The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:1073] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mrs Fraser (of Monedy) (Patient) / 16 January 1781 / (Outgoing)
Reply 'For a Lady whose Case was communicated by Mr Fraser'
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 3 images for this document.
[Page 1]
[Page 2]
[Page 3]
Metadata
| Field | Data |
|---|---|
| DOC ID | 1073 |
| RCPE Catalogue Number | CUL/1/1/13/127 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 16 January 1781 |
| Annotation | None |
| Type | Scribal copy ( includes Casebook Entry) |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | Yes |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply 'For a Lady whose Case was communicated by Mr Fraser' |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1441] |
Case of Mrs Fraser whose stomach disorder may be caused by an obstruction of the pylorus. |
3 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:3693] | Patient | Mrs Fraser (of Monedy) |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:3694] | Patient's Relative / Spouse / Friend | Mr Fraser |
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 | Inverness | North Highlands | Scotland | Europe | inferred |
Normalized Text
For a Lady whose Case was communicated
by Mr Fraser ✍
I am persuaded there is an obstruction probably
a schirrosity at the Pylorus or lower orifice of the
Stomach, which prevents almost every thing from
passing beyond it. It is still more unlucky that
the vomiting which must attend the disease is
likely to frustrate the effects of any medicine we
can throw into the Stomach. I dare say that very
proper medicines have been employed, but I
could wish to have known these that I might not
advise to repeat attempts which have already
perhaps been fruitless. However I have at the
bottom of this subjoined a Forumula which if any
thing can be effectual in moving downwards
I expect it from this. It is to be taken by half
a table spoonful or less at one time, but this
should be repeated every half hour till She has
taken two table spoonfuls of it. And if it can
be retained till the whole of such a dose is taken
I shall expect good effects from it. If there is any
time of day that her Stomach is less liable to vom¬
iting than ↑at↑ another that should be the time for
trying this medicine. I dont doubt but that
Opiates have been tried to stop her constant vom¬
iting, but I am afraid it has been with little effect
- But if upon any occasion they have been found to
stop the vomiting for any time, let a moderate
[Page 2]
dose be again tried with the medicine I advise and
if it answers the purpose of keeping this medicine
o medicine upon the Stomach it is giving it
the best chance for going through.
The great swelling of the Epigastric region
is probably entirely flatulent as it falls upon
evacuations of wind and therefore some relief
may be now and then procured by promoting that
evacuation. The Medicine for this which I have
found the most effectual is Æther & a tea spoon¬
ful of this may be given in plain or pepper¬
mint water. when the distension is very trouble¬
some. If this has been tried already without
effect I should not insist on its being repeated
and if it has not been tried I must leave the
repetition of to the discretion of some Person
upon the spot.
If the Laxative medicine I have advised
shall not go through, the injections hitherto
used must be continued for tho they do not
bring off much excremental matter because
there is little to be brought off - They are
necessary to bring away the flatulence which
readily accumulates in empty Bowels.
The measures now proposed will be I hope be
of some service in palliating the distress, but I
should wish to go if possible to the root of the
disease & in the view I have of it the only
[Page 3]
Medicine I can think of promising is the Cicuta.
If the Stomach can be brought to retain a medicine
the best form of the Cicuta is a properly dried powd¬
er, & this made into Pills may be given by
the mouth in such doses as every Practitioner
nowsa days knows to be proper. If these shall
not be retained in the Stomach it may be
attempted by injection & there either the Powd¬
er or a proper extract may be employed,
only in larger doses then might be proper at
first to give by the mouth.
This is all I can suggest in such ↑a↑ desperate
cases & I say nothing of Diet or Drink. -----
✍as it must be determined by what the Stomach can
bear or retain.
Take three ounces of the best castor oil and one and a half ounces of Daffy's Elixir (as in the Edinburgh Pharmacopoeia). Mix. Label: Laxative oil &cc
Diplomatic Text
For a Lady whose Case was communicated
by Mr Fraser ✍
I am persuaded there is an obstruction probably
a schirrosity at the Pylorus or lower orifice of the
Stomach, which prevents almost every thing from
passing beyond it. It is still more unlucky that
the vomiting which must attend the disease is
likely to frustrate the effects of any medicine we
can throw into the Stomach. I dare say that very
proper medicines have been employed, but I
could wish to have known these that I might not
advise to repeat attempts which have already
perhaps been fruitless. However I have at the
bottom of this subjoined a Forumula which if any
thing can be effectual in moving downwards
I expect it from this. It is to be taken by half
a table spoonful or less at one time, but this
should be repeated every half hour till She has
taken two table spoonfuls of it. And if it can
be retained till the whole of such a dose is taken
I shall expect good effects from it. If there is any
time of day that her Stomach is less liable to vom¬
iting than ↑at↑ another that should be the time for
trying this medicine. I dont doubt but that
Opiates have been tried to stop her constant vom¬
iting, but I am afraid it has been with little effect
- But if upon any occasion they have been found to
stop the vomiting for any time, let a moderate
[Page 2]
dose be again tried with the medicine I advise and
if it answers the purpose of keeping this medicine
o medicine upon the Stomach it is giving it
the best chance for going through.
The great swelling of the Epigastric region
is probably entirely flatulent as it falls upon
evacuations of wind and therefore some relief
may be now and then procured by promoting that
evacuation. The Medicine for this which I have
found the most effectual is Æther & a tea spoon¬
ful of this may be given in plain or pepper¬
mint water. when the distension is very trouble¬
some. If this has been tried already without
effect I should not insist on its being repeated
and if it has not been tried I must leave the
repetition of to the discretion of some Person
upon the spot.
If the Laxative medicine I have advised
shall not go through, the injections hitherto
used must be continued for tho they do not
bring off much excremental matter because
there is little to be brought off - They are
necessary to bring away the flatulence which
readily accumulates in empty Bowels.
The measures now proposed will be I hope be
of some service in palliating the distress, but I
should wish to go if possible to the root of the
disease & in the view I have of it the only
[Page 3]
Medicine I can think of promising is the Cicuta.
If the Stomach can be brought to retain a medicine
the best form of the Cicuta is a properly dried powd¬
er, & this made into Pills may be given by
the mouth in such doses as every Practitioner
nowsa days knows to be proper. If these shall
not be retained in the Stomach it may be
attempted by injection & there either the Powd¬
er or a proper extract may be employed,
only in larger doses then might be proper at
first to give by the mouth.
This is all I can suggest in such ↑a↑ desperate
cases & I say nothing of Diet or Drink. -----
✍as it must be determined by what the Stomach can
bear or retain.
℞ ol. ricin. opt. ℥iij Tinct. Sen. comp Ph. Ed. ℥jſs
ℳ. S. Lax. oil &cc
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