases and Observations on the Hydrophobia: By J. Vaughan, M. D. To which is annexed, an account of the Caesarian section; with reflections on dividing the symphysis of the ossa pubis.
Diplomatic Text
Dr Vaughan C
The Disease is no doubt one of those Anomalous spas¬
modic affections which have their chief seat in the Nervous
System. But I consider the whole body as such a system, &
this disorder had its first rise from an affection of the san¬
guiferous & I am well persuaded that this young Lady cannot
be entirely relieved till the catamenia have taken their usual
flow both in time & quantity & to obtain this we must I
think chiefly direct your practice, & as she knows her
usual periods, it is only upon the approach of these that you
can employ remedies to any good purpose . You ask my
opinion of Electricity, & I must say that it may possibly be
of use in discussing Paroxysms, but whether or not it
will answer that purpose, I am well persuaded that it
is the most powerful Emmenagogue that we know of &
if we can find any other means of relieving Paroxysms
I should wish always to defer Electricity till wtin 2
or 3 days of the expected period, & when also the Paroxysms
are likely to be the most frequent ---
I cannot suggest a new remedy to you
in this Case & can only give you my opinion about the
Conduct of these which you have either employed or
speak of Employing --
As the case has nothing febrile I hold no
Evacuations to be necessary or even proper. I hold vomiting
to be altogether unnecessary, & tho a regular Belly is
very proper, I hold purging to be superfluous & possibly
hurtful. You have employed some very proper Antispas¬
modics & I leave you to Employ them again as your
[Page 2]
past Experience shall direct, but I hold Opium
to be the most certain & powerful, But large doses
will be necessary, & I suspect that by joining the
Laudanum wt asafotida Volatile Salt or oyr
Antispasmodics, you have shortened the dose
of Laudanum & thereby missed of its Effects. Please
try it entirely by itself & in sufficient doses. The only
times proper for its use is a little before a Paroxysm
is expected if you have either by the time of day or
other Circumstances means of foreseeing that. When the
Paroxysm comes on it is commonly too late to give the
Laudanum except it is in an uncommonly large dose
& then too, it commonly does no more than shorten the
Paroxysm. When a fit is actually come on I know
no Antispasmodic more powerful than the Vitriolic Aether
which you do not mention to have been employed. Take care
to have it pure & free from any sulphureous taint & give it
in the quantity of a Tea spoonful or two, properly mixed wt
a little water. Take a Phial of an Ounce or an Ounce & a half
size, fill this nearly wt water, then add the Aether, cork
it close & let the Phial inverted upon the Cork stand till
the time of using it, when a little shaking & pouring
out from the inverted Phial will render it fit to be
swallowed & it should be swallowed immediately - This
young Ladies fits should be in some measure prevented
or moderated by ye use of Tonic, but Bark & Steel are
commonly too slow in such cases & their Continuance
in the necessary quantity is commonly hurtful to the
stomach. I would expect more from the flowers of Zinc
or Cuprum Ammon. & most from the later, but it is so ↓ready↓
[Page 3]
to move the stomach that I doubt if your Patient will
bear it. If you try it, you must begin with one Eight of a
grain & increase the dose by degrees to what the stomach
will just bear, for I hold some degree of nausea, however
small to be a necessary test of the Action of the medicine
Of all Tonics, I hold cold bathing to be one of the
best, but the present Season is extremely inconvenient
for the use of it, unless you can begin with washing wt
tempered water & very slowly increase the Coldness every
day or two, till you can bring it to the temperature of
50 in Farenheit. This however is a troublesome & tedious
Operation & I would have you in the mean time, instead
of Cold water employ Cold air - You have not mentioned
any trial of exercise of any kind, but I am persuaded
that it might be a remedy both for diverting the spasmodic
fits & promoting the menses. If it had been more early
in the Season I should have advised riding on horseback
but at present I would only propose going in a carriage
suiting it as well as possible to what she bears, but
the more the better & always with the admission of as much
fresh air as she can safely bear ---
Her Diet is probably very well suited & as
her appetite is bad, there is probably little nicity
necessary in the choice of her food. However if I was
to make a Choice, I would say that Animal food is
generally improper in all cases of mobility & I would
prefer a Diet of Milk & Farinacea alone. Roots Greens
& Garden things are generally hurtful. I take notice
of what you say concerning liquid food & I leave you to
judge by trial how far it extends to milk & milk meats
[Page 4]
To conclude the subject I need not say, that the remote
& Exciting Causes are to be carefully studied obviated
& removed as without pains taken in that way, all
our labour may be in vain.
I was much obliged to you for your Cases
on the Hydrophobia, & 1 I was resolved to have thanked
you for it, but my numerous Avocations put it out of
my head, I should do it now, but I hope you will
perceive that I have bestowed some attention upon
this Case & indeed as much as at present my time
can possibly allow
Notes:
1: See James Vaughan, Two Cases of the Hydrophobia; with observations on that disease. By J. Vaughan, M.D. To the above cases and observations annexed, an account of the cæsarian section; as it was lately performed at Leicester (London: 1778), which was revised the same year for a second-edition as Cases and Observations on the Hydrophobia: By J. Vaughan, M. D. To which is annexed, an account of the Caesarian section; with reflections on dividing the symphysis of the ossa pubis.
XML
XML file not yet available.
Feedback
Send us specfic feeback about this document [DOC ID:1050]
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...
