The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:3571] From: Dr James Robertson / To: Dr William Cullen (Professor Cullen) / Regarding: Mrs Jane Fraser (of Relick) (Patient) / 9 August 1789 / (Incoming)
Letter from James Robertson, relating the case of Mrs Fraser, at the request of Mr Fraser of Relick. Mrs Fraser symptoms include pain in the lower abdomen, accompanied by nausea, vomiting and a frequent desire to pass water. Robertson also enclosed a sample of a substance Mrs Fraser passed by urine.
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- Normalized Text
- Diplomatic Text
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Facsimile
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Metadata
| Field | Data |
|---|---|
| DOC ID | 3571 |
| RCPE Catalogue Number | CUL/1/2/2459 |
| Main Language | English |
| Document Direction | Incoming |
| Date | 9 August 1789 |
| 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 James Robertson, relating the case of Mrs Fraser, at the request of Mr Fraser of Relick. Mrs Fraser symptoms include pain in the lower abdomen, accompanied by nausea, vomiting and a frequent desire to pass water. Robertson also enclosed a sample of a substance Mrs Fraser passed by urine. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | Yes |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:788] |
Case of Mrs [Jane] Fraser of Relict [Relig/Reelig], who suffers from breathlessness and pain in her side; she subsequently falls down stairs, becomes pregnant and is then dissuaded from suckling her child for fear of her catching milk fever and a cold. |
21 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:4776] | Author | Dr James Robertson |
| [PERS ID:1] | Addressee | Dr William Cullen (Professor Cullen) |
| [PERS ID:857] | Patient | Mrs Jane Fraser (of Relick) |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:4776] | Patient's Physician / Surgeon / Apothecary | Dr James Robertson |
| [PERS ID:858] | Patient's Relative / Spouse / Friend | Mr Fraser (of Relick) |
Places linked to this document
| Role in document | Specific Place | Settlements / Areas | Region | Country | Global Region | Confidence |
|---|---|---|---|---|---|---|
| Place of Writing | Inverness | North Highlands | Scotland | Europe | certain | |
| Destination of Letter | Edinburgh | Edinburgh and East | Scotland | Europe | certain | |
| Mentioned / Other | Reelig (Relig / Relict / Relick) | East Highlands | Scotland | Europe | certain | |
| Place of Handstamp | Inverness | North Highlands | Scotland | Europe | inferred |
Normalized Text
I am desired by Mr. Fraser of Relick to write
you concerning the health of Mrs. Fraser
On the 1st. instant when in Church, she was suddenly seized with
acute pain, extending from the top of the Oss Ischium, down
to the Labia Pudenda, affecting them with a sensation similar to
that after labour; It extended also across the back immediately above
the Glutæi muscles, & was attended with a pain & difficulty ↑& desire↑ of passing
urine, alternated too with an involuntary dribbling; she passed
but little at a time, but on the whole discharged the natural
quantity; the urine did not scald the surrounding parts; She com¬
plained also of a prickling in the thighs, & of a sensation approach¬
ing to numbness especially in the right thigh; The pain was
especially acute in the lower side of the Belly; it was not con¬
stant in its violence, but seemed to originate in the Belly & ex¬
tend to the back; it was much increased on motion or pressure;
When most acute it was accompanied with Singultus & with
much tremor & these soon terminated in a gentle fit of Hyste¬
ria. Her pulse was soft & slow even when most agitated with
pain; Volatile Salt I therefore did not judge necessary & especially as the
pain recurred & abated alternately; there was no thirst, & the Skin
was cool, Belly open; was regular at last menstruation.-
Fomentations were applied with some relief to the pain, &
Lintseed tea with small doses of nitre relieved the urinary
complaint; The nervous symptoms, & Mrs. Fraser says, the pain↓s↓
[Page 2]
were immediately relieved by a mucilaginous draught containing 5 grains
of musk; her feet & legs became very hott after it, & she soon fell a¬
sleep; in two hours she awoke free of pain, & continued easy all the
day after, but weak. - She has long, as you already know, com¬
plained of a pain in the left side, tho' it was troublesome before
this attack yet during the fit she was not sensible of it; she
felt ↑it↑ however after recovering from the other pain. -
2d. After an easy night with a good deal of refreshing sleep
she waked about 6 A.M. with some pain & about 9 she was
seized with greater violence than ever; every symptom as yesterday,
but the pain of the back & loins now acute & attended with much
nausea & some vomiting. - Pulse under 70 & soft; Skin cool unless a
temporary warmth occasioned by the violence of pain. Belly cos¬
tive since yesterday morning. - The nausea & vomiting were re¬
moved by large draughts of warm water; Formentations were used
as before & two emollient clysters were given with much benefit
from the second; the Lintseed tea & Nitre were continued; & some
relief especially to the pain in the back was observed from gentle
friction of Ӕther; The Nervous symptoms returned & at the same
hour /1 P.M./ she fell asleep, after the Musk draught with the
addition of Liquid Laudanum twenty-five drops; she observed the same heat
in the feet & legs & waked at 3 P.M. much better; she
continued so all the evening, & had an anodyne of thirty drops
Liquid Laudanum at bed time.- This morning she had a degree of
tenesmus before the Pain became so acute, & when straining at
stool she observed mixed with about 2 oz. of urine that she
[Page 3]
had passed, an apparently membranous substance of an inch in length
& of a dark brown color, at one end especially. On closer exami¬
nation this substance seemed to be mucus; it had no organiza¬
tion. As she passed nothing by stool, & as from its size it
could not unobserved have passed the urethra, I conclude it
was discharge from the vagina. -
3d. After a good night she was seized at the same hour
as on the preceding days with every symptom tho' in a
less violent manner; the nausea & vomiting did not recurr,
The Pulse good, no febrile symptom; the pain was not so
constant, nor did the nervous symptoms, (the Singultus
& Tremor,) terminate in any fit of Hysteria; She was much
relieved by the Fomentations & especially by the Ӕther,
She fell asleep precisely as before, with the feeling of
warmth in the feet & legs, & waked shortly much relieved.
Had some purging in the night therefore the enema
was not repeated. The Lintseed tea was continued & a
one scruple of the compound Powder of Gum Tragacanth three times thro.
the day, was ordered. The pain in passing urine seemed
much abated, tho the frequent desire still continued, I
should have observed that on this day she had no a¬
nodyne nor musk draught.
4th. Passed the night ↑in↑ a calm way, was seized with pain
as
[Page 4]
before, in the morning, in the lower & right side of Belly & in
the back, the desire of making water still continued, but the
ardor much less; the Pain to day was less acute & was re¬
lieved for a time from the Ӕther; the nervous symptoms
were but moderate; she fell asleep naturally as for¬
merly & in less than an hour waked relieved as before.
The Lintseed tea and Tragacanth Powder were continued, &
she remained well all the evening; half an ounce of Castor Oil was
ordered at bed time, & she was directed to apply the
Ӕther freely next morning before the usual periodical
attack of pain. -
5th. Has no pain, the Ӕther was applied as directed &
two copious stools were the effect of the castor oil.
Mrs. Fraser has continued well since, unless some gentle
threatening now & then. - She has been restricted as you
some time ↑ago↑ directed, to a vegetable & milk diet; the same
was continued during this complaint. On the 10th. of last
April she was safely delivered of a healthy child; some
time before delivery she was sensible of a disagreeable
weight in the right side; She continued to recover after
the birth of her child till on the 10th. day ↑after↑she was
seized as on the 1st. instant & the usual discharge as
immediately after labour came on, she was speedily re¬
lieved by injestions, fomentations, & Lintseed tea, lest that
[Page 5]
she had fluor albus till the natural period of her first
menstruation; then She had an atural discharge both as
to quantity & color; In a fourthnight after this she took a
long walk for the first time since her delivery when
there immediately came on a copious discharge of bloody
matter resembling pus; before this discharge entirely went
off she was sensible of one or two substances coming a¬
way as on the 2d. instant; In a month or rather more af¬
ter, she menstruated again, but the discharge was
more florid & copious than usual; from this menstrua¬
tion untill her attack on the 1st. instant she continued
well but that the pectoral complaints were some¬
times troublesome. In her first labour six years ago, there was
some cause to suspect the Oss. coccygis was injured; at that
time {illeg} she had great difficulty to walk for some
period after; since, she has frequently complained of much
pain in that part, but in two labours between the first
& the last she felt nothing of it; in the last & repeatedly
since she has complained of it, & she was for some weeks
after the last, unable to walk but on crutches. -
On the 5th. instant, the first day she was free of her pre¬
sent complaint from the 1st., she passed, (at least she thinks
so, for she was not immediately sensible of it,) by urine
[Page 6]
the inclosed substance. Mrs. Fraser has never been before
subject to any complaint in the urinary organs; her
urine was never observed to have any sandy sediment
nor were any of her relations ever subject to stone. The
only ↑known↑probable cause of her late attack was having laced
herself tighter than usual, & having stood during prayer
in church where her health for some time had not
allowed her to go. -
I am conscious the above account is neither so
concise nor so connected as it should be; I am much
hurried & I am really at a loss what to attribute Mrs.
Frasers complaint to; & I trust you will make every a¬
llowance for a young man in such a situation; If I have
neglected any thing you would wish to be informed of I
will expect to hear; From some enquiries I have made
Mrs. Fraser dreads some calculous complaint, perhaps it
might be proper to remove this suspicion (as I have al¬
ready endeavoured) from her mind at least; I delay
pursuing any plan of cure till I have your answer &
I have the honor to be with great respect
Your attached pupil
& obedient humble Servant
[Page 7]
Doctor Cullen
Physician
Edinr.
Dr. Robertson
Concerning Mrs. Fraser
Augt. 1789
V. XX. p. 265
Diplomatic Text
I am desired by Mr. Fraser of Relick to write
you concerning the health of Mrs. Fraser
On the 1st. instn. when in Church, she was suddenly seized with
acute pain, extending from the top of the Oss Ischium, down
to the Labia Pudenda, affecting them with a sensation similar to
that after labour; It extended also across the back immediately above
the Glutæi muscles, & was attended with a pain & difficulty ↑& desire↑ of passing
urine, alternated too with an involuntary dribbling; she passed
but little at a time, but on the whole discharged the natural
quantity; the urine did not scald the surrounding parts; She com¬
plained also of a prickling in the thighs, & of a sensation approach¬
ing to numbness especially in the right thigh; The pain was
especially acute in the lower side of the Belly; it was not con¬
stant in its violence, but seemed to originate in the Belly & ex¬
tend to the back; it was much increased on motion or pressure;
When most acute it was accompanied with Singultus & with
much tremor & these soon terminated in a gentle fit of Hyste¬
ria. Her P. was soft & slow even when most agitated with
pain; V. S. I therefore did not judge necessary & especially as the
pain recurred & abated alternately; there was no thirst, & the Skin
was cool, B. open; was regular at last menstruation.-
Fomentations were applied with some relief to the pain, &
Lintseed tea with small doses of nitre relieved the urinary
complaint; The nervous symptoms, & Mrs. Fraser says, the pain↓s↓
[Page 2]
were immediately relieved by a mucilaginous draught containing 5 grs
of musk; her feet & legs became very hott after it, & she soon fell a¬
sleep; in two hours she awoke free of pain, & continued easy all the
day after, but weak. - She has long, as you already know, com¬
plained of a pain in the left side, tho' it was troublesome before
this attack yet during the fit she was not sensible of it; she
felt ↑it↑ however after recovering from the other pain. -
2d. After an easy night with a good deal of refreshing sleep
she waked about 6 A.M. with some pain & about 9 she was
seized with greater violence than ever; every symptom as yesterday,
but the pain of the back & loins now acute & attended with much
nausea & some vomiting. - P. under 70 & soft; Skin cool unless a
temporary warmth occasioned by the violence of pain. Belly cos¬
tive since yesterday morning. - The nausea & vomiting were re¬
moved by large draughts of warm water; Formentations were used
as before & two emollient clysters were given with much benefit
from the second; the Lintseed tea & Nitre were continued; & some
relief especially to the pain in the back was observed from gentle
friction of Ӕther; The Nervous symptoms returned & at the same
hour /1 P.M./ she fell asleep, after the Musk draught wt. the
addition of Liq. Laud. gtt. XXV; she observed the same heat
in the feet & legs & waked at 3 P.M. much better; she
continued so all the evening, & had an anodyne of gtt. XXX
Liq. Laud. at bed time.- This morning she had a degree of
tenesmus before the Pain became so acute, & when straining at
stool she observed mixed with about 2 oz. of urine that she
[Page 3]
had passed, an apparently membranous substance of an inch in length
& of a dark brown color, at one end especially. On closer exami¬
nation this substance seemed to be mucus; it had no organiza¬
tion. As she passed nothing by stool, & as from its size it
could not unobserved have passed the urethra, I conclude it
was discharge from the vagina. -
3d. After a good night she was seized at the same hour
as on the preceding days with every symptom tho' in a
less violent manner; the nausea & vomiting did not recurr,
The P. good, no febrile symptom; the pain was not so
constant, nor did the nervous symptoms, (the Singultus
& Tremor,) terminate in any fit of Hysteria; She was much
relieved by the Fomentations & especially by the Ӕther,
She fell asleep precisely as before, with the feeling of
warmth in the feet & legs, & waked shortly much relieved.
Had some purging in the night therefore the enema
was not repeated. The Lintseed tea was continued & a
℈i of the Pulv. Gum. Tragacanth. comp. three times thro.
the day, was ordered. The pain in passing urine seemed
much abated, tho the frequent desire still continued, I
should have observed that on this day she had no a¬
nodyne nor musk draught.
4th. Passed the night ↑in↑ a calm way, was seized with pain
as
[Page 4]
before, in the morning, in the lower & right side of Belly & in
the back, the desire of making water still continued, but the
ardor much less; the Pain to day was less acute & was re¬
lieved for a time from the Ӕther; the nervous symptoms
were but moderate; she fell asleep naturally as for¬
merly & in less than an hour waked relieved as before.
The Lintseed tea and Pulv. Tragacanth. were continued, &
she remained well all the evening; ℥ſs Ol. Ricin was
ordered at bed time, & she was directed to apply the
Ӕther freely next morning before the usual periodical
attack of pain. -
5th. Has no pain, the Ӕther was applied as directed &
two copious stools were the effect of the castor oil.
Mrs. Fraser has continued well since, unless some gentle
threatening now & then. - She has been restricted as you
some time ↑ago↑ directed, to a vegetable & milk diet; the same
was continued during this complaint. On the 10th. of last
April she was safely delivered of a healthy child; some
time before delivery she was sensible of a disagreeable
weight in the right side; She continued to recover after
the birth of her child till on the 10th. day ↑after↑she was
seized as on the 1st. instt. & the usual discharge as
immediately after labour came on, she was speedily re¬
lieved by injestions, fomentations, & Lintseed tea, lest that
[Page 5]
she had fluor albus till the natural period of her first
menstruation; then She had an atural discharge both as
to quantity & color; In a fourthnight after this she took a
long walk for the first time since her delivery when
there immediately came on a copious discharge of bloody
matter resembling pus; before this discharge entirely went
off she was sensible of one or two substances coming a¬
way as on the 2d. instn.; In a month or rather more af¬
ter, she menstruated again, but the discharge was
more florid & copious than usual; from this menstrua¬
tion untill her attack on the 1st. instn. she continued
well but that the pectoral complaints were some¬
times troublesome. In her first labour six years ago, there was
some cause to suspect the Oss. coccygis was injured; at that
time {illeg} she had great difficulty to walk for some
period after; since, she has frequently complained of much
pain in that part, but in two labours between the first
& the last she felt nothing of it; in the last & repeatedly
since she has complained of it, & she was for some weeks
after the last, unable to walk but on crutches. -
On the 5th. instn., the first day she was free of her pre¬
sent complaint from the 1st., she passed, (at least she thinks
so, for she was not immediately sensible of it,) by urine
[Page 6]
the inclosed substance. Mrs. Fraser has never been before
subject to any complaint in the urinary organs; her
urine was never observed to have any sandy sediment
nor were any of her relations ever subject to stone. The
only ↑known↑probable cause of her late attack was having laced
herself tighter than usual, & having stood during prayer
in church where her health for some time had not
allowed her to go. -
I am conscious the above account is neither so
concise nor so connected as it should be; I am much
hurried & I am really at a loss what to attribute Mrs.
Frasers complaint to; & I trust you will make every a¬
llowance for a young man in such a situation; If I have
neglected any thing you would wish to be informed of I
will expect to hear; From some enquiries I have made
Mrs. F. dreads some calculous complaint, perhaps it
might be proper to remove this suspicion (as I have al¬
ready endeavoured) from her mind at least; I delay
pursuing any plan of cure till I have your answer &
I have the honor to be with great respect
Your attached pupil
& obed hbl Servt.
[Page 7]
Doctor Cullen
Physician
Edinr.
Dr. Robertson
C. Mrs. Fraser
Augt. 1789
V. XX. p. 265
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