Cullen

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

 

[ID:233] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mr Norris (Patient) / 10 December 1781 / (Outgoing)

Reply 'For Mr Norris'

Facsimile

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Metadata

FieldData
DOC ID 233
RCPE Catalogue Number CUL/1/1/14/119
Main Language English
Document Direction Outgoing
Date10 December 1781
Annotation None
TypeMachine copy
Enclosure(s) Enclosure(s) present
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply 'For Mr Norris'
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1427]
Case of Mr Norris who has asthma and is given very substantial advice on regimen.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:3252]PatientMr Norris
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr 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

[Page 1]

For Mr. Norris


The nature of Mr. Norris complaint is suffici¬
ently evident and I am sorry to observe that ↑it↑ is often
difficult to cure especially when it has for any kind
been in the constitution. However it can always be
relieved and when a proper regimen is observed it com¬
monly can be rendered very tolerable.


In most cases it is best long before the patients --
own experience has directed him to a great part of
the necessary regimen and it seems to have done so
in this case and I must begin in with saying that the
avoiding what he finds to ↑be↑ manifestly hurtfull must
be Mr. Norris first cure and without it all the powers
of medicine may be useless.


As he finds the air of the town is always ready
to bring on his Asthma he must therefore keep out of
it as well as he can and he must not only avoid sleeping
in town all night but he should also avoid being in it
at any late hours of the night; particularly in winter



[Page 2]

when the town houses are kept very close and warm.


The next attention necessary to Mr. Norris is guarding
against cold which is best done by warm cloathing and
particularly by flannel next his Skin. He must how¬
ever even with that avoid being exposed to much cold or
wet. He must be attentive to make no change of cloath¬
ing from thicker to thinner. He should avoid standing
or Sitting in any Stream of cold air and one of the most
certain means of avoiding cold is to avoid being at any
time being very warm and when such a state is acci¬
dentally brought on to take care not to be immediately
exposed to cold.


Another precaution necessary to Mr. Norris
is avoiding bodily exercise. This always hurries
the blood into the Lungs and therefore the breathing
and exi a certain degree bodily exercise brings in a
hurried breathing ↑or an asthma in the Soundest person and persons
disposed to asthma must certainly be more delicate
in this respect and I have always found asthmatic [&?]
readily



[Page 3]

readily hurt in this way. Mr. Norris therefore must not
only avoid dancing but even walking fast, walking uphill
or upstairs or when some of these are unavoidable to move
at great leisure.


The above precautions will be readily enough as
fas as possible complyed with but what I am next to
propose tho as necessary may not be so easy. This ↑is↑ mode¬
rate living. A full stomach always straitens the
breast and the more so as that meat is slower of digestion
and this is not all for nourishing food fills the blood-
vessels
and gives too much exercise to the lungs. I
think it is absolutely necessary therefore that Mr. Norris
Should be very moderate that is rather sparing in diet.
He must take animal food only at dinner and than
too, prefer the lighter kinds and take them moderately
filling up his meal with broth, pudding & vegetables
With respect to the last I would ↑not↑ have him deal very
much in them as their flatulence is sometimes --



[Page 4]

troublesome to asthmatics but if this is not the case with
Mr. Norris vegetables are otherwise a very proper part of
his diet. I believe a good deal of milk and grain would
be a very usefull part of his diet if he digests milk to¬
lerably well. Much fish of any kind is certainly improper


If fullness of solid food be improper fullness of strong
drinks is no less so. I hope it is not necessary for Mr.
Norris to abstain entirely from Wine but I am certain
that he should take it very moderately and that every
excess will very much confirm his disease. I have
found very few asthmatics bear spirits in any shape
and particularly in Sour punch. Let Mr. Norris
therefore be cautious in these respect and also in the
use of malt liquors except of a little fine small beer.
If this is ready to be windy on his stomach let him
drink at his meals good porter mixed with two or
at least one part of water. Strong Wines as Ma¬
deira or red Port diluted with water I hold to be



[Page 5]

safer than Claret, french white wines, Rhenish or other
small bodied wines taken alone. Both Tea and Coffee
I hold to be bad for him.


These are the particulars chiefly to be observed in
Mr. Norris regimen and if these are carefully observed
I am persuaded they will do much to render his complaint
easy and for this purpose I depend more tupon his regi¬
men than upon the remedies I am next to advise.


As fresh Air is so necessary to him he should be
in it as often as business will allow him. He should
therefore be in the country and very frequent but
moderate riding will ↑be↑ one of the best remedies he can
employ. He should not only do a good deal in this
way during the vacations but also in the summer
season he should ride a little as often as he can.


When in spite of precautions or from the ne¬
glect of precautions as asthmatic fit has come on if
it is any thing violent the taking a taking a little blood



[Page 6]

from the arm might give some relief but I am averse
to employing this remedy without some necessity.


When a fit approaches by degrees a vomit will always
be usefull in preventing its coming to any height


When in spite of this or other measures a fit be¬
comes considerable a blister between the shoulders will
generally give some relief and an Issue might be of some
service in keeping off fits but its effect does not continue
long and I would trust more to fresh blistering even
for putting off threatening fits.


For preventing attacks I expect that Mr. Norris
will find benefit from taking the Pectoral pills A. for
two or three weeks at a time.


When fits have actually come on I expect that the
pectoral Mixture B. will give relief and bring the fit
sooner to a termination


In case of all sudden attacks or sudden exacerbations
a dose of Æther or Laudanum is likely to be usefull.


William Cullen

Edinburgh 10th. December 1781



[Page 7]

For Mr. Norris

Take three drachms Liquorice Extract. Divided into small pieces, sink it into enough boiling water in order to let it soften and reduced into a pulp. To this, add one drachm of Gum Ammoniacum and one drachm of the best Myrrh crushed into a fine powder. Add enough boiling water in order to have a mass to be divided into pills of five grains each. Label Pectoral Pills; three to be taken every night at bed time.


Asafætif. opt. ʒij
Aq. menth. pip. ℥iv
Solve et colato adde
Acet. Scillitic. ℥fs
Aq. cinnam. SImpl ℥ijβ.
Syr. Scillit. ℥j
ℳ. Signa Pectoral Mixture a table Spoonfull to be taken
two or three times a day


W.C.

10th. December 1781

Diplomatic Text

[Page 1]

For Mr. Norris


The nature of Mr. Norris complaint is suffici¬
ently evident and I am sorry to observe that ↑it↑ is often
difficult to cure especially when it has for any kind
been in the constitution. However it can always be
relieved and when a proper regimen is observed it com¬
monly can be rendered very tolerable.


In most cases it is best long before the patients --
own experience has directed him to a great part of
the necessary regimen and it seems to have done so
in this case and I must begin in with saying that the
avoiding what he finds to ↑be↑ manifestly hurtfull must
be Mr. Norris first cure and without it all the powers
of medicine may be useless.


As he finds the air of the town is always ready
to bring on his Asthma he must therefore keep out of
it as well as he can and he must not only avoid sleeping
in town all night but he should also avoid being in it
at any late hours of the night; particularly in winter



[Page 2]

when the town houses are kept very close and warm.


The next attention necessary to Mr. Norris is guarding
against cold which is best done by warm cloathing and
particularly by flannel next his Skin. He must how¬
ever even with that avoid being exposed to much cold or
wet. He must be attentive to make no change of cloath¬
ing from thicker to thinner. He should avoid standing
or Sitting in any Stream of cold air and one of the most
certain means of avoiding cold is to avoid being at any
time being very warm and when such a state is acci¬
dentally brought on to take care not to be immediately
exposed to cold.


Another precaution necessary to Mr. Norris
is avoiding bodily exercise. This always hurries
the blood into the Lungs and therefore the breathing
and exi a certain degree bodily exercise brings in a
hurried breathing ↑or an asthma in the Soundest person and persons
disposed to asthma must certainly be more delicate
in this respect and I have always found asthmatic [&?]
readily



[Page 3]

readily hurt in this way. Mr. Norris therefore must not
only avoid dancing but even walking fast, walking uphill
or upstairs or when some of these are unavoidable to move
at great leisure.


The above precautions will be readily enough as
fas as possible complyed with but what I am next to
propose tho as necessary may not be so easy. This ↑is↑ mode¬
rate living. A full stomach always straitens the
breast and the more so as that meat is slower of digestion
and this is not all for nourishing food fills the blood-
vessels
and gives too much exercise to the lungs. I
think it is absolutely necessary therefore that Mr. Norris
Should be very moderate that is rather sparing in diet.
He must take animal food only at dinner and than
too, prefer the lighter kinds and take them moderately
filling up his meal with broth, pudding & vegetables
With respect to the last I would ↑not↑ have him deal very
much in them as their flatulence is sometimes --



[Page 4]

troublesome to asthmatics but if this is not the case with
Mr. Norris vegetables are otherwise a very proper part of
his diet. I believe a good deal of milk and grain would
be a very usefull part of his diet if he digests milk to¬
lerably well. Much fish of any kind is certainly improper


If fullness of solid food be improper fullness of strong
drinks is no less so. I hope it is not necessary for Mr.
Norris to abstain entirely from Wine but I am certain
that he should take it very moderately and that every
excess will very much confirm his disease. I have
found very few asthmatics bear spirits in any shape
and particularly in Sour punch. Let Mr. Norris
therefore be cautious in these respect and also in the
use of malt liquors except of a little fine small beer.
If this is ready to be windy on his stomach let him
drink at his meals good porter mixed with two or
at least one part of water. Strong Wines as Ma¬
deira or red Port diluted with water I hold to be



[Page 5]

safer than Claret, french white wines, Rhenish or other
small bodied wines taken alone. Both Tea and Coffee
I hold to be bad for him.


These are the particulars chiefly to be observed in
Mr. Norris regimen and if these are carefully observed
I am persuaded they will do much to render his complaint
easy and for this purpose I depend more tupon his regi¬
men than upon the remedies I am next to advise.


As fresh Air is so necessary to him he should be
in it as often as business will allow him. He should
therefore be in the country and very frequent but
moderate riding will ↑be↑ one of the best remedies he can
employ. He should not only do a good deal in this
way during the vacations but also in the summer
season he should ride a little as often as he can.


When in spite of precautions or from the ne¬
glect of precautions as asthmatic fit has come on if
it is any thing violent the taking a taking a little blood



[Page 6]

from the arm might give some relief but I am averse
to employing this remedy without some necessity.


When a fit approaches by degrees a vomit will always
be usefull in preventing its coming to any height


When in spite of this or other measures a fit be¬
comes considerable a blister between the shoulders will
generally give some relief and an Issue might be of some
service in keeping off fits but its effect does not continue
long and I would trust more to fresh blistering even
for putting off threatening fits.


For preventing attacks I expect that Mr. Norris
will find benefit from taking the Pectoral pills A. for
two or three weeks at a time.


When fits have actually come on I expect that the
pectoral Mixture B. will give relief and bring the fit
sooner to a termination


In case of all sudden attacks or sudden exacerbations
a dose of Æther or Laudanum is likely to be usefull.


William Cullen

Edinr. 10th. Decr. 1781



[Page 7]

For Mr. Norris


Extract. Glycyrrhi ʒiij
In frustula conciso affunde aquæ fervent. q. s. ut
mollescat et contundatur in pulpam cui adde
in pulverem trita
Gum ammoniac.
Myrrh. opt. @ʒj
et cum aquæ fervent. q. s. massa dividenda in
pilulas Sing. gr. v
Signa Pectoral Pills three to be taken every night
at bed time


Asafætif. opt. ʒij
Aq. menth. pip. ℥iv
Solve et colato adde
Acet. Scillitic. ℥fs
Aq. cinnam. SImpl ℥ijβ.
Syr. Scillit. ℥j
ℳ. Signa Pectoral Mixture a table Spoonfull to be taken
two or three times a day


W.C.

10th. Decr. 1781

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