The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:4702] From: Dr William Cullen (Professor Cullen) / To: Colonel George Clerk (Clarke, Clark) / Regarding: Colonel George Clerk (Clarke, Clark) (Patient) / 30 August 1783 / (Outgoing)
Reply, for 'Col. Clerk'. Cullen supplies a full dietary and exercise regimen for Colonel Clerk. Cullen also apologises for his delay in replying to letters 2302 and 2304, as he had been away attending to a 'person of consequence'. He advises in detail on diet, since 'few medicines' will be of service, other than the (laxative) oil already prescribed (in letter 4626). He advises warm bathing, regretting that the Colonel has been unable to go to Buxton, and recommends wintering on the Mediterranean coast, rather than inland in Southern France. He does not believe there is any 'Venereal taint' in his ailment.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 13 images for this document.
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Metadata
Field | Data |
---|---|
DOC ID | 4702 |
RCPE Catalogue Number | CUL/1/1/16/106 |
Main Language | English |
Document Direction | Outgoing |
Date | 30 August 1783 |
Annotation | None |
Type | Machine scribal copy |
Enclosure(s) | No enclosure(s) |
Autopsy | No |
Recipe | No |
Regimen | Yes |
Letter of Introduction | No |
Case Note | No |
Summary | Reply, for 'Col. Clerk'. Cullen supplies a full dietary and exercise regimen for Colonel Clerk. Cullen also apologises for his delay in replying to letters 2302 and 2304, as he had been away attending to a 'person of consequence'. He advises in detail on diet, since 'few medicines' will be of service, other than the (laxative) oil already prescribed (in letter 4626). He advises warm bathing, regretting that the Colonel has been unable to go to Buxton, and recommends wintering on the Mediterranean coast, rather than inland in Southern France. He does not believe there is any 'Venereal taint' in his ailment. |
Manuscript Incomplete? | No |
Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
Case ID | Description | Num Docs |
---|---|---|
[Case ID:1473] |
Case of Colonel George Clerk [Clark, Clarke, Clerke] who becomes excessively weak and feeble from chronic costiveness, breathlessness, and other chronic complaints. In New York he has a perpetual fever and stomach complaint and mentions consulting Cullen before but no firm evidence traced unless he is the same patient as Case 283 in 1768. |
24 |
People linked to this document
Person ID | Role in document | Person |
---|---|---|
[PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
[PERS ID:2507] | Addressee | Colonel George Clerk (Clarke, Clark) |
[PERS ID:2507] | Patient | Colonel George Clerk (Clarke, Clark) |
[PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
[PERS ID:3462] | Patient's Physician / Surgeon / Apothecary | Dr Michel Philippe Bouvart (Monsieur; Bumart (misspelling by Cullen or scribe)) |
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 | Rooks Nest | Godstone | London and South-East | England | Europe | inferred |
Therapeutic Recommendation | South of France | France | Europe | certain | ||
Therapeutic Recommendation | Buxton | Midlands | England | Europe | certain | |
Therapeutic Recommendation | Mediterranean coast | South of France | France | Europe | certain | |
Mentioned / Other | Britain | Europe | certain |
Normalized Text
Coll. Clerk
I had the honour of both your letters together
about ten days ago but having been called to some dis¬
tance to attend a person of consequence 1 it has not
been in my power to give you an answer sooner.
I am still of opinion that you have no [particular?]
disease and that the whole of your complaints de¬
pend upon a Constitution originally faulty and now
much broken by various accidents. It is in conse¬
quence of this opinion that I told you formerly and
must repeat it now that few medicines can be of
service to you and almost only those which can
obviate your Costive habit and for this I would
still recommend the same Oil I did before and
[that it pass?] quickly through you I consider of
a particular advantage for I can not believe
that it will leave any thing behind that it
should bring away and I will tell you now
[Page 2]
what I have often found to be a valuable property of it
Though a person at first using it may require a pretty
large dose when it is repeated pretty often as it must
be in costive habits it generally comes to answer in
a small dose in keeping the body regular without
purging. I thought proper to say all this but I
would still allow you if you like it better to em¬
ploy your infusion of Rhubarb and water, though
I have generally found Rhubarb to leave a binding
behind it which the Oil does not.
Though I am not to offer you medicines I
hope you may still find a remedy particularly
in moderate warm bathing and upon this sup¬
position I recommended Buxton to you and I
regret that you could not go there. Some of your
reasons for this were perhaps well founded but
some others of them I cannot admitt of as such
The accommodation there is now greatly improved
and the Climate in the months of June and July
is generally very good and if you remain in
[Page 3]
Britain or return to it in the spring I would
still advise you to try Buxton. In the mean¬
time as I consider the Bathing as the principal
part of the remedy I think you may try it at
home in an ordinary bathing vessel. If you take
water from a Spring or Pit well never from a
Brook or river you may take one part of it
boiling water and put to it three parts of cold
you will have water nearly of the temperature
of Buxton and into this you may go for ten minutes
at first and increase the time of your remaining
in such a Bath afterwards as you shall bear
it observing only that if you remain in it
for longer than a quarter of an hour the water
is in danger of cooling and the heat of it
must be supported by pouring in a little boiled
water but at the side of the vessel. Here I must
bid you attend to this that a very warm bath
would probably do you harm and that water
[Page 4]
cooling upon you might also do so. I must beg you therefore
to employ always the same exact measures in preparing
your Bath and to learn also by trial the exact measure
the quantity necessary to keep up the heat of it for
any length of time. I think at first you should
take a bath every other day only but afterwards if
you find it agree with you as I expect you may
take it every day or as often as you find it agreeable.
As you cannot have Buxton water to drink I
advise you in place of it to take from a pint to
a quart of Selzer water every day at the times
most agreeable to you and especially at the times
your stomach is most empty.
These are the only remedies I would mention
to you and I mention no others because I am strongly
of opinion that you are to expect your greatest relief
from a proper Regimen. In this I would most
willingly advise you but I cannot do it very
particularly without knowing more exactly your
[Page 5]
ordinary manner, for your own experience of what
has agreed and disagreed with you must have the
greatest share in directing this matter. I shall
however offer you several observations on this sub¬
ject.
I think Tea if it is either strong or taken
very warm is a very bad Breakfast for you but
I know that it is difficult to quit the habit of Tea
and I therefore advise you to take only a weak
Bohea tea with a little Cinnamon in it and to take it
at a very moderate warmth. I should not have
forbid you to take a little butter but as you find
it not to agree in any quantity with your stomach
you do well in being sparing of it. You may
certainly take a little honey but much of that or
any kind of sweet is very likely to disagree with
a weak and flatulent stomach. It is very necessary
to observe that whatever meal you take it should
be always in moderate quantity for I suspect it
[Page 6]
has very much the bulk of what you take that affects
both your stomach and breathing. it is on this account
I would advise you to make two dinners instead of
one. At one oClock you may take a Cupful of broth
not very strong and made either of beef, Veal or
fowl but not of mutton and even of the former avoi¬
ding carefully any fat about the meat you employ
or instead of broth you may at the same time of day
take a glass or two of Calves feet jelly that has very
little acid in it and with either your broth or jelly
you may take a piece of Diet loaf baked pretty
dry.
About three hours after this you may take
a more solid Dinner but chusing always the lighter
kinds of food. Both beef and mutton I think too
heavy for you but you may take a bit of either of
them boiled if they are otherwise very tender.
Veal is an Ambiguous food and to some people very
heavy but if it is not so to you, you may take
[Page 7]
a bit of the leaner parts of it done upon the Grid iron
The same is to be said of Lamb though a Knuckle of
this boiled may often be light enough. The safest kind
of meat for you will be white fowl either of Pullet
or Turkey. A light kind of food if you can like it
is b well boiled tripe. You must absolutely avoid
Pork and Bacon, Goose, Duck or any water fowl
Young Partridge you may take a little of and some
times a little Pidgeon. Fish will probably go down
with you as easily as any thing but a Choice is
very necessary, the heavier kinds as Salmond, Herring
Turbot and even Cod you should avoid but the
lighter kinds as Codling, Haddock Whiting or
flounder you may take pretty freely I need hardly
say that whether you take meat or fish they should
be dressed in the plainest and lightest manner, frying
and baking and all strong or heavy sauces be entirely
avoided. I have thus given you my opinion about
[Page 8]
some choice of your food and I must add what I think of
as much consequence that the quantity of it should always
be very moderate and if at any time your appetite
would lead you to go beyond a small quantity of
solid food you must satisfy it & fill up your meal
with some light pudding and tender Vegetables
with respect to the latter I hold bread to be the
safest and for your constitution I judge the second
or Household bread to be better than the finer, which
even of them you take let it be well fermented
and baked and if you at any time suspect that
it is not done enough you should mend it by a
little toasting. With respect to Greens, Roots or
other Garden things you should avoid all raw and
cold Vegetables as Lettuce and Cucumber and such
flatulent things as Cabbage. Let what you
take be young and tender and always very well
boiled. All these Vegetables however are hazardous
for your stomach and even with the precautions
[Page 9]
mentioned should be always taken sparingly. In
ripe fruit I should be willing to indulge you a
little but I am certain that a large or frequent
use of them would be dangerous and therefore
I advise you to proceed in this Article with great
caution.
I have now given you a Bill of fare for
Dinner but for Supper I need not as you very
properly take none at all. You may sometimes
after Dinner if you find it light on your stomach
take a dish of Tea such as I have advised for the
morning but I am very averse from your taking
any Coffee.
For your ordinary drink at Dinner I
think plain water with a little Sherry in it is the
best. I cannot possibly indulge you in Small
beer but if you can take some good Porter mixed in
two parts of water I believe you may do it safely
[Page 10]
I think it very proper for you to take two or three
glasses of wine every day at Dinner and even one or
two at Supper time if you don't find it heat you.
The wine that I would prefer are some of the strongest
as Madeira, Sherry or Red Port but the quantity
of these should be small and they will always be
safer by a little water taken along with them.
Claret, French white wine, Hock or Rhenish I
hold to be unsafe and a little good Burgundy is
the only french wine that you can safely taste.
When your stomach is very flatulent or distressed
to acidity a little spirits and water may be safer
than any kind of wine but in this drink allowed
only from necessity you must proceed with great
diffidence.
I think I have written now pretty fully
on the subject of Diet and the next Article
I would speak of is your Exercise. I would have
you to be as much in the open air and in gentle
[Page 11]
exercise as the weather and your strength will allow
Your Phaeton driven by yourself is the more
desireable mode of it taking care however al¬
ways to avoid fatigue and more especially cold. For
this later purpose you should always warmly
cloathed I think your flannel should be next
your skin with as many waistcoats above it as
you please and such Cloathing is the best means
you can employ for guarding against the coldness
of your Arms and at the same time furred Gloves
on your hands will be of service. In these ad¬
vices I provide for a British Climate but I
must here give you my opinion fairly that a
British Climate will be very dangerous for you
in Winter and if you can do it with ease and
pleasure I would advise you to pass the winter
somewhere very near to the Coast of the Medi¬
terranean for even the inland places of the
South of France are not sufficiently secure.
[Page 12]
If you follow my advice in this take care to get to
your destination against the first of November and to
remain there till the end of April.
I have now touched on almost every particular
of your letters except my opinion of Mr. Bumart 2 in
which I cannot in the least join and I am very certain
that any Venereal taint in your body in the course
of fifteen or sixteen years must have discovered
itself very clearly which if it has not done by any
circumstance that you have ever mentioned to me
The symptoms of excoriation and swelling you
mention I have known happen to many persons
the most absolutely free from any Venereal taint.
You desire my sincere opinion of your state and I
shall give it you. Your constitution is certainly broken
and weakened to a considerable degree and I doubt
if it ever can be restored to much strength and firmness
but I perceive no threatning of immediate danger and
with attention and care you may carry on life tolerably
well for a long time to come. I shall willingly con¬
tribute to it as well as I can and I hope by this
[Page 13]
letter I have given you some proof of it as it has
cost me more time and pains than I can commonly
bestow amidst my incessant hurry upon many
other patients. I shall not however be satisfied
with this if you shall have yet any other ques¬
tions to put. Let me have them and you may
depend upon my punctuality and attention in
answering them being with very great regard
Sir
your most Obedient and
most humble Servant
Edinburgh 30th. August
1783
Diplomatic Text
Coll. Clerk
I had the honour of both your letters together
about ten days ago but having been called to some dis¬
tance to attend a person of consequence 1 it has not
been in my power to give you an answer sooner.
I am still of opinion that you have no [particular?]
disease and that the whole of your complaints de¬
pend upon a Constitution originally faulty and now
much broken by various accidents. It is in conse¬
quence of this opinion that I told you formerly and
must repeat it now that few medicines can be of
service to you and almost only those which can
obviate your Costive habit and for this I would
still recommend the same Oil I did before and
[that it pass?] quickly through you I consider of
a particular advantage for I can not believe
that it will leave any thing behind that it
should bring away and I will tell you now
[Page 2]
what I have often found to be a valuable property of it
Though a person at first using it may require a pretty
large dose when it is repeated pretty often as it must
be in costive habits it generally comes to answer in
a small dose in keeping the body regular without
purging. I thought proper to say all this but I
would still allow you if you like it better to em¬
ploy your infusion of Rhubarb and water, though
I have generally found Rhubarb to leave a binding
behind it which the Oil does not.
Though I am not to offer you medicines I
hope you may still find a remedy particularly
in moderate warm bathing and upon this sup¬
position I recommended Buxton to you and I
regret that you could not go there. Some of your
reasons for this were perhaps well founded but
some others of them I cannot admitt of as such
The accommodation there is now greatly improved
and the Climate in the months of June and July
is generally very good and if you remain in
[Page 3]
Britain or return to it in the spring I would
still advise you to try Buxton. In the mean¬
time as I consider the Bathing as the principal
part of the remedy I think you may try it at
home in an ordinary bathing vessel. If you take
water from a Spring or Pit well never from a
Brook or river you may take one part of it
boiling water and put to it three parts of cold
you will have water nearly of the temperature
of Buxton and into this you may go for ten minutes
at first and increase the time of your remaining
in such a Bath afterwards as you shall bear
it observing only that if you remain in it
for longer than a quarter of an hour the water
is in danger of cooling and the heat of it
must be supported by pouring in a little boiled
water but at the side of the vessel. Here I must
bid you attend to this that a very warm bath
would probably do you harm and that water
[Page 4]
cooling upon you might also do so. I must beg you therefore
to employ always the same exact measures in preparing
your Bath and to learn also by trial the exact measure
the quantity necessary to keep up the heat of it for
any length of time. I think at first you should
take a bath every other day only but afterwards if
you find it agree with you as I expect you may
take it every day or as often as you find it agreeable.
As you cannot have Buxton water to drink I
advise you in place of it to take from a pint to
a quart of Selzer water every day at the times
most agreeable to you and especially at the times
your stomach is most empty.
These are the only remedies I would mention
to you and I mention no others because I am strongly
of opinion that you are to expect your greatest relief
from a proper Regimen. In this I would most
willingly advise you but I cannot do it very
particularly without knowing more exactly your
[Page 5]
ordinary manner, for your own experience of what
has agreed and disagreed with you must have the
greatest share in directing this matter. I shall
however offer you several observations on this sub¬
ject.
I think Tea if it is either strong or taken
very warm is a very bad Breakfast for you but
I know that it is difficult to quit the habit of Tea
and I therefore advise you to take only a weak
Bohea tea with a little Cinnamon in it and to take it
at a very moderate warmth. I should not have
forbid you to take a little butter but as you find
it not to agree in any quantity with your stomach
you do well in being sparing of it. You may
certainly take a little honey but much of that or
any kind of sweet is very likely to disagree with
a weak and flatulent stomach. It is very necessary
to observe that whatever meal you take it should
be always in moderate quantity for I suspect it
[Page 6]
has very much the bulk of what you take that affects
both your stomach and breathing. it is on this account
I would advise you to make two dinners instead of
one. At one oClock you may take a Cupful of broth
not very strong and made either of beef, Veal or
fowl but not of mutton and even of the former avoi¬
ding carefully any fat about the meat you employ
or instead of broth you may at the same time of day
take a glass or two of Calves feet jelly that has very
little acid in it and with either your broth or jelly
you may take a piece of Diet loaf baked pretty
dry.
About three hours after this you may take
a more solid Dinner but chusing always the lighter
kinds of food. Both beef and mutton I think too
heavy for you but you may take a bit of either of
them boiled if they are otherwise very tender.
Veal is an Ambiguous food and to some people very
heavy but if it is not so to you, you may take
[Page 7]
a bit of the leaner parts of it done upon the Grid iron
The same is to be said of Lamb though a Knuckle of
this boiled may often be light enough. The safest kind
of meat for you will be white fowl either of Pullet
or Turkey. A light kind of food if you can like it
is b well boiled tripe. You must absolutely avoid
Pork and Bacon, Goose, Duck or any water fowl
Young Partridge you may take a little of and some
times a little Pidgeon. Fish will probably go down
with you as easily as any thing but a Choice is
very necessary, the heavier kinds as Salmond, Herring
Turbot and even Cod you should avoid but the
lighter kinds as Codling, Haddock Whiting or
flounder you may take pretty freely I need hardly
say that whether you take meat or fish they should
be dressed in the plainest and lightest manner, frying
and baking and all strong or heavy sauces be entirely
avoided. I have thus given you my opinion about
[Page 8]
some choice of your food and I must add what I think of
as much consequence that the quantity of it should always
be very moderate and if at any time your appetite
would lead you to go beyond a small quantity of
solid food you must satisfy it & fill up your meal
with some light pudding and tender Vegetables
with respect to the latter I hold bread to be the
safest and for your constitution I judge the second
or Household bread to be better than the finer, which
even of them you take let it be well fermented
and baked and if you at any time suspect that
it is not done enough you should mend it by a
little toasting. With respect to Greens, Roots or
other Garden things you should avoid all raw and
cold Vegetables as Lettuce and Cucumber and such
flatulent things as Cabbage. Let what you
take be young and tender and always very well
boiled. All these Vegetables however are hazardous
for your stomach and even with the precautions
[Page 9]
mentioned should be always taken sparingly. In
ripe fruit I should be willing to indulge you a
little but I am certain that a large or frequent
use of them would be dangerous and therefore
I advise you to proceed in this Article with great
caution.
I have now given you a Bill of fare for
Dinner but for Supper I need not as you very
properly take none at all. You may sometimes
after Dinner if you find it light on your stomach
take a dish of Tea such as I have advised for the
morning but I am very averse from your taking
any Coffee.
For your ordinary drink at Dinner I
think plain water with a little Sherry in it is the
best. I cannot possibly indulge you in Small
beer but if you can take some good Porter mixed in
two parts of water I believe you may do it safely
[Page 10]
I think it very proper for you to take two or three
glasses of wine every day at Dinner and even one or
two at Supper time if you don't find it heat you.
The wine that I would prefer are some of the strongest
as Madeira, Sherry or Red Port but the quantity
of these should be small and they will always be
safer by a little water taken along with them.
Claret, French white wine, Hock or Rhenish I
hold to be unsafe and a little good Burgundy is
the only french wine that you can safely taste.
When your stomach is very flatulent or distressed
to acidity a little spirits and water may be safer
than any kind of wine but in this drink allowed
only from necessity you must proceed with great
diffidence.
I think I have written now pretty fully
on the subject of Diet and the next Article
I would speak of is your Exercise. I would have
you to be as much in the open air and in gentle
[Page 11]
exercise as the weather and your strength will allow
Your Phaeton driven by yourself is the more
desireable mode of it taking care however al¬
ways to avoid fatigue and more especially cold. For
this later purpose you should always warmly
cloathed I think your flannel should be next
your skin with as many waistcoats above it as
you please and such Cloathing is the best means
you can employ for guarding against the coldness
of your Arms and at the same time furred Gloves
on your hands will be of service. In these ad¬
vices I provide for a British Climate but I
must here give you my opinion fairly that a
British Climate will be very dangerous for you
in Winter and if you can do it with ease and
pleasure I would advise you to pass the winter
somewhere very near to the Coast of the Medi¬
terranean for even the inland places of the
South of France are not sufficiently secure.
[Page 12]
If you follow my advice in this take care to get to
your destination against the first of November and to
remain there till the end of April.
I have now touched on almost every particular
of your letters except my opinion of Mr. Bumart 2 in
which I cannot in the least join and I am very certain
that any Venereal taint in your body in the course
of fifteen or sixteen years must have discovered
itself very clearly which if it has not done by any
circumstance that you have ever mentioned to me
The symptoms of excoriation and swelling you
mention I have known happen to many persons
the most absolutely free from any Venereal taint.
You desire my sincere opinion of your state and I
shall give it you. Your constitution is certainly broken
and weakened to a considerable degree and I doubt
if it ever can be restored to much strength and firmness
but I perceive no threatning of immediate danger and
with attention and care you may carry on life tolerably
well for a long time to come. I shall willingly con¬
tribute to it as well as I can and I hope by this
[Page 13]
letter I have given you some proof of it as it has
cost me more time and pains than I can commonly
bestow amidst my incessant hurry upon many
other patients. I shall not however be satisfied
with this if you shall have yet any other ques¬
tions to put. Let me have them and you may
depend upon my punctuality and attention in
answering them being with very great regard
Sir
your most Obedient and
most humble Servant
Edr. 30th. August
1783
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