Cullen

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

 

[ID:2522] From: Dr Richard Worthington / To: Dr William Cullen (Professor Cullen) / Regarding: Miss M Burton (Patient) / 25 September 1784 / (Incoming)

Letter from Richard Worthington, concerning the case of Miss M. Burton, an 18-year-old girl who suffers from epigastric pain, vomiting and heartburn. He hopes that Cullen will reply soon since the patient is 'casually in this town'.

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Metadata

FieldData
DOC ID 2522
RCPE Catalogue Number CUL/1/2/1573
Main Language English
Document Direction Incoming
Date25 September 1784
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Letter from Richard Worthington, concerning the case of Miss M. Burton, an 18-year-old girl who suffers from epigastric pain, vomiting and heartburn. He hopes that Cullen will reply soon since the patient is 'casually in this town'.
Manuscript Incomplete? No
Evidence of Commercial Posting Yes

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1680]
Case of Miss M. Burton, a teenaged girl debilitated by a painful epigastric disorder marked by episodes of vomiting, especially at night.
2


People linked to this document

Person IDRole in documentPerson
[PERS ID:3947]AuthorDr Richard Worthington
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:5538]PatientMiss M Burton
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:3947]Patient's Physician / Surgeon / ApothecaryDr Richard Worthington

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Chester North-West England Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe certain
Place of Handstamp Carlisle North-West England Europe certain
Place of Handstamp Chester North-West England Europe certain

Normalized Text

[Page 1]
Chester – September 25th – 84 –
Dear Sir/


Allow me once more to avail myself of
the privelege I enjoy in being permitted to make these
occasional applications, by requesting your opinion of
the following curious case, which has lately become the
subject of my practice ––


Miss M: Burton, (age 18 years) having had a cough (without
any bad attendant symptoms) for two or three months and
a sickness for as many days, was attacked in the night,
near two years ago, with great pain in the epigastric
region
, but which abated very much in the course of a
few hours: an emetic was taken the following day which
operated agreably to expectation: from that period to
the present she has vomited constantly, within three
or four minutes, after any injesta received by the
stomach
, whether solid or fluid: medicines also,
of whatever sort if more than two tea spoonfuls are
administered per dose, are equally discarded =
she has seldom been free from pain in some part
of the epigastric region
since her attack, of which
the most usual situation has been the center
& front of it, about an inch below the ensiform
cartilage
: sometimes (especially when violent)
the pain descends into the superiour part of the



[Page 2]

umbilical region
, and which indeed, by the patient's
description, appears, as well as the epigastric, to
have been the seat of her disease on her first attack
two years ago: the right side is frequently affected
with pain also, which appears to operate in
the direction of the stomach –– During the first
3 months of her illness she was occasionally
(for some hours) free from pain, but, for these last
six last, pain has increased in degree, and in a
greater or less, has been constant –– sickness pre¬
cedes her vomitings
, while these increase the pain
and are generally followed by a cramp of the
stomach
: she was subjected to frequent cramps
in
the limbs when in health, but these are
greatly diminished: pressure upon the parts
affected (if considerable) occasions sickness
and an uneasiness, which the patient de¬
scribes to be a creeping sensation
: tho', from
repeated external examinations by the hands
nothing decisive has been learned –


Hickup has been present every night during
the last eighteen months, continues a quarter
of an hour, and is commonly repeated twice or
thrice before morning: it seldom happens when
she is not in bed: hands & feet are inclined
to coldness ––––




[Page 3]


A tendency to costiveness prevails, & she has occasi¬
onally had small dejections of blood by stool, parti¬
cularly after travelling, motion being always
succeeded by pain in the bowels & by an aug¬
mentation of that in the stomach –– She has not any
regular sleep
, occasioned at one time by considerable
pain in the affected parts, at another by a general
restlessness
–– the debility is great, yet her spirits
are remarkably good, and, saving that she is become
paler
, she looks as well as when she was in health,
not being in the least emaciated ––


She was not at all subjected to stomach or other
complaints 'till a year previous to this
her continued illness, at which period
she remembers to have been affected with
an habitual sickness, but no vomiting, for the
term of six weeks –– This, however, went off, leaving
her perfectly well –– Has always had a small
appetite –– Pulse common standard and in
no way remarkable –– Menstruation regular ––


I avoid, Sir, to say what have been the ideas
of the complaint, that I may obtain your perfectly
free and uninfluenced opinion: it may be necessa¬
ry to observe that there is no reason to believe any
one of the means used has proved more beneficial
than another: I ought also to have mentioned
earlier, that cardialgia is occasionally present,



[Page 4]

and that pyrosis was very troublesome during
the first months of her illness ––


Having so long broke in upon your leisure
(of which I know your portion to be very limited)
allow me to hope your indulgence, and, with
best respects to your family subscribe myself

your much obliged and faithful servant
Rd. Worthington


P.S. My patient is casually in this town, which
will render as early a reply as you can conveni¬
ently favour me with, Sir, particularly acceptable ––


Dr. Cullen ––
Edinburgh.


Mr. Richd. Worthington
September 1784
V. XVI. p. 198.

Diplomatic Text

[Page 1]
Chester – Sepbr. 25th – 84 –
Dear Sir/


Allow me once more to avail myself of
the privelege I enjoy in being permitted to make these
occasional applications, by requesting your opinion of
the following curious case, which has lately become the
subject of my practice ––


Miss M: Burton, (age 18 yrs.) having had a cough (without
any bad attendant symptoms) for two or three months and
a sickness for as many days, was attacked in the night,
near two years ago, with great pain in the epigastric
region
, but which abated very much in the course of a
few hours: an emetic was taken the following day wch.
operated agreably to expectation: from that period to
the present she has vomited constantly, within three
or four minutes, after any injesta received by the
stomach
, whether solid or fluid: medicines also,
of whatever sort if more than two tea spoonfuls are
administered pr. dose, are equally discarded =
she has seldom been free from pain in some part
of the epigastric region
since her attack, of which
the most usual situation has been the center
& front of it, about an inch below the ensiform
cartilage
: sometimes (especially when violent)
the pain descends into the superiour part of the



[Page 2]

umbilical region
, and which indeed, by the patient's
description, appears, as well as the epigastric, to
have been the seat of her disease on her first attack
two years ago: the right side is frequently affected
with pain also, which appears to operate in
the direction of the stomach –– During the first
3 months of her illness she was occasionally
(for some hours) free from pain, but, for these last
six last, pain has increased in degree, and in a
greater or less, has been constant –– sickness pre¬
cedes her vomitings
, while these increase the pain
and are generally followed by a cramp of the
stomach
: she was subjected to frequent cramps
in
the limbs when in health, but these are
greatly diminished: pressure upon the parts
affected (if considerable) occasions sickness
and an uneasiness, which the patient de¬
scribes to be a creeping sensation
: tho', from
repeated external examinations by the hands
nothing decisive has been learned –


Hickup has been present every night during
the last eighteen months, continues a quartr.
of an hour, and is commonly repeated twice or
thrice before morning: it seldom happens when
she is not in bed: hands & feet are inclined
to coldness ––––




[Page 3]


A tendency to costiveness prevails, & she has occasi¬
onally had small dejections of blood by stool, parti¬
cularly after travelling, motion being always
succeeded by pain in the bowels & by an aug¬
mentation of that in the stomach –– She has not any
regular sleep
, occasioned at one time by considerable
pain in the affected parts, at another by a general
restlessness
–– the debility is great, yet her spirits
are remarkably good, and, saving that she is become
paler
, she looks as well as when she was in health,
not being in the least emaciated ––


She was not at all subjected to stomach or other
complaints 'till a year previous to this
her continued illness, at which period
she remembers to have been affected with
an habitual sickness, but no vomiting, for the
term of six weeks –– This, however, went off, leaving
her perfectly well –– Has always had a small
appetite –– Pulse common standard and in
no way remarkable –– Menstruation regular ––


I avoid, Sir, to say what have been the ideas
of the complaint, that I may obtain your perfectly
free and uninfluenced opinion: it may be necessa¬
ry to observe that there is no reason to believe any
one of the means used has proved more beneficial
than another: I ought also to have mentioned
earlier, that cardialgia is occasionally present,



[Page 4]

and that pyrosis was very troublesome during
the first months of her illness ––


Having so long broke in upon your leisure
(of which I know your portion to be very limited)
allow me to hope your indulgence, and, with
best respects to your family subscribe myself

your much obliged and faithful servant
Rd. Worthington


P.S. My patient is casually in this town, which
will render as early a reply as you can conveni¬
ently favour me with, Sir, particularly acceptable ––


Dr. Cullen ––
Edinburgh.


Mr. Richd. Worthington
Septr. 1784
V. XVI. p. 198.

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