The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:4701] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mrs (Patient) / 30 August 1783 / (Outgoing)
Reply, 'For --'. Letter for an unnamed female patient with headaches which recur during her menstrual period.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 6 images for this document.
[Page 1]
[Page 2]
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[Page 5]
[Page 6]
Metadata
| Field | Data |
|---|---|
| DOC ID | 4701 |
| RCPE Catalogue Number | CUL/1/1/16/105 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 30 August 1783 |
| Annotation | None |
| Type | Machine copy |
| Enclosure(s) | Enclosure(s) present |
| Autopsy | No |
| Recipe | Yes |
| Regimen | Yes |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply, 'For --'. Letter for an unnamed female patient with headaches which recur during her menstrual period. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1671] |
Case of an unnamed female patient with headaches. |
2 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:5846] | Patient | Mrs |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
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 |
Normalized Text
For ---
I have carefully considered the Case laid before me
and which seems to be very exactly and fully narrated.
I am sorry to observe in the first place that the Case
must be difficult as the causes of it have now been ap¬
plied for a [long?] time and every repetition of ↑its↑ effects con¬
firms the faults of the Constitution but I hope that
it can still admitt of much relief and it is to be hoped
in a few more years of {illeg} will allow it to be Cured
very entirely.
I consider the disease as consisting in in a
Disposition of the System to form too much blood which
is thrown particularly upon the Vessels of the womb
and which by certain accidents to were overstretched
and are now very much released and all this is ac¬
ompanied with a constitution of the nerves liable
{illeg}
All [diseases?] {illeg} as Constitutional are
[Page 2]
rendered so by repetition and habit must be difficult to mend
and I must more readily think so as the disease has hither[to]
baffled all remedies and Regimen. I dont doubt but the
remedies were judiciously chosen and the regimen prope[rly]
adapted but it would have enabled me to advise much
more clearly and saved me from troubling the patient
with superfluous advice if I had been informed of th[e]
remedies and regimen already employed with their effe[cts]
and if this can yet be conveniently done I shall not
grudge any trouble in rendering my advice more compl[ete]
and effectual.
In the mean time I shall offer what I think
most effectual. I have given below a prescription which
I have found useful in such cases and would now ventur[e]
to recommend it to this Lady. As soon as the Menstrua[al]
period is over she will please to begin by taking a single
pill in the morning before she takes any thing else. If
this pill gives her a little sickness or squeamishness it
is enough and she will please continue to take such
a dose every morning till the return of next menstrual
[Page 3]
period. But if the single pill does not at all affect her
stomach after two days trial she will please take two
pills for a dose and if even these have no sensible effect
she will pause after every two days to increase the dose
by a single pill till she finds a dose that gives a little
sickness or squeamishness and at such a dose she is to
continue for the rest of the time mentioned. During the
time of Menstruation she is to Omitt this medicine but as
soon as the period is entirely over she will please to enter
upon it again and take it during the whole of her interval.
After these two Courses of the medicine I should be glad
to know its effects, for if then it shall have had no effects
upon the disease I shall be doubtful of insisting on its
further use.
This is the only remedy I can at present advise
but if I had known more particularly what remedies had
been already employed I should perhaps have been able
to advise now some others or at least be able if the
{illeg} advised shall prove fruitless {illeg}
[Page 4]
others hereafter.
I am equally anxious to advise on the subject of regimen
which has probably may I think do more than any medicine
possibly it has already very properly advised but
I must still offer my opinion in a few particulars.
A very low Diet of Vegetables might be very
hazardous but a full Diet of Animal food must be abso¬
lutely pernicious. The Diet therefore must be of a middle
kind but always inclined to be sparing.
The only safe drink is water and all fermented
or spirituous liquors are to be avoided unless former
habits have rendered them in some measure necessary.
Tea, Coffee or any warm liquor I consider as very
hurtful. I would not advise any very cold drink but
think that any thing even approaching to tepid is im¬
proper. Cold is certainly to be guarded against but
the body should be always kept as cool as it safely may
and warm in Chambers must be very hurtful
Moderate Exercise in a Carriage may be very
[Page 5]
useful but all bodily Exercise and even walking must
aggravate the disease and during the whole time of
menstruation I would advise the Lady's being almost
constantly in a horizontal posture but lying upon a
Couch so as to be at the same time as cool as possible
for lying much under bed Cloaths will be at all
times very improper.
I have now but one other Article of advice
to offer and which is probably expected and that is
that I should particularly advise for the most dis¬
tressing circumstances of the Case the head achs. I
believe they can only be Cured by mending the general
faults of the Circulation and which the medicine I
have prescribed is intended to do, and in the mean
time I believe the headachs can only be palliated or for
a time relieved by Laudanum. I doubt if this can
be safely employed for the headach which proceeds
menstruation but for that which follows it may
be a safe & proper remedy.
Edinburgh 30th.. August
1783
[Page 6]
For
Take ten copper pills, ten grains of powdered Ipecacuanha and a sufficient quantity of mucilage of thick Gum Arabic to make a mass to be divided into twenty pills. Label: Tonic Pills one or more to be taken in the morning before breakfast.
30th August
1783.
Diplomatic Text
For ---
I have carefully considered the Case laid before me
and which seems to be very exactly and fully narrated.
I am sorry to observe in the first place that the Case
must be difficult as the causes of it have now been ap¬
plied for a [long?] time and every repetition of ↑its↑ effects con¬
firms the faults of the Constitution but I hope that
it can still admitt of much relief and it is to be hoped
in a few more years of {illeg} will allow it to be Cured
very entirely.
I consider the disease as consisting in in a
Disposition of the System to form too much blood which
is thrown particularly upon the Vessels of the womb
and which by certain accidents to were overstretched
and are now very much released and all this is ac¬
ompanied with a constitution of the nerves liable
{illeg}
All [diseases?] {illeg} as Constitutional are
[Page 2]
rendered so by repetition and habit must be difficult to mend
and I must more readily think so as the disease has hither[to]
baffled all remedies and Regimen. I dont doubt but the
remedies were judiciously chosen and the regimen prope[rly]
adapted but it would have enabled me to advise much
more clearly and saved me from troubling the patient
with superfluous advice if I had been informed of th[e]
remedies and regimen already employed with their effe[cts]
and if this can yet be conveniently done I shall not
grudge any trouble in rendering my advice more compl[ete]
and effectual.
In the mean time I shall offer what I think
most effectual. I have given below a prescription which
I have found useful in such cases and would now ventur[e]
to recommend it to this Lady. As soon as the Menstrua[al]
period is over she will please to begin by taking a single
pill in the morning before she takes any thing else. If
this pill gives her a little sickness or squeamishness it
is enough and she will please continue to take such
a dose every morning till the return of next menstrual
[Page 3]
period. But if the single pill does not at all affect her
stomach after two days trial she will please take two
pills for a dose and if even these have no sensible effect
she will pause after every two days to increase the dose
by a single pill till she finds a dose that gives a little
sickness or squeamishness and at such a dose she is to
continue for the rest of the time mentioned. During the
time of Menstruation she is to Omitt this medicine but as
soon as the period is entirely over she will please to enter
upon it again and take it during the whole of her interval.
After these two Courses of the medicine I should be glad
to know its effects, for if then it shall have had no effects
upon the disease I shall be doubtful of insisting on its
further use.
This is the only remedy I can at present advise
but if I had known more particularly what remedies had
been already employed I should perhaps have been able
to advise now some others or at least be able if the
{illeg} advised shall prove fruitless {illeg}
[Page 4]
others hereafter.
I am equally anxious to advise on the subject of regimen
which has probably may I think do more than any medicine
possibly it has already very properly advised but
I must still offer my opinion in a few particulars.
A very low Diet of Vegetables might be very
hazardous but a full Diet of Animal food must be abso¬
lutely pernicious. The Diet therefore must be of a middle
kind but always inclined to be sparing.
The only safe drink is water and all fermented
or spirituous liquors are to be avoided unless former
habits have rendered them in some measure necessary.
Tea, Coffee or any warm liquor I consider as very
hurtful. I would not advise any very cold drink but
think that any thing even approaching to tepid is im¬
proper. Cold is certainly to be guarded against but
the body should be always kept as cool as it safely may
and warm in Chambers must be very hurtful
Moderate Exercise in a Carriage may be very
[Page 5]
useful but all bodily Exercise and even walking must
aggravate the disease and during the whole time of
menstruation I would advise the Lady's being almost
constantly in a horizontal posture but lying upon a
Couch so as to be at the same time as cool as possible
for lying much under bed Cloaths will be at all
times very improper.
I have now but one other Article of advice
to offer and which is probably expected and that is
that I should particularly advise for the most dis¬
tressing circumstances of the Case the head achs. I
believe they can only be Cured by mending the general
faults of the Circulation and which the medicine I
have prescribed is intended to do, and in the mean
time I believe the headachs can only be palliated or for
a time relieved by Laudanum. I doubt if this can
be safely employed for the headach which proceeds
menstruation but for that which follows it may
be a safe & proper remedy.
Edinr. 30th.. August
1783
[Page 6]
For
℞ pil. e cupro № X
pulv. Ipecacuan. gr. X
Mucilag. G. Arabic. crass. q. s. ut f. massa
dividenda in pil. № XX.
Sig. Tonic Pills one or more to be taken
in the morning before breakfast.
30th August
1783.
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