The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:1968] From: Dr Thomas Stephen / To: Dr William Cullen (Professor Cullen) / Regarding: Mrs Thomson (Patient) / 17 January 1781 / (Incoming)
Letter from Thomas Stephen, concerning the case of Mrs Thomson at Elgin. Mrs Thomson, 'aged about 50, fair complexion, sanguine habit, and the Mother of several Children' and who underwent menopause at the age of 47, suffers heavy uterine bleeding. Thomas Stephen suspects ulceration of the Uterus or a cancerous disposition.
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- Normalized Text
- Diplomatic Text
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Facsimile
There are 4 images for this document.
[Page 1]
[Page 2]
[Page 3]
[Page 4]
Metadata
| Field | Data |
|---|---|
| DOC ID | 1968 |
| RCPE Catalogue Number | CUL/1/2/1047 |
| Main Language | English |
| Document Direction | Incoming |
| Date | 17 January 1781 |
| 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 Thomas Stephen, concerning the case of Mrs Thomson at Elgin. Mrs Thomson, 'aged about 50, fair complexion, sanguine habit, and the Mother of several Children' and who underwent menopause at the age of 47, suffers heavy uterine bleeding. Thomas Stephen suspects ulceration of the Uterus or a cancerous disposition. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1437] |
Case of Mrs Thomson at Elgin who has a haemorrhage and severe abdominal pains. |
2 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:820] | Author | Dr Thomas Stephen |
| [PERS ID:1] | Addressee | Dr William Cullen (Professor Cullen) |
| [PERS ID:3258] | Patient | Mrs Thomson |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:820] | Patient's Physician / Surgeon / Apothecary | Dr Thomas Stephen |
| [PERS ID:3257] | Other | Mr Blair |
Places linked to this document
| Role in document | Specific Place | Settlements / Areas | Region | Country | Global Region | Confidence |
|---|---|---|---|---|---|---|
| Place of Writing | Elgin | East Highlands | Scotland | Europe | certain | |
| Destination of Letter | Edinburgh | Edinburgh and East | Scotland | Europe | certain |
Normalized Text
Elgin 17th January
1781
Dear Sir
The following state of Mrs Thomson's case
is sent for your advice and opinion - Should
your Prognosis be unfavourable be pleasd to com¬
municate it in such manner as the Patient may
not have occasion to see it - Mr Blair
who delivers this has orders to give you two Gui¬
neas - I am with the greatest respect
Dear Sir
Your most obedient humble servant
Thos Stephen
Mrs Thomson aged about 50, fair complexion, [sa]nguine
habit, and the Mother of several Children, enjoyed good
health and continued regular in her Menses, till about
the age of 47, when they became less regular and ceas'd
altogether. She was then troubl'd with flying pains
in her head, Shoulders, and thro' her body, for about
a year and half; when in the beginning of June last,
after riding a horseback one day, about 24 Miles, at
a quick pace, the discharge returnd, and continued
till the first of September without a days intermission,
and in such quantity, that in the space of two days,
she commonly voided as much blood as equall'd what
in health, she was wont ↑to lose↑, in the whole time of a monthly
period, which normally lasted three days.
[Page 2]
From the begining of September, she has been greatly
excruciated, with most severe pains in her back, and
lower belly, frequently [shooting down?] the insides of her
thighs, and gets very little ease but what is procur¬
red by Opiates. The discharge still continues and
in great quantity, sometimes fluid red blood, at other
times clotted, but mostly a bloody Ichor, extremely
fetid. She is much reduced in Strength, and
her appetite for food much gone, her belly is bound
and she is often troubld with tenesmus and diffi¬
culty of urine, which she renders in small quan¬
tity - Pulse not above 70 in the Minute - tho'
rather weak - skin not hot - but complains
much of thirst; owing perhaps in some measure
to the Opium she takes.
As I had not occasion, to see this patient before the
month of November last, I knew not what Medicines
she took, further than some Aloetic Pills she showd
me, and which I dissuaded from the use of.
From the very great pain, and fetid discharge, I
suspected ulceration of the Uterus, and a cancerous
disposition, in that organ. The Mouth of which is
open, tumid, jagged and uneven and hard to the
touch, but my Patient did not complain of pain,
on pressing it with my finger.
[Page 3]
What occurrd to me, as proper in this case, was -
1st. to obviate costiveness. 2ly to give ease and palliate
with Opiates. 3ly To try the Cicuta - and 4thly to
order a proper Regimen -
The first indication was endeavour'd at by
an Electuary ex Sulphuri & Ol. Ricini; but this
disagreeing with the patients taste and Stomach,
was changed for one Composd of Electm. Lenitiv.
cum Sulphur. & Jalap - and tiring of this,
she now takes some Pills of Rhubarb. Jalap &
Soap.
The second indication has been pr{illeg}
same measure, but 7 grains or 8 of {illeg}
at bedtime, which procures three {illeg}
hours of sleep - through the night, and gives
her ease.
She has not yet taken the extract of Cicu¬
ta, in greater quantity than about ten grains
in the day, and these sit very uneasy
on her Stomach --
As to the fourth Indication, she has been ad¬
visd to live mostly on Milk and Vegetables,
and forbid what-ever has tendency to heat &c
Thos Stephen
[Page 4]
Doctor Cullen
Edinburgh
Thomas Stephens
Query
Mrs. Thomson
January 1781
XI. p.142.
Diplomatic Text
Elgin 17th Jany
1781
Dear Sir
The following state of Mrs Thomson's case
is sent for your advice and opinion - Should
your Prognosis be unfavourable be pleasd to com¬
municate it in such manner as the Patient may
not have occasion to see it - Mr Blair
who delivers this has orders to give you two Gui¬
neas - I am with the greatest respect
Dear Sir
Your most obedt. humble Servt
Thos Stephen
Mrs Thomson aged about 50, fair complexion, [sa]nguine
habit, and the Mother of several Children, enjoyed good
health and continued regular in her Menses, till about
the age of 47, when they became less regular and ceas'd
altogether. She was then troubl'd with flying pains
in her head, Shoulders, and thro' her body, for about
a year and half; when in the beginning of June last,
after riding a horseback one day, about 24 Miles, at
a quick pace, the discharge returnd, and continued
till the first of September without a days intermission,
and in such quantity, that in the space of two days,
she commonly voided as much blood as equall'd what
in health, she was wont ↑to lose↑, in the whole time of a monthly
period, which normally lasted three days.
[Page 2]
From the begining of September, she has been greatly
excruciated, with most severe pains in her back, and
lower belly, frequently [shooting down?] the insides of her
thighs, and gets very little ease but what is procur¬
red by Opiates. The discharge still continues and
in great quantity, sometimes fluid red blood, at other
times clotted, but mostly a bloody Ichor, extremely
fetid. She is much reduced in Strength, and
her appetite for food much gone, her belly is bound
and she is often troubld with tenesmus and diffi¬
culty of urine, which she renders in small quan¬
tity - Pulse not above 70 in the Minute - tho'
rather weak - skin not hot - but complains
much of thirst; owing perhaps in some measure
to the Opium she takes.
As I had not occasion, to see this patient before the
month of November last, I knew not what Medicines
she took, further than some Aloetic Pills she showd
me, and which I dissuaded from the use of.
From the very great pain, and fetid discharge, I
suspected ulceration of the Uterus, and a cancerous
disposition, in that organ. The Mouth of which is
open, tumid, jagged and uneven and hard to the
touch, but my Patient did not complain of pain,
on pressing it with my finger.
[Page 3]
What occurrd to me, as proper in this case, was -
1st. to obviate costiveness. 2ly to give ease and palliate
with Opiates. 3ly To try the Cicuta - and 4thly to
order a proper Regimen -
The first indication was endeavour'd at by
an Electuary ex Sulphuri & Ol. Ricini; but this
disagreeing with the patients taste and Stomach,
was changed for one Composd of Electm. Lenitiv.
cum Sulphur. & Jalap - and tiring of this,
she now takes some Pills of Rhubarb. Jalap &
Soap.
The second indication has been pr{illeg}
same measure, but 7 grains or 8 of {illeg}
at bedtime, which procures three {illeg}
hours of sleep - through the night, and gives
her ease.
She has not yet taken the extract of Cicu¬
ta, in greater quantity than about ten grains
in the day, and these sit very uneasy
on her Stomach --
As to the fourth Indication, she has been ad¬
visd to live mostly on Milk and Vegetables,
and forbid what-ever has tendency to heat &c
Thos Stephen
[Page 4]
Doctor Cullen
Edinr.
Thos. Stephens
Q
Mrs. Thomson
Jany. 1781
XI. p.142.
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