Cullen

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

 

[ID:4164] From: Dr William Cullen (Professor Cullen) / To: Earl Dunbar Douglas (Hamilton) (Lord Selkirk, 4th Earl of Selkirk) / Regarding: Lady Mary Douglas (Patient) / 6 October 1777 / (Outgoing)

Reply to 'The Right Honourable the Earl of Selkirk', concerning the case of his daughter Lady Mary.

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Metadata

FieldData
DOC ID 4164
RCPE Catalogue Number CUL/1/1/10/21
Main Language English
Document Direction Outgoing
Date6 October 1777
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) Enclosure(s) mentioned, but missing
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply to 'The Right Honourable the Earl of Selkirk', concerning the case of his daughter Lady Mary.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:365]
Case of Lady Mary Douglas diagnosed with a 'weakness of her bowels'.
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:886]AddresseeEarl Dunbar Douglas (Lord Selkirk, 4th Earl of Selkirk)
[PERS ID:1070]PatientLady Mary Douglas
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:1017]Patient's Relative / Spouse / FriendLady Helen Douglas (Lady Selkirk)
[PERS ID:886]Patient's Relative / Spouse / FriendEarl Dunbar Douglas (Lord Selkirk, 4th Earl of Selkirk)

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
Destination of Letter St Mary's Isle Borders Scotland Europe inferred

Normalized Text

[Page 1]
The Right Honourable The Earl of Selkirk
My Lord


I suppose that notwithstanding all I have said to Lady Selkirk
your Lordship will expect something in writing from me on the
subject of Lady Mary. I am glad that so much time has been allowed
as to allow me to form a clear judgment of the nature of the case.
I very early formed my opinion and time has confirmed it. I could
find no disease than but a weakness of stomach and bowels
producing indigestion and fits of looseness. For this I ordered two
medicines the prescriptions for which I have sent along with this, 1
one of them was intended to correct any sharpness that might
be in the Bowels and the other was intended to strengthen the
bowels so as to prevent the breeding of more foulness. Both I think
have answered the purpose and Lady Mary is so well recovered
that I shall advise both the medecines to be laid aside as soon as
Lady Mary enters upon her Journey homewards and I must observe
that tho' Lady Mary had not been so much recovered as she is
I should have advised the same Intermission of the Medicines
as I have been long assured that medicines long continued
not only lose their powers but also commonly do harm and



[Page 2]

especially in children.


Tho Lady Mary is now so well nothing is precarious
as the state of weak bowels, they are hurt by slight and often
unheeded causes and therefore their disorders frequently return.
On this account Lady Selkirk or Your Lordship must no be soon
alarmed tho' some inequality of appetite and spirits, some
gripings and even loosness should appear. Perhaps nature again
next day may set matters to rights or two or three doses of the
white mixture may do the business and I would not hurt her
on any constant use of that or have recourse to the Bark mixture
unless the ailments were considerable and seemed to be permanent.
However after a long Interval in the use of these medicines and
especially in the spring If Lady Mary should be threatened with
ailments I would think it very proper to give her a course of
the medicines for two or three weeks.


In the mean time every measure in the way of regimen
for strengthening her constitution and particularly her bowels
are to be employed. One of the best is much fresh air and ex¬
ercise. Walking abroad is frequently to be allowed but in this
way children are apt either either to do too little or too much,
too little if they are forced to walk very slowly and too much
when they are allowed to run and romp till they are heated and
fatigued. A medium is to be observed and at that rate child¬
ren naturally take and bear a good deal of exercise. In deli¬
cate children the medium is difficult to be observed and
for such riding is a safer measure and as the young lady
can ride by herself she should frequently practise it even



[Page 3]

in winter when the weather is mild. I would not have her get
wet but if that can be avoided I would not be afraid of a shower
and I think riding in little bad weather, often does service.


After fresh air and exercise the most strengthening measure
is cold bathing. This practised by immersion and in the sea
too, is the most effectual but this is not at all convenient in win¬
ter and at least not in delicate persons not before accustomed to
it. But great benefit can be got even in winter by cold washing
and bathing within doors and if persons would proceed by de¬
grees and by exact weight and measure it may be begun at any
time. Take three parts of water from a well or spring but never
from a river and to this immediately before using it add one
part of boiling water and you'll have a mixture that may be
employed to wash the most delicate person. It is to be practised
every day but every second day one eight of the boiling water is
to be left out so that in a fortnight the whole is withdrawn and
the water afterwards is to be used as it comes from the well. With
these measures some attention is to be given to diet. Weakness of Bowels
disposed to acesancy requires some animal food and Lady may
every day have some beef tea and two or three times a week a
little solid animal food of the lighter kinds, but as animal food
is otherwise bad for children I would have Lady Mary in this
respect kept within bounds. On the other hand her stomach
will not bear roots greens or other Garden things or at least these
things must be taken very sparingly and her Ladyship's vegetable
food must be of the mealy or grain kind. These may be prepa¬
red in different ways and frequently with milk. Fruit must
be given very sparingly. A little baked or boiled apple may be



[Page 4]

given now and then, and either raisins or currants may be taken
with grains. A ripe, dry, mealy potatoe may be taken frequently.
Bread and butter if the last is not in great (↑large↑) proportion may be
taken freely. Lady Mary's dri↑n↑k must be plain water. Malt
liquor would do harm and wine is no ways necessary -


Tea and Coffee are both hurtfull. [Content?] if not taken too
warm is very proper. Nothing further occurs but to say what
I shall always say that I have the honour to be with the utmost
respect and sinc↑e↑re regard. My Lord, your Lordship's most
obedient humble sert servant

W. C.

Edinburgh 6th. October
1777

Notes:

1: Not copied into casebook.

Diplomatic Text

[Page 1]
The Right Honourable The Earl of Selkirk
My Lord


I suppose that notwithstanding all I have said to Lady Selkirk
your Lordship will expect something in writing from me on the
subject of Lady Mary. I am glad that so much time has been allowed
as to allow me to form a clear judgment of the nature of the case.
I very early formed my opinion and time has confirmed it. I could
find no disease than but a weakness of stomach and bowels
producing indigestion and fits of looseness. For this I ordered two
medicines the prescriptions for which I have sent along with this, 1
one of them was intended to correct any sharpness that might
be in the Bowels and the other was intended to strengthen the
bowels so as to prevent the breeding of more foulness. Both I think
have answered the purpose and Lady Mary is so well recovered
that I shall advise both the medecines to be laid aside as soon as
Lady Mary enters upon her Journey homewards and I must observe
that tho' Lady Mary had not been so much recovered as she is
I should have advised the same Intermission of the Medicines
as I have been long assured that medicines long continued
not only lose their powers but also commonly do harm and



[Page 2]

especially in children.


Tho Lady Mary is now so well nothing is precarious
as the state of weak bowels, they are hurt by slight and often
unheeded causes and therefore their disorders frequently return.
On this account Lady Selkirk or Your Lordship must no be soon
alarmed tho' some inequality of appetite and spirits, some
gripings and even loosness should appear. Perhaps nature again
next day may set matters to rights or two or three doses of the
white mixture may do the business and I would not hurt her
on any constant use of that or have recourse to the Bark mixture
unless the ailments were considerable and seemed to be permanent.
However after a long Interval in the use of these medicines and
especially in the spring If Lady Mary should be threatened with
ailments I would think it very proper to give her a course of
the medicines for two or three weeks.


In the mean time every measure in the way of regimen
for strengthening her constitution and particularly her bowels
are to be employed. One of the best is much fresh air and ex¬
ercise. Walking abroad is frequently to be allowed but in this
way children are apt either either to do too little or too much,
too little if they are forced to walk very slowly and too much
when they are allowed to run and romp till they are heated and
fatigued. A medium is to be observed and at that rate child¬
ren naturally take and bear a good deal of exercise. In deli¬
cate children the medium is difficult to be observed and
for such riding is a safer measure and as the young lady
can ride by herself she should frequently practise it even



[Page 3]

in winter when the weather is mild. I would not have her get
wet but if that can be avoided I would not be afraid of a shower
and I think riding in little bad weather, often does service.


After fresh air and exercise the most strengthening measure
is cold bathing. This practised by immersion and in the sea
too, is the most effectual but this is not at all convenient in win¬
ter and at least not in delicate persons not before accustomed to
it. But great benefit can be got even in winter by cold washing
and bathing within doors and if persons would proceed by de¬
grees and by exact weight and measure it may be begun at any
time. Take three parts of water from a well or spring but never
from a river and to this immediately before using it add one
part of boiling water and you'll have a mixture that may be
employed to wash the most delicate person. It is to be practised
every day but every second day one eight of the boiling water is
to be left out so that in a fortnight the whole is withdrawn and
the water afterwards is to be used as it comes from the well. With
these measures some attention is to be given to diet. Weakness of Bowels
disposed to acesancy requires some animal food and Lady may
every day have some beef tea and two or three times a week a
little solid animal food of the lighter kinds, but as animal food
is otherwise bad for children I would have Lady Mary in this
respect kept within bounds. On the other hand her stomach
will not bear roots greens or other Garden things or at least these
things must be taken very sparingly and her Ladyship's vegetable
food must be of the mealy or grain kind. These may be prepa¬
red in different ways and frequently with milk. Fruit must
be given very sparingly. A little baked or boiled apple may be



[Page 4]

given now and then, and either raisins or currants may be taken
with grains. A ripe, dry, mealy potatoe may be taken frequently.
Bread and butter if the last is not in great (↑large↑) proportion may be
taken freely. Lady Mary's dri↑n↑k must be plain water. Malt
liquor would do harm and wine is no ways necessary -


Tea and Coffee are both hurtfull. [Content?] if not taken too
warm is very proper. Nothing further occurs but to say what
I shall always say that I have the honour to be with the utmost
respect and sinc↑e↑re regard. My Lord, your Lordship's most
obedient humble sert servant

W. C.

Edinr. 6th. Octr.
1777

Notes:

1: Not copied into casebook.

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