The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:1091] From: Dr William Cullen (Professor Cullen) / To: Anonymous / Regarding: Mr Stewart (Patient) / 26 February 1781 / (Outgoing)
Reply 'For Mr Stewart'. He has called upon Cullen in person since the last letter was received.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 5 images for this document.
[Page 1]
[Page 2]
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[Page 5]
Metadata
| Field | Data |
|---|---|
| DOC ID | 1091 |
| RCPE Catalogue Number | CUL/1/1/13/145 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 26 February 1781 |
| Annotation | None |
| Type | Scribal copy ( includes Casebook Entry) |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | Yes |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply 'For Mr Stewart'. He has called upon Cullen in person since the last letter was received. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1442] |
Case of Mr Stewart who has a stomach disorder. |
1 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:3371] | Addressee | |
| [PERS ID:3370] | Patient | Mr Stewart |
| [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 Mr Stewart.
I was favoured with yours by Mr. Stewart when
he went South & he has now called upon me in his return. Upon
considering every circumstance of the Case I think there is no
room for suspecting a topical plethora Affection & the whole
of his Symptoms depend on somewhat that has induced a
general weakness of the Nervous System but I hope this
is to no such degree that a few medicines & a good deal
of Attention to his manner of life may entirely recover
If the pain of the Epigastric region should return
with any violence & that you can say that it has been
[Page 2]
commonly relieved by bleeding I should allow it to be repeated
but I am averse to the practice as it is not favourable to the
general train of his disease
The disease appears to me to affect the Stomach particularly
& when want of appetite, flatulence & other Symptoms of indigestion
show the stomach to be loaded I would have him take a gentle Vomit
but not to be repeated oftener than very necessary for the effects
of it are not durable & the frequent repetition of Vomiting does not
strengthen the Stomach.
I should endeavour to obviate his Complaints by strengthening
the tone of the Stomach & of the whole System by the medicines
prescribed below, He should take them constantly for a fortnight
or 3 weeks at one time but after that he should intermitt them
for a week or two & return to them sooner or later as the effects of
the first trial & the state of his Complaints may seem to require
With these medicines let him be as much in the fresh
air & in gentle exercise as he conveniently can. Moderate walking
will be of service but any length of walking that either heats
or fatigues him will do harm & particularly any hurried or
violent motion will be ready to bring back his palpitations
& both by that & otherwise do him much harm. The exercise
which will be of most service is Riding on horseback & he
should practice this as oft as weather & business will any
wise allow.
His Diet should be of a middling kind neither full
nor low, he should take some Animal food every day at
[Page 3]
Dinner but none at Supper. At Dinner he should never
make a full meal of meat but should fill it up with
plain Soup pudding & vegetables but in the later he
ought to be sparing & avoid all those which he knows are
liable to prove windy on his Stomach. The farinacea in
every shape are safer than Grains or roots but the later
may be used more freely in the Summer than at other
Seasons. He may take some of the lighter kinds of
fish but even these seldom & sparingly & this rule should
be especially observed in the Case of Salmon & herring.
His ordinary Drink should be plain water unless
he finds it very ready to make him Costive & in this Case
he may take good Porter with two parts of water. Common
Small beer can hardly be proper but if he has at hand
a mellow & well hopped Strong beer he may take that with
two parts of water for his ordinary draught. If he has
been in the pretty constant habit of taking a little strong
drink after his meals I have no objection to his Continuing
it, providing he find that the liquor he takes is not ready
to become either sour or windy in his stomach. Upon
this Condition he may take a Glass or two either of wine or
well brewed & mellow strong Ale but the later will be
in the most hazard of hurting him & while he is liable
to acidity or flatulence he must take a little spirits & water
tho' I would not have him accustom his stomach to this
as long as it will bear either Ale or Wine ----
[Page 4]
He should neither at breakfast nor at any other time take either
Indian Tea or Coffee but if he is attached to somewhat in the
shape of Tea let it be Sassafras or Cocoa tea, or one made up
of Sages Balm, Rosemary or other plant of home growth with
such Tea he may take dry toast & a little butter but it should
be a little only & he should not take any honey, jelly marmalade
or other sweet meats.
Either at breakfast or Supper he may take a fresh soft
boiled Egg but he should not practice it very constantly.
I omitted to enquire how his Stomach digests Milk, if it
do it well he may take it either at breakfast ot Supper
but once a day will be enough.
Let me conclude the subject of Diet with observing
that it is a matter of more consequence than he may imagine
& that almost every stomach has its peculiarities & therefore
the management of it must often depend upon the attentive
observation of every person for himself ---
Costiveness will readily hurt Mr. Stewart & should
be therefore carefully avoided & whenever he misses for two
days to go to Stool he should take a medicine I leave you to
find the one that may answer best with him. I only say
that Rhubarb is improper & that the Aloetic Answer better
Let Mr. Stewart at all times take care to avoid Cold
particularly in his feet & legs.
If either you have observations to make or Mr
Stewart has any questions to put let me have them
[Page 5]
& you may depend on my Attention. If Mr. Stewart
should not upon the plan I have given recover entirely as
I wish I should think of advising Cold bathing but I
would not determine this till I know his state of health
about the beginning of May which is as soon as he can
begin to bathe.
Take ten grams of prepared powdered steel, five grams of powdered cinnamon, fifteen grams of very pure white sugar; mix to make a powder and in this way make fourteen doses. Label Strengthening Powders one to be taken twice a day washing down each dose with two table spoonfuls of the following
Take an ounce of spring water, three ounces of simple Cinnamon water, two ounces of tincture of Peruvian Bark, an ounce of tincture of Aromatics. Mix, and label Strengthening Tincture, two tablespoonfuls to be taken after every dose of the powders
Diplomatic Text
For Mr Stewart.
I was favoured with yours by Mr. Stewart when
he went South & he has now called upon me in his return. Upon
considering every circumstance of the Case I think there is no
room for suspecting a topical plethora Affection & the whole
of his Symptoms depend on somewhat that has induced a
general weakness of the Nervous System but I hope this
is to no such degree that a few medicines & a good deal
of Attention to his manner of life may entirely recover
If the pain of the Epigastric region should return
with any violence & that you can say that it has been
[Page 2]
commonly relieved by bleeding I should allow it to be repeated
but I am averse to the practice as it is not favourable to the
general train of his disease
The disease appears to me to affect the Stomach particularly
& when want of appetite, flatulence & other Symptoms of indigestion
show the stomach to be loaded I would have him take a gentle Vomit
but not to be repeated oftener than very necessary for the effects
of it are not durable & the frequent repetition of Vomiting does not
strengthen the Stomach.
I should endeavour to obviate his Complaints by strengtheg
the tone of the Stomach & of the whole System by the medicines
prescribed below, He should take them constantly for a fortnight
or 3 weeks at one time but after that he should intermitt them
for a week or two & return to them sooner or later as the effects of
the first trial & the state of his Complaints may seem to require
With these medicines let him be as much in the fresh
air & in gentle exercise as he conveniently can. Moderate walking
will be of service but any length of walking that either heats
or fatigues him will do harm & particularly any hurried or
violent motion will be ready to bring back his palpitations
& both by that & otherwise do him much harm. The exercise
which will be of most service is Riding on horseback & he
should practice this as oft as weather & business will any
wise allow.
His Diet should be of a middling kind neither full
nor low, he should take some Animal food every day at
[Page 3]
Dinner but none at Supper. At Dinner he should never
make a full meal of meat but should fill it up with
plain Soup pudding & vegetables but in the later he
ought to be sparing & avoid all those which he knows are
liable to prove windy on his Stomach. The farinacea in
every shape are safer than Grains or roots but the later
may be used more freely in the Summer than at other
Seasons. He may take some of the lighter kinds of
fish but even these seldom & sparingly & this rule should
be especially observed in the Case of Salmon & herring.
His ordinary Drink should be plain water unless
he finds it very ready to make him Costive & in this Case
he may take good Porter with two parts of water. Common
Small beer can hardly be proper but if he has at hand
a mellow & well hopped Strong beer he may take that wt.
two parts of water for his ordinary draught. If he has
been in the pretty constant habit of taking a little strong
drink after his meals I have no objection to his Continuing
it, providing he find that the liquor he takes is not ready
to become either sour or windy in his stomach. Upon
this Condition he may take a Glass or two either of wine or
well brewed & mellow strong Ale but the later will be
in the most hazard of hurting him & while he is liable
to acidity or flatulence he must take a little spirits & water
tho' I would not have him accustom his stomach to this
as long as it will bear either Ale or Wine ----
[Page 4]
He should neither at breakfast nor at any other time take either
Indian Tea or Coffee but if he is attached to somewhat in the
shape of Tea let it be Sassafras or Cocoa tea, or one made up
of Sages Balm, Rosemary or other plant of home growth wt.
such Tea he may take dry toast & a little butter but it should
be a little only & he should not take any honey, jelly marmalade
or other sweet meats.
Either at breakfast or Supper he may take a fresh soft
boiled Egg but he should not practice it very constantly.
I omitted to enquire how his Stomach digests Milk, if it
do it well he may take it either at breakfast ot Supper
but once a day will be enough.
Let me conclude the subject of Diet with observing
that it is a matter of more consequence than he may imagine
& that almost every stomach has its peculiarities & therefore
the management of it must often depend upon the attentive
observation of every person for himself ---
Costiveness will readily hurt Mr. Stewart & should
be therefore carefully avoided & whenever he misses for two
days to go to Stool he should take a medicine I leave you to
find the one that may answer best with him. I only say
that Rhubarb is improper & that the Aloetic Answer better
Let Mr. Stewart at all times take care to avoid Cold
particularly in his feet & legs.
If either you have observations to make or Mr
Stewart has any questions to put let me have them
[Page 5]
& you may depend on my Attention. If Mr. Stewart
should not upon the plan I have given recover entirely as
I wish I should think of advising Cold bathing but I
would not determine this till I know his state of health
about the beginning of May which is as soon as he can
begin to bathe.
℞ Limat. mart. ppt. gr. x Cinnam. pulv. gr. v. Sacch.
alb. puriss. gr. xv m. f. pulv. et f. h. m. dos No. xiv
Signa Strengthening Powders one to be taken twice a day
washing down each dose with two table spoonfuls of
the following
℞ Aq. font. ℥j Aq. Cinnam. simpl. ℥iij Tinct. Cort
Peruv. ℥ij Tinct. Aromat. ℥j
ℳ. Signa Strengthening Tincture two table spoonfuls
to be taken after every dose of the powders
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