Cullen

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

 

[ID:3611] From: Dr James Robertson / To: Dr William Cullen (Professor Cullen) / Regarding: Mrs Jane Fraser (of Relick) (Patient) / 19 December 1789 / (Incoming)

Letter from James Robertson, concerning the case of Mrs Fraser of Relick. Mrs Fraser's symptoms include a feeling of tightness in the breast, breathlessness and spitting blood which recedes upon guarding against cold. Mrs Fraser has also developed sponginess and bleeding in her gums. Robertson recommended an extraction of a decaying tooth, but Mrs Fraser is afraid of losing too many teeth.

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Metadata

FieldData
DOC ID 3611
RCPE Catalogue Number CUL/1/2/2499
Main Language English
Document Direction Incoming
Date19 December 1789
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 James Robertson, concerning the case of Mrs Fraser of Relick. Mrs Fraser's symptoms include a feeling of tightness in the breast, breathlessness and spitting blood which recedes upon guarding against cold. Mrs Fraser has also developed sponginess and bleeding in her gums. Robertson recommended an extraction of a decaying tooth, but Mrs Fraser is afraid of losing too many teeth.
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 IDRole in documentPerson
[PERS ID:4776]AuthorDr James Robertson
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:857]PatientMrs Jane Fraser (of Relick)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:4776]Patient's Physician / Surgeon / ApothecaryDr James Robertson
[PERS ID:858]Patient's Relative / Spouse / FriendMr 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

[Page 1]
Dear Sir


I was duly favoured with yours of the 17th. August in an¬
swer to mine respecting Mrs. Fraser of Relick; I confessed to you my
difficulty in classing all the symptoms she complained of, under any
regular disease; yet I attributed them fortunately to the cause you
gave, but was relieved from much alarm by your belief, that the concre¬
tion had nothing stony in it's nature, & that it's formation was probably
accidental; Anxiety is the natural attendant of want of experience & in
me it may perhaps originate in want of knowledge.


Mrs. Fraser has had no return of the complaint alluded to, & during
the Northern Jubilee held at Inverness she was able to go thro' a weeks fa¬
tigue in attending it; When I last wrote you, tho' she at that time com¬
plained of no pectoral uneasiness, yet I should have mentioned that
she often ailed with in the course of the Spring & Summer before her
attack in August; she often used to complain of uneasiness in the chest,
arising from a sense of tightness across it; this was attended with some
Dyspnœa; to me it seemed rather a kind of nervous panting, than a¬
rising from any inflammatory tendency of the lungs; it was attended
too with some expectoration in the morning if a brownish hue; the
expectorated matter did not seem of a purulent kind, but sometimes
from the brightness of the brown it appeared as if a little streaked
with blood
; This complaint was not attended with any cough, nor
with any firmness of quickness in the pulse, nor did it continue
but for a few days ↑at a time↑; a greater attention to herself, by avoiding cold &c.
was the only ostensible cause of it's going off.




[Page 2]

Since her attack in August she has enjoyed good health, except that,
some weeks ago she began to be sensible of a sponginess in her gums
which has increased, & of their aptness to bleed, but not attended with
any factor of her breath; the gum has separated from some of her
teeth, & at the roots of two there seems to be a loss of substance, for the
tooth is bare to it's socket; I gave her some Peruvian Bark only to
wash her mouth, & her bowels are kept free; I forbid the use of either
brush, powder or tincture to clean her teeth with, all of which she
formerly used; I allow her to use water with some of the Tincture of Myrrh;
but in case this complaint increases I am at some loss what to ad¬
vise, especially as Relick says you formerly forbid the internal
use of Bark on account of her pectoral complaints, & as she has
once or twice of late, complained of a slight uneasiness in the breast
of only a few minutes duration, but attended with no other symptoms.
She has used the Bark about ten days, & tho' not very evident, I can
see that there is a more closs adhesion of the gums to the teeth, & that
the part where there seems as if a loss of substance, has changed the
color from a white as if slightly ulcerated, to a beginning healthy red.


On the even however of an increase of this complaint I wish to be
directed as to the internal use of the Bark or any other remedy you
may think more adviseable. - She is regular in every respect, her
Pulse is naturally slow, at least since I have been acquainted with
her it is seldom more than 65; She is not plethoric; tho' she is
said to be of a more healthy appearance than for some years, she
has still a delicate look.


Mrs. Fraser has for several months on much exposure to cold



[Page 3]

been subject to a Rheumatic affection of the left cheeck, sometimes
attended with fever, & often with swelling extending down the neck
towards the shoulder; On this side, the second of the dentes molar
of the lower jaw is a little carious & sometimes a little pained; As
she had the same on the opposite side extracted some years ago
for the toothach, I have recommended her losing this one also,
lest she may shortly be seized with regular fits of the Odontalgia
& lest it may contribute even now to the Rheumatic affection.
Mrs. Fraser however is against losing any more of her teeth, es¬
pecially she says, as there is some threatening of a caries in one
of her fairest fore teeth; this I did not promise to mention to you,
but left it to herself when she might have occasion to write
you; I have been tedious but Relick is an anxious husband,
I shall expect your answer soon & I am most respectfully


Dear Sir
Your attached [Pupil]
& obedient humble [Servant]
Ja Robertson

Inverness 19th. December
1789



[Page 4]


Doctor Cullen
Physician
Edinr.


Dr. Robertson
Concerning
Mrs. Fraser of
Relic
Decr. 1789
V. XX p. 359
August 17th

Diplomatic Text

[Page 1]
Dear Sir


I was duly favoured with yours of the 17th. Augt. in an¬
swer to mine respecting Mrs. Fraser of Relick; I confessed to you my
difficulty in classing all the symptoms she complained of, under any
regular disease; yet I attributed them fortunately to the cause you
gave, but was relieved from much alarm by your belief, that the concre¬
tion had nothing stony in it's nature, & that it's formation was probably
accidental; Anxiety is the natural attendant of want of experience & in
me it may perhaps originate in want of knowledge.


Mrs. Fraser has had no return of the complaint alluded to, & during
the Northern Jubilee held at Invs. she was able to go thro' a weeks fa¬
tigue in attending it; When I last wrote you, tho' she at that time com¬
plained of no pectoral uneasiness, yet I should have mentioned that
she often ailed with in the course of the Spring & Summer before her
attack in Augt.; she often used to complain of uneasiness in the chest,
arising from a sense of tightness across it; this was attended with some
Dyspnœa; to me it seemed rather a kind of nervous panting, than a¬
rising from any inflammatory tendency of the lungs; it was attended
too with some expectoration in the morning if a brownish hue; the
expectorated matter did not seem of a purulent kind, but sometimes
from the brightness of the brown it appeared as if a little streaked
with blood
; This complaint was not attended with any cough, nor
with any firmness of quickness in the pulse, nor did it continue
but for a few days ↑at a time↑; a greater attention to herself, by avoiding cold &c.
was the only ostensible cause of it's going off.




[Page 2]

Since her attack in Augt. she has enjoyed good health, except that,
some weeks ago she began to be sensible of a sponginess in her gums
which has increased, & of their aptness to bleed, but not attended with
any factor of her breath; the gum has separated from some of her
teeth, & at the roots of two there seems to be a loss of substance, for the
tooth is bare to it's socket; I gave her some Peruvian Bark only to
wash her mouth, & her bowels are kept free; I forbid the use of either
brush, powder or tincture to clean her teeth with, all of which she
formerly used; I allow her to use water with some of the Tinct. Myrrh;
but in case this complaint increases I am at some loss what to ad¬
vise, especially as Relick says you formerly forbid the internal
use of Bark on account of her pectoral complaints, & as she has
once or twice of late, complained of a slight uneasiness in the breast
of only a few minutes duration, but attended with no other symptoms.
She has used the Bark about ten days, & tho' not very evident, I can
see that there is a more closs adhesion of the gums to the teeth, & that
the part where there seems as if a loss of substance, has changed the
color from a white as if slightly ulcerated, to a beginning healthy red.


On the even however of an increase of this complaint I wish to be
directed as to the internal use of the Bark or any other remedy you
may think more adviseable. - She is regular in every respect, her
P. is naturally slow, at least since I have been acquainted with
her it is seldom more than 65; She is not plethoric; tho' she is
said to be of a more healthy appearance than for some years, she
has still a delicate look.


Mrs. Fraser has for several months on much exposure to cold



[Page 3]

been subject to a Rheumatic affection of the left cheeck, sometimes
attended with fever, & often with swelling extending down the neck
towards the shoulder; On this side, the second of the dentes molar
of the lower jaw is a little carious & sometimes a little pained; As
she had the same on the opposite side extracted some years ago
for the toothach, I have recommended her losing this one also,
lest she may shortly be seized with regular fits of the Odontalg.
& lest it may contribute even now to the Rheumatic affection.
Mrs. Fraser however is against losing any more of her teeth, es¬
pecially she says, as there is some threatening of a caries in one
of her fairest fore teeth; this I did not promise to mention to you,
but left it to herself when she might have occasion to write
you; I have been tedious but Relick is an anxious husband,
I shall expect your answer soon & I am most respectfully


Dear Sir
Your attached [Pupil]
& obedt. hble. [Servant]
Ja Robertson

Invs. 19th. Decr.
1789



[Page 4]


Doctor Cullen
Physician
Edinr.


Dr. Robertson
C
Mrs. Fraser of
Relic
Decr. 1789
V. XX p. 359
August 17th

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