The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:1216] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Miss Middleton (Patient) / 13? March? 1772? / (Outgoing)
Reply, in the form of a retained authorial draft in Cullen's hand of revised directions for Miss Middleton, a dyspepsic patient. The scribal copy (dated 13 March 1772) entered into the casebook is [DOC ID:461].
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- Normalized Text
- Diplomatic Text
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Facsimile
There are 4 images for this document.
[Page 1]
[Page 2]
[Page 3]
[Page 4]
Metadata
| Field | Data |
|---|---|
| DOC ID | 1216 |
| RCPE Catalogue Number | CUL/1/2/316 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 13? March? 1772? |
| Annotation | None |
| Type | Authorial original |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | Yes |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply, in the form of a retained authorial draft in Cullen's hand of revised directions for Miss Middleton, a dyspepsic patient. The scribal copy (dated 13 March 1772) entered into the casebook is [DOC ID:461]. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
This is the draft of:
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:261] |
Case of Miss Middleton with a stomach complaint. |
2 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:1267] | Patient | Miss Middleton |
| [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 Miss Middleton.
I have carefully considered the account which Miss
Middleton has been pleased to give me of her ailments and can
perceive that they have now had so long a seat in her constitution
that they may require a great deal of time and pains to ↑be↑ removed
but I hope that at length they may be greatly perhaps entirely
relieved.
After the swellings which Miss Middleton was troubled
with last year, I am very doubtful if she can safely meddle
with any mineral waters whatever, and if she does it must be by
a very cautious trial & that of Bath will be the safest. But I
am clear that nothing promises to be of more service ↑to her↑ than a
long Journey and I think you (↑she↑) should try this as soon as the weather
and her own strength will admit of it. It is very possible that
a sea voyage might be of service and I should not be much afraid of
the sea sickness, but as it would be undertaken with diffidence and
perhaps attended with anxiety and otherwise exposed to uncertain
circumstances I cannot advise it, but in the case of ↑a↑ land Journeys
being impracticable which I hope it shall not be ↑the case↑. Till this
can be attempted Miss Middleton must palliate her ailments as
well as she can. The Laudanum must be continued both to
[Page 2]
procure rest and remove pain ↑and↑ if Miss M. can find that
it has the effect of preventing pains and {illeg} retching she should
take it at other times as well as at bedtime, but I cannot speak
positively about this without being upon the spot and knowing
the course of the ailment more exactly. The chief inconvenience
that attends the frequent and free use of Laudanum is Costiveness,
and this ↑must↑ be carefully obviated. The best means I think in this
Case will be by water Glysters which I think may be otherwise
usefull and should be given frequently and in large quantities
Besides the use of the Laudanum I hope Miss M. complaints
may be relieved by the Infusion ordered below. As she finds
her stomach bear it she may take such doses two or three
times every day. It will best to take them at some distance
from her little meals, but I would have her try them particu¬
larly when she feels that oppression at her stomach which is
the forerunner of her retchings. If thes ↑Infusion 2↑ should not answer
as the stomach is so often a nice and whimsical organ I hav would
↑have↑ her try the steel Drops also ordered below. They are to be taken
by twenty or thirty at a time in half a gill of water. This must
be always pretty warm and the times of taking are the same as
[Page 3]
for the Infusions.
For a stomach liable (↑ready↑) to reject every thing it is difficult to
prescribe a diet and for in such Cases for the most part the rule
is to give what the stomach will bear tho perhaps otherwise
not very eligible. At present the Chocolate, the Sago and the panada
do seem to be (↑me↑) very proper and I believe some other things
prepared from grain might also be tried; but I suspect that no
kind of wine added to any of these will answer well and if some¬
thing to give a relish to these otherwise insipid things is neces¬
sary I would prefer a little Cinnamon Tea with a tea spoonful
of brandy to any kind of Wine. Miss M. has not told me
if any kind of feverishness hangs about her or at times disturbs
her and therefore I dare not say how far she may try animal food,
but I imagine that a little broth or Calves feet jelly might be
be usefull to her. I wish too that her own inclinations might
be gratified with a little milk, but while this is so much dispo¬
sed to curdle, it cannot be proper. I have however frequently found
that new milk mixed with an equal part of ↑warm↑ watergruel and well
sweetned with sugar was more easily digested than plain milk
and Miss M. may ↑at least↑ make a trial of this. I must conclude
[Page 4]
with observing that I think all the circumstances of Miss M.
constitution and ailments are not fully told and therefore that
my directions may ↑not↑ be exactly suited to them but if Miss M.
shall be pleased to put any further questions she may de¬
pend upon my attention and punctuality in answering them
Take two drachms each of Peruvian Bark and Cinnamon, and half a drachm of White Cinnamon. Crush, and pour over four ounces of French Brandy, and half an hour later, a pint of hot but not boiling Water. Steep for twenty-four hours and strain. Add enough thin Spirits of Vitriol for agreeable acidity. Label: Stomachic Infusion.
Take two ounces of Tincture of Mars from the Edinburgh Pharmacœpia. Label: Steel Drops.
Diplomatic Text
For Miss Middleton.
I have carefully considered the account which Miss
Middleton has been pleased to give me of her ailments and can
perceive that they have now had so long a seat in her constitution
that they may require a great deal of time and pains to ↑be↑ removed
but I hope that at length they may be greatly perhaps entirely
relieved.
After the swellings which Miss Middleton was troubled
with last year, I am very doubtful if she can safely meddle
with any mineral waters whatever, and if she does it must be by
a very cautious trial & that of Bath will be the safest. But I
am clear that nothing promises to be of more service ↑to her↑ than a
long Journey and I think you (↑she↑) should try this as soon as the weather
and her own strength will admit of it. It is very possible that
a sea voyage might be of service and I should not be much afraid of
the sea sickness, but as it would be undertaken with diffidence and
perhaps attended with anxiety and otherwise exposed to uncertain
circumstances I cannot advise it, but in the case of ↑a↑ land Journeys
being impracticable which I hope it shall not be ↑the case↑. Till this
can be attempted Miss Middleton must palliate her ailments as
well as she can. The Laudanum must be continued both to
[Page 2]
procure rest and remove pain ↑and↑ if Miss M. can find that
it has the effect of preventing pains and {illeg} retching she should
take it at other times as well as at bedtime, but I cannot speak
positively about this without being upon the spot and knowing
the course of the ailment more exactly. The chief inconvenience
that attends the frequent and free use of Laudanum is Costiveness,
and this ↑must↑ be carefully obviated. The best means I think in this
Case will be by water Glysters which I think may be otherwise
usefull and should be given frequently and in large quantities
Besides the use of the Laudanum I hope Miss M. complaints
may be relieved by the Infusion ordered below. As she finds
her stomach bear it she may take such doses two or three
times every day. It will best to take them at some distance
from her little meals, but I would have her try them particu¬
larly when she feels that oppression at her stomach which is
the forerunner of her retchings. If thes ↑Infusion 2↑ should not answer
as the stomach is so often a nice and whimsical organ I hav would
↑have↑ her try the steel Drops also ordered below. They are to be taken
by twenty or thirty at a time in half a gill of water. This must
be always pretty warm and the times of taking are the same as
[Page 3]
for the Infusions.
For a stomach liable (↑ready↑) to reject every thing it is difficult to
prescribe a diet and for in such Cases for the most part the rule
is to give what the stomach will bear tho perhaps otherwise
not very eligible. At present the Chocolate, the Sago and the panada
do seem to be (↑me↑) very proper and I believe some other things
prepared from grain might also be tried; but I suspect that no
kind of wine added to any of these will answer well and if some¬
thing to give a relish to these otherwise insipid things is neces¬
sary I would prefer a little Cinnamon Tea with a tea spoonful
of brandy to any kind of Wine. Miss M. has not told me
if any kind of feverishness hangs about her or at times disturbs
her and therefore I dare not say how far she may try animal food,
but I imagine that a little broth or Calves feet jelly might be
be usefull to her. I wish too that her own inclinations might
be gratified with a little milk, but while this is so much dispo¬
sed to curdle, it cannot be proper. I have however frequently found
that new milk mixed with an equal part of ↑warm↑ watergruel and well
sweetned with sugar was more easily digested than plain milk
and Miss M. may ↑at least↑ make a trial of this. I must conclude
[Page 4]
with observing that I think all the circumstances of Miss M.
constitution and ailments are not fully told and therefore that
my directions may ↑not↑ be exactly suited to them but if Miss M.
shall be pleased to put any further questions she may de¬
pend upon my attention and punctuality in answering them
℞ Cort. Peruvian. cont.
Cinnamon cont. @ ʒij
Canell. alb. cont. ʒſs.
Contusis affunde
Spir. Vin. Gall. ℥iv. et post semihoram
Aq. fervid. non bullient. lbi.
Digere per horas xxiv. et colatura adde Spir. Vitriol. ten.
q. s. ad gratam aciditatem.
Signa Stomachic Infusion.
℞ Tinct. Mart. Ph. ed. ℥ij
Sig. Steel Drops.
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