The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:118] From: Dr William Cullen (Professor Cullen) / To: Dr Robert Marshall / Regarding: Mr William Duguid (Patient) / 15 April 1781 / (Outgoing)
Reply 'For Mr Duguid'; listed, possibly erroneously, as 'Dr Erskine's Case' in the volume index. Cullen regards Duguid's condition 'as entirely a Nervous weakness depending on some affection of the lower part of the Medulla Spinalis'. He advises blistering, anointing with oil, and the use of the flesh-brush. Electricity and bathing are also suggested. He gives advice on diet and lifestyle, and a recipe for the oil.
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- Normalized Text
- Diplomatic Text
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Facsimile
There are 6 images for this document.
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Metadata
| Field | Data |
|---|---|
| DOC ID | 118 |
| RCPE Catalogue Number | CUL/1/1/14/7 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 15 April 1781 |
| Annotation | None |
| Type | Machine scribal copy |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | Yes |
| Regimen | Yes |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply 'For Mr Duguid'; listed, possibly erroneously, as 'Dr Erskine's Case' in the volume index. Cullen regards Duguid's condition 'as entirely a Nervous weakness depending on some affection of the lower part of the Medulla Spinalis'. He advises blistering, anointing with oil, and the use of the flesh-brush. Electricity and bathing are also suggested. He gives advice on diet and lifestyle, and a recipe for the oil. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1326] |
Case of William Duguid who has had extensive treatments for a venereal infection (named in one letter as syphilis) but whose current disorders are attributed to a nervous weakness of his lower spine. He later develops a bony 'excrescence' on his shin. |
10 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:1829] | Addressee | Dr Robert Marshall |
| [PERS ID:78] | Patient | Mr William Duguid |
| [PERS ID:1829] | Patient's Physician / Surgeon / Apothecary | Dr Robert Marshall |
| [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 |
| Destination of Letter | Glasgow | Glasgow and West | Scotland | Europe | inferred |
Normalized Text
For Mr Duguid vid. p 25.
After considering the whole history of Mr. Duguids
complaints I am clear, that he is free from every
complaint or suspicion of complaint except the
affection of his lower extremities.
This affection I consider as entirely a Nervous
weakness depending on some affection of the lower
part of the Medulla Spinalis. What this precisely
may be I dare not positively determine; but I
hope it may be mended by the following measures.
1. Let a Blistering Plaster be applied upon
the Os Sacrum; but it should not lie on longer
than is just enough to blister the Part; and very
often eight or at most ten Hours are sufficient
for the purpose, and during the application
let him drink plentifully of Arabic Emulsion.
[Page 2]
If this measure gives any more strength to his
Limbs and particularly if it gives him more
power and freedom in making Water, I would
repeat a Blister to the same part in ten or
twelve days after the first.
2. Let his Limbs from the Haunch down¬
wards, be well rubbed every morning with a flesh
Brush. The rubbing may be gentle, but should
be continued for a long time, not less than a
quarter of an hour to each Limb; And if this
be found to preserve the Heat or increase the
strength, it should be repeated again some time
before Dinner; but it is not to be employed in
the Evening
3. Every night at bedtime, let his Ancles
and knees be anointed with the Strengthening
Oil prescribed on the Paper apart. Let it be rub¬
bed upon the Joints gently, with a firm finger
[Page 3]
and let these Joints both night and day be
covered with an additional piece of Flannel. Every
morning some fine Oatmeal may be sprinkled
on the Joints so as to allow all the Oiliness to
be washed off with a little warm water, which
must be always done and the parts well dried
before the Flesh Brush is applied.
4. If these measures employed for a week
or two should have no effect in recovering the
strength of his Limbs and removing the diffi¬
culty of making Water, let him be put into
a warm↑Bath↑; but immerged no deeper than his
waist, and this may be repeated two or three
times a week, The Heat of the Bath at first
may be moderate, a little below the natural
Heat of the Body; but in repeating bathings it
may be gradually increased till it is six or eight
degrees above the heat of the Human Body.
[Page 4]
Into the Water of the Bath before it is heated
there is to be put a quantity of common salt
from a thirtieth to a twentieth Part of the
water employed.
5. If this neither shews no considerable effects
either good or bad, I would think of employing
Electricity; but I would not in the first instance
employ either Bathing or Electricity and before
either are employed, I would wish to have a
report of the effects of the other Remedies above
advised.
6. Mr Duguid should constantly take care
to keep his feet and legs free from all cold and
moisture; and should take care never to stand or
even to sit in a cold Chamber. Much standing
is in no Case proper for him nor should he even
sit long at one time. Frequent and [gentle?]
walking is very proper for him; but he
[Page 5]
should never walk long at one time. Riding may
be of some service but is not an important Remedy
in this Case and should never be long at one time
and always with great care to keep his Limbs very
warm and dry
7. In Diet, Mr Duguid may take any ordinary
fair; only avoiding at all times either by the
quantity or quality of his food to load his sto¬
mach. ––
For ordinary Drink he may take small
Beer or Water as he likes best and at Mails he
may take two or three Glasses of Wine or Punch
if the later be with little souring. But in all
kind of strong Drink he must be extremely
temperate for taking so much as to be in the
least heating will be very hurtful.
8. For the present I cannot propose any
[Page 6]
internal medicine except it may be a table spoon¬
ful of whole unbruised mustard seed and if it
seems to provoke Urine and not to purge much
he may take such a Dose in the morning as well
as at night.
1781.
Take 3 ounces of best Olive Oil, an ounce of Oil of Amber, and a ½ ounce of very caustic Spirit of Ammoniac Salts. Mix. Label: Strengthening Oil, for anointing the Knees and ancles at bedtime.
Diplomatic Text
For Mr Duguid vid. p 25.
After considering the whole history of Mr. Duguids
complaints I am clear, that he is free from every
complaint or suspicion of complaint except the
affection of his lower extremities.
This affection I consider as entirely a Nervous
weakness depending on some affection of the lower
part of the Medulla Spinalis. What this precisely
may be I dare not positively determine; but I
hope it may be mended by the following measures.
1. Let a Blistering Plaster be applied upon
the Os Sacrum; but it should not lie on longer
than is just enough to blister the Part; and very
often eight or at most ten Hours are sufficient
for the purpose, and during the application
let him drink plentifully of Arabic Emulsion.
[Page 2]
If this measure gives any more strength to his
Limbs and particularly if it gives him more
power and freedom in making Water, I would
repeat a Blister to the same part in ten or
twelve days after the first.
2. Let his Limbs from the Haunch down¬
wards, be well rubbed every morning with a flesh
Brush. The rubbing may be gentle, but should
be continued for a long time, not less than a
quarter of an hour to each Limb; And if this
be found to preserve the Heat or increase the
strength, it should be repeated again some time
before Dinner; but it is not to be employed in
the Evening
3. Every night at bedtime, let his Ancles
and knees be anointed with the Strengthening
Oil prescribed on the Paper apart. Let it be rub¬
bed upon the Joints gently, with a firm finger
[Page 3]
and let these Joints both night and day be
covered with an additional piece of Flannel. Every
morning some fine Oatmeal may be sprinkled
on the Joints so as to allow all the Oiliness to
be washed off with a little warm water, which
must be always done and the parts well dried
before the Flesh Brush is applied.
4. If these measures employed for a week
or two should have no effect in recovering the
strength of his Limbs and removing the diffi¬
culty of making Water, let him be put into
a warm↑Bath↑; but immerged no deeper than his
waist, and this may be repeated two or three
times a week, The Heat of the Bath at first
may be moderate, a little below the natural
Heat of the Body; but in repeating bathings it
may be gradually increased till it is six or eight
degrees above the heat of the Human Body.
[Page 4]
Into the Water of the Bath before it is heated
there is to be put a quantity of common salt
from a thirtieth to a twentieth Part of the
water employed.
5. If this neither shews no considerable effects
either good or bad, I would think of employing
Electricity; but I would not in the first instance
employ either Bathing or Electricity and before
either are employed, I would wish to have a
report of the effects of the other Remedies above
advised.
6. Mr Duguid should constantly take care
to keep his feet and legs free from all cold and
moisture; and should take care never to stand or
even to sit in a cold Chamber. Much standing
is in no Case proper for him nor should he even
sit long at one time. Frequent and [gentle?]
walking is very proper for him; but he
[Page 5]
should never walk long at one time. Riding may
be of some service but is not an important Remedy
in this Case and should never be long at one time
and always with great care to keep his Limbs very
warm and dry
7. In Diet, Mr Duguid may take any ordinary
fair; only avoiding at all times either by the
quantity or quality of his food to load his sto¬
mach. ––
For ordinary Drink he may take small
Beer or Water as he likes best and at Mails he
may take two or three Glasses of Wine or Punch
if the later be with little souring. But in all
kind of strong Drink he must be extremely
temperate for taking so much as to be in the
least heating will be very hurtful.
8. For the present I cannot propose any
[Page 6]
internal medicine except it may be a table spoon¬
ful of whole unbruised mustard seed and if it
seems to provoke Urine and not to purge much
he may take such a Dose in the morning as well
as at night.
1781.
℞ Ol. olivar. opt. ℥iij
__ succin. ℥j
Spirit. sal. Ammon. bene caustic. ℥ſs
ℳ. Sig. Strengthening Oil, for anointing
the Knees and ancles at bedtime.
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