The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:4103] From: Dr William Cullen (Professor Cullen) / To: Anonymous / Regarding: Mr Seward (Patient) / 12? August? 1777? / (Outgoing)
Reply 'For Mr Seward'. Includes advice on using the shower bath machine.
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- Normalized Text
- Diplomatic Text
- Metadata
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Facsimile
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Metadata
Field | Data |
---|---|
DOC ID | 4103 |
RCPE Catalogue Number | CUL/1/1/9/76 |
Main Language | English |
Document Direction | Outgoing |
Date | 12? August? 1777? |
Annotation | None |
Type | Scribal copy ( includes Casebook Entry) |
Enclosure(s) | No enclosure(s) |
Autopsy | No |
Recipe | Yes |
Regimen | No |
Letter of Introduction | No |
Case Note | No |
Summary | Reply 'For Mr Seward'. Includes advice on using the shower bath machine. |
Manuscript Incomplete? | No |
Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
Case ID | Description | Num Docs |
---|---|---|
[Case ID:927] |
Case of Mr Seward who Cullen considers to be in a state of nervous debility, partly inherited. |
1 |
People linked to this document
Person ID | Role in document | Person |
---|---|---|
[PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
[PERS ID:2080] | Addressee | |
[PERS ID:2079] | Patient | Mr Seward |
[PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
[PERS ID:2080] | Patient's Physician / Surgeon / Apothecary |
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 |
Therapeutic Recommendation | Europe | certain |
Normalized Text
For Mr Seward. ––
A faulty constitution derived from his parents has been rendered
still worse by various accidents so that Mr Seward is now both
in his nerves & solids reduced to a state of great debility & lax¬
ity. Among other causes of Mr S–– complaints we dont doubt
but a gouty disposition derived from his parents & which for want
of vigour in his constitution cannot have its due course, may
have a great share. We consider Mr S– complaints to belong
to no particular disease nor to come under any particular appel¬
lation, but to consist in a general affection of his whole habit.
To restore such a habit to any usual degree of strength, we
think is impossible, but I am perswaded that by attention &
pains many of the complaints may be relieved, the returns of
them may be prevented & Mr Sewards life rendered easy & com¬
fortable. For these purposes we should propose the follow¬
ing measures.
For strengthening his habit the most effectual remedies are riding
on horseback & cold bathing. –– The first he should practise
very constantly not allowing a forenoon that is fair to pass with¬
out some exercise in that way but it should always be moderate
& never carried the length of fatigue. When bad weather prevents going on
horseback or when any length of journey is to be perform'd, Mr S–– must
employ a carriage.
With respect to cold bathing Mr S–– must be reconciled to it by de¬
grees. For this purpose I would have him employ the shower bath.
In the cylinder he should at first put only six Gallons of water, four
of which are to be taken from a spring or pump well, & never from a river
& to these are to be added two Gallons of boiling water. This mixture
will hardly feel cold but the bathing is to be repeated every day, &
every day after the first the cold water remaining the same, the
hot is to be diminished by half a pint. When the hot water is
diminished to one half it will then be very to add every day as much
[Page 2]
cold water as is taken away of the hot, so that there may be always upon
the whole a due quantity in the Cylinder, & when the hole of the hot
water is taken away the Cylinder may be filled up to what it will
hold & which we suppose may be ten Gallons. If this business is
conducted in the manner now directed & particularly that exact mea¬
sures are always employed we have no doubt but that Mr S–– may
be reconciled to cold bathing & receive much benefit from it, & if this
turns out as we suppose, Mr S–– often having employ'd the shower
bath for some little time may take cold bathing in the sea as in any
manner he likes best
Besides these measures for strengthening the whole body some assis¬
tance may be got from chalybeate medicines & that particularly for
strengthening the stomack the part in all such cases more especially
affected. What we think the lightest & most effectual form of using these
we have set down in a paper apart. These as prescribed may be
taken for 2 or 3 weeks together, & no longer at one time but after
intermitting them for 2 or 3 weeks Mr S– may take another course
of them sooner or later & for a longer or shorter time as the 1st effects
of the 1st course shall direct. If in the first course the medicines
shall agree well with the stomach he may have the dose of the
chalybeate increased to double the quantity now prescribed.
While these strengthening measures are pursued a particular attention
must be given to diet which in general must neither ↑be↑ sparing or full
Every day at dinner he should take some animal food of any kind he
likes best but avoiding only the heavier kinds as Bacon Pork, or much
fat of any kind. The lighter kinds of fish he may take but not so frequent¬
ly. Withall this His animal food should be in moderate quantity &
he should never make a full meal of it, but make part of it of some
kind of pudding. Maccaroni is very improper for him. As all things
from the Garden are liable to become flatulent he should take them
sparingly, or not at all when he finds himself liable to indigestion. –
Under Garden things I comprehend all kinds of fruit. ––
For ordinary drink there is nothing safe but plain water very cold.
[Page 3]
Malt liquor very improper. A little strong drink may be
of service to his stomach, but a little only is admissible & it should
be wine of the strongest body, as madeira, good sherry, or very
good red port neither green nor old. When his stomach is liable
to acidity no wine is allowable, but he may take a little
spirits & water, & the spirits may be of what kind he likes best;
but of this liquor he should take very sparingly & as seldom as he
can.
As Mr S– has been in the habit of suppers & does not sleep well
without them we will not bid him abstain altogether but it would
be better if he could & we advise to leave off by degrees & at least
to avoid meat & use Milk it its place. This he does not digest
well at present but he may be brought to bear it in this way. Put
Cows milk as fresh from the Cow as possible to an equal part of
thin water gruel & sweeten the whole with sugar. This mix¬
ture he is to take with bread, rice or sago in the same way as people
take plain milk but let him take at a first in moderate
quantity, & by degrees he may come to take more of it. ––
At breakfast we hold tea & coffee both bad & think weak chocolate
cocoa tea or water gruel much better. A little bread & butter
without any of these is very allowable & a soft boiled egg might
be a good breakfast for him –
It will be of great service to Mr S– to be much in the cool air &
to take care to keep always cool both by day & night & avoid
being in any chamber heated by fire or by much company. Part
of this relates to his being in Brittain & the summer season; but the
winter in Britain will be bad for him & he should take to
a southern climate for the winter, at least till his nerves
are strengthen'd. Wherever he is a soft warm bed will
be bad, he should lye on a hair mattrase with as few bed cloaths
as will defend him from the Cold.
Frequent walking serviceable but always moderate & without
fatigue. N B Nothing of more consequence than to keep
his feet dry & he must therefore avoid walking on wet ground or
getting his feet wet, if by accident it should happen, he should
make haste to get dry stockings &c. Without the application of
[Page 4]
external cold MrS feet are ready to become cold & this he should obviate
with great care. The best means is the rubbing his feet gently but for a long
time together every morning & evening with a flesh brush or a piece of flan¬
nel.
As Mr S ailments often affects his spirits he should avoid solitude &
indolence. Possibly he may not relish amusements & particularly that
of company, but he should allow them as much as possible. To a man
of his ↑knowledge↑ reading may be a favorite amusement – it should however be
taken with moderation & with choice of what is new & amusing
avoiding all serious & intense study. Business requiring constant
application is certainly not admissible but some business nei¬
ther require constant nor anxious application might be of great
service. A little farming, Gardening, or planting might be of use.
After saying so much of what was proper for Mr S– it is
necessary to say what is improper ––
As Mr S– stomach is often out of order it might be supposed Vomit
would be proper & it is possible they might sometimes give
relief – but that relief would be of short duration & the frequent prac¬
tice hurtfull ––
Some physicians might think of purgatives in this case, but as
Mr S–– is not liable to costiveness there is no occasion & pur¬
ging would hurt him. It is however possible that costiveness
may at times occur, & it should be immediately remedied, but by the
gentlest means. Magnesia is one of the most proper in this case
Where weakness of the stomach appears it is usual to have
recourse to Bitters & Bark & in many cases they are use¬
full & might be perhaps in this but they are not very power¬
full & we are perswaded the frequent use of them is often
pernicious –
[Page 5]
For Mr Seward
Take 5 grains of Red Chalybeate, 10 grains of ground Cinnamon, and 15 grains of white lump Sugar. Mix to make a powder, and from this make 14 doses. Label: Strengthening powders one to be taken twice a day an hour before dinner & supper on a little currant jelly. ––
Take 2 ounces of the Edinburgh Pharmacopœia's Tincture of Mars. Label: Strengthening Drops 20 to be taken in a glass of water after every Dose of the Powders. ––
Diplomatic Text
For Mr Seward. ––
A faulty constitution derived from his parents has been rendered
still worse by various accidts. so that Mr Seward is now both
in his nerves & solids reduced to a state of great debility & lax¬
ity. Among other causes of Mr S–– complaints we dont doubt
but a gouty disposition derived from his parents & which for want
of vigour in his constitution cannot have its due course, may
have a great share. We consider Mr S– complaints to belong
to no particular disease nor to come under any particular appel¬
lation, but to consist in a general affection of his whole habit.
To restore such a habit to any usual degree of strength, we
think is impossible, but I am perswaded that by attention &
pains many of the complts may be relieved, the returns of
them may be prevented & Mr Sewards life rendered easy & com¬
fortable. For these purposes we should propose the follow¬
ing measures.
For strengthg. his habit the most effectual remedies are ridg
on horseback & cold bathing. –– The first he should practise
very constantly not allowing a forenoon that is fair to pass with¬
out some exercise in that way but it should always be moderate
& never carried the length of fatigue. When bad weather prevents going on
horseback or wn any length of journey is to be perform'd, Mr S–– must
employ a carriage.
With respect to cold bathing Mr S–– must be reconciled to it by de¬
grees. For this purpose I would have him employ the shower bath.
In the cylinder he should at first put only six Gallons of water, four
of which are to be taken from a spring or pump well, & never from a river
& to these are to be added two Gallons of boilg water. This mixture
will hardly feel cold but the bathing is to be repeated every day, &
every day after the first the cold water remaing the same, the
hot is to be diminished by half a pint. When the hot water is
diminished to one half it will then be very to add every day as much
[Page 2]
cold water as is taken away of the hot, so that there may be always upon
the whole a due quantity in ye Cylinder, & when ye hole of the hot
water is taken away the Cylinder may be filled up to what it will
hold & which we suppose may be ten Gallons. If this business is
conducted in ye manner now directed & particularly that exact mea¬
sures are always employed we have no doubt but that Mr S–– may
be reconciled to cold bathg & receive much benefit from it, & if this
turns out as we suppose, Mr S–– often havg employ'd the shower
bath for some little time may take cold bathg in ye sea as in any
manner he likes best
Besides these measures for strengtheng the whole body some assis¬
tance may be got from chalybeate medicines & that particularly for
strengtheng the stomack the part in all such cases more especially
affected. What we think ye lightest & most effectual form of usg these
we have set down in a paper apart. These as prescribed may be
taken for 2 or 3 weeks together, & no longer at one time but after
intermittg them for 2 or 3 weeks Mr S– may take another course
of them sooner or later & for a longer or shorter time as ye 1st effects
of ye 1st course shall direct. If in ye first course the medicines
shall agree well wh ye stomach he may have ye dose of the
chalybeate increased to double ye quantity now prescribed.
While these strengtheng measures are pursued a particular attention
must be given to diet which in general must neither ↑be↑ sparg or full
Every day at dinner he should take some animal food of any kind he
likes best but avoidg only the heavier kinds as Bacon Pork, or much
fat of any kind. The lighter kinds of fish he may take but not so frequent¬
ly. Withall this His animal food should be in moderate quantity &
he should never make a full meal of it, but make part of it of some
kind of pudding. Maccaroni is very improper for him. As all things
from ye Garden are liable to become flatulent he should take them
sparingly, or not at all when he finds himself liable to indigestion. –
Under Garden things I comprehend all kinds of fruit. ––
For ordinary drink there is nothing safe but plain water very cold.
[Page 3]
Malt liquor very improper. A little strong drink may be
of service to his stomach, but a little only is admissible & it sd
be wine of ye strongest body, as madeira, good sherry, or very
good red port neither green nor old. When his stomach is liable
to acidity no wine is allowable, but he may take a little
spirits & water, & ye spts may be of what kind he likes best;
but of this liquor he sd take very sparingly & as seldom as he
can.
As Mr S– has been in ye habit of suppers & does not sleep well
without ym we will not bid him abstain altogether but it wd
be better if he could & we advise to leave off by degrees & at least
to avoid meat & use Milk it its place. This he does not digest
well at present but he may be brought to bear it in ys way. Put
Cows milk as fresh from the Cow as possible to an equal part of
thin water gruel & sweeten ye whole with sugar. This mix¬
ture he is to take with bread, rice or sago in ye same way as people
take plain milk but let him take at a first in moderate
quantity, & by degrees he may come to take more of it. ––
At breakfast we hold tea & coffee both bad & think weak chocolate
cocoa tea or water gruel much better. A little bread & butter
without any of these is very allowable & a soft boiled egg might
be a good breakfast for him –
It will be of gt service to Mr S– to be much in ye cool air &
to take care to keep always cool both by day & night & avoid
being in any chamber heated by fire or by much company. Part
of this relates to his being in Brittain & ye summer season; but ye
winter in Britain will be bad for him & he should take to
a southern climate for ye winter, at least till his nerves
are strengthen'd. Wherever he is a soft warm bed will
be bad, he should lye on a hair mattrase with as few bed cloaths
as will defend him from ye Cold.
Frequent walkg serviceable but always moderate & without
fatigue. N B Nothing of more consequence than to keep
his feet dry & he must therefore avoid walkg on wet ground or
gettg his feet wet, if by accident it should happen, he should
make haste to get dry stockgs &c. Without the application of
[Page 4]
external cold MrS feet are ready to become cold & this he sd obviate
with gt care. The best means is ye rubbg his feet gently but for a long
time together every morng & eveng with a flesh brush or a piece of flan¬
nel.
As Mr S ailmts often affects his spirits he sd avoid solitude &
indolence. Possibly he may not relish amusemts & particularly yt
of company, but he sd allow ym as much as possible. To a man
of his ↑knowledge↑ readg may be a favorite amusemt – it should however be
taken with moderation & with choice of what is new & amusg
avoidg all serious & intense study. Business requiring constant
application is certainly not admissible but some business nei¬
ther require constt nor anxious application might be of great
service. A little farmg, Gardeng, or plantg might be of use.
After sayg so much of what was proper for Mr S– it is
necessary to say what is improper ––
As Mr S– stomach is often out of order it might be supposed Vomit
wd be proper & it is possible they might sometimes give
relief – but that relief wd be of short duration & the freqt prac¬
tice hurtfull ––
Some physicians might think of purgatives in ys case, but as
Mr S–– is not liable to costiveness there is no occasion & pur¬
ging wd hurt him. It is however possible that costiveness
may at times occur, & it sd be immediately remedied, but by ye
gentlest means. Magnesia is one of ye most proper in this case
Where weakness of the stomach appears it is usual to have
recourse to Bitters & Bark & in many cases they are use¬
full & might be perhaps in this but they are not very power¬
full & we are perswaded ye frequent use of them is often
pernicious –
[Page 5]
For Mr Seward
℞ Rubig chalyb. ppt gr v
Cinnamon pulv gr x
Sacchar alb. duriss. gr xv
ℳ f. pulvis et f. h. m. dos № xiv
Sig. Strengthening powders one to be taken twice a day an hour
before dinner & supper on a little currant jelly. ––
℞ Tinct. mart. Pharm. Edin ℥ii
Sig Strengtheng Drops 20 to be taken in a glass of water after
every Dose of the Powders. ––
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