Cullen

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

 

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Mr Thos. Hamilton Concerning Mrs Rae
Dear Sir


Mrs Raes complaints are very distressing tho not to
be well understood by any but those who have felt the like
themselves. I think I know them & consider them as partly
a nervous weakness, often tedious but never dangerous. I can
find no marks of any ailment threatening the breast but
considering what threats were four years ago, You was right in
advising the Flannel Shift & Asses Milk. -- The first cant (latter Shirt↑)
be wrong (↑cant ↑). The Milk cant be wrong in a person who otherwise
takes so little nourishment, & the Shirt is necessary upon every
Supposition for the whole of the season that is to follow. - Mrs
Rs complaints are not to be readily relieved by medicine & I am
not surprised that you have not given any - Tho I do not expect



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much from it, I have advised the Simple Tinctura Martis to be taken to
20 drops in a glass of water twice a day. I hope in spite of Mrs
Rs aversion to medicine she may be persuaded to continue this
but that aversion preventing going farther in that line at present.


What can be done for Mrs R - is chiefly by exercise & I believe
riding only. The late jaunt did little service & I impute its failure
to its being done too slowly & at too much ease. Riding on horseback
does much more than Carriage & I advise her to ride every forenoon
for two or three hours that the weather is tolerable. And if care is
taken to have her body & Limbs well covered I would not have her be
[nice?] in weather. The Season is now too far advanced to allow as
to expect fine weather but I hope our frosts are still far off. - As
to Diet I cant be positive - I should not be afraid of her taking a bit
of solid meat & glass of wine but while her appetite is bad & she
has rather an aversion to Solids I would not press them upon her
& on the other hand while she has no trouble from flatulency or
indigestion I can see no objection to her taking what Vegetables she
likes, & even what she likes best. -- It well depend upon her to
observe what happens & to direct accordingly. - As to drink as
she informs me that acids are ready to hurt her I would suspect every
thing ready to become acescent & therefore Small beer & in general
malt liquor but good Porter with double its quantity of water
may be very safe. Of Wines the Strongest as Madeira or good
Sherry ↑diluted with water↑ are the Safest & a glass or two every day may be only proper.
Tea & Coffee are both bad. I hope the Cocoa will stand in place



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of better. - I have only to add that her mind requires as much
attention as her body. However averse She Should see her friends
both at home & abroad, every amusement & easy occupation
are to be sought for while Silence & Solitude are to be avoided.

I am always &c.
WC.

Edinburgh September 23d.
1779
For yourself


The letter inclosing this is intended to be ostensible 1 &
if Mrs Rae is not in town you'll please send my letter to
Aikenhead directly. --


Tho. I can find nothing physical about Mrs Rae at
present, the family disposition & former threatenings gives
one suspicion & especially as I have more than once found
Phthisis come on in this way & I must therefore recommend
it to you to watch the approaches if they should appear &
that we may take our measures accordingly.

WC.

Notes:

1: Meaning it is written for the patient to read. But Cullen, out of concern not to alarm the patient, does not want her to see this cover-note which is for Hamilton's eyes only. Since both letters were transcribed into the casebook together they were assigned the one document number.