Cullen

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

 

[ID:4952] From: Dr William Cullen (Professor Cullen) / To: Colonel George Clerk (Clarke, Clark) / Regarding: Colonel George Clerk (Clarke, Clark) (Patient) / 9 December 1784 / (Outgoing)

Reply for 'Col. Clarke'. Cullen's letter concerns the case of Colonel George Clerke and is addressed to him in response to notes sent by his nephew, Colonel Maxwell. Cullen reiterates previous advice and says it is now too late in the season for the Colonel to go abroad for the winter.

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Metadata

FieldData
DOC ID 4952
RCPE Catalogue Number CUL/1/1/17/146
Main Language English
Document Direction Outgoing
Date9 December 1784
Annotation None
TypeMachine scribal copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Reply for 'Col. Clarke'. Cullen's letter concerns the case of Colonel George Clerke and is addressed to him in response to notes sent by his nephew, Colonel Maxwell. Cullen reiterates previous advice and says it is now too late in the season for the Colonel to go abroad for the winter.
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 IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:2507]AddresseeColonel George Clerk (Clarke, Clark)
[PERS ID:2507]PatientColonel George Clerk (Clarke, Clark)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:3190]Patient's Relative / Spouse / FriendColonel William Maxwell (General Sir William Maxwell of Calderwood, 7th Bt (after 1829))

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
Mentioned / Other Britain Europe certain

Normalized Text

[Page 1]
Col. Clarke


Your friend Col. Maxwell has just now
{illeg}ated to me several passages of your last letter
to him and your many complaints give me much
concern. I would be happy to relieve them all but
I am afraid that some of them depending upon the
weakness of
your bowels cannot be entirely [cured?].


The oppression across your Stomach, the wind
that is so troublesome in it and even the difficulty
of breathing
are all the effects of the Slow and costive
belly which weak bowels are always liable to and
I am very doubtful if it be possible to bring your
bowels
to do their duty without the use of medicine
I have no objection to your chewing a little Rhubarb
before dinner but chewing it is safer and swallowing
your Saliva is safer thand I believe more effectual
than taking a dose of the powder. You may



[Page 2]

take it however in either Shape as shall {illeg}
to yourself but in neither Shape can you depend
upon it or indeed properly employ it as a laxative
I hope that you are well reconciled to the Castor Oil
in the shape I formerly proposed it but the effects
of its frequent use turns out differently in
different persons. In some the repeated use of it
renders it effectual in a less dose than was at
first necessary and if this is the Case with you
you can have no reason for declining the use of it
but in some persons the contrary happens and
the repeated use renders a larger and larger
dose continually necessary and if this has happened
to you I shall not be surprised if you wish for
a different kind of medicine. Till however I
know this more exactly I shall not prescribe


[Page 3]

another {illeg} shall only say that you may try to render
{illeg} it more effectual either by putting the tincture of
Senna
to it on the proportion of a third rather than
in a fourth as I formerly prescribed it, or, instead of
the tincture of Senna you may employ the tincture of
Jalap
in the proportion of a fourth or a third as you
may find necessary.


With respect to your diet to render it as little
flatulent as possible I have certainly wrote you
before as fully and clearly as I could. The Sum of it
is, that you should take chiefly Animal food and
very sparingly of Vegetables, that all fermented liquors
are hazardous but that good Porter with an equal
part of water is safer than water alone and that
of wines Madeira or good Sherry diluted with a
little water is safer than any weaker bodied



[Page 4]

wines and I think Claret except of the most [superior?]
kind absolutely improper.


With respect to your taking to a warmer Climate
if you had consulted me in the month of October
I should certainly have advised you to it, for though
I could not expect it to restore your Constitution
I think it might ↑have↑ Secured you against some
mischiefs to be apprehended from the Winter of
Britain but now the Winter is Set in and it
Sets in with us just now with uncommon severity
I think you could not be transported to a warm
Climate but with the utmost danger and therefore
you must make the best you can of your present
Situation by avoiding Cold with as much attention
and care as possible.


There is nothing puzzles me more than to



[Page 5]

relieve your headach because I do not know the
circumstance of it sufficiently, fully and exactly
but hope it is neither frequent nor violent and
that your attention to your general Regimen
will render it tolerable.


Your want of Sleep and the consequences
of this your frequent calls to make water might
be relieved by the use of Laudanum but I could
hardly advise this without being on the spot to
observe how far the use of it should increase
either fever
or Costiveness.


The itchiness on your Nose and Lips certainly
arises from your bowelsand will I hope be
relieved by your attention to the regularity of these
but in the mean time when the itching is
very urgent
it may possibly be relieved by



[Page 6]

touching it with a mixture of equal parts of Rum
and Vinegar Shaking them together in a Phial very
well before using it.


I have now I think touched every part of your
Subject as I wish upon this and every other occasion
to shew you that I am very earnestly


Dear Col.
Your most Obedient humble servant
William Cullen.

Edinburgh 9th. December
1784

Diplomatic Text

[Page 1]
Col. Clarke


Your friend Col. Maxwell has just now
{illeg}ated to me several passages of your last letter
to him and your many complaints give me much
concern. I would be happy to relieve them all but
I am afraid that some of them depending upon the
weakness of
your bowels cannot be entirely [cured?].


The oppression across your Stomach, the wind
that is so troublesome in it and even the difficulty
of breathing
are all the effects of the Slow and costive
belly which weak bowels are always liable to and
I am very doubtful if it be possible to bring your
bowels
to do their duty without the use of medicine
I have no objection to your chewing a little Rhubarb
before dinner but chewing it is safer and swallowing
your Saliva is safer thand I believe more effectual
than taking a dose of the powder. You may



[Page 2]

take it however in either Shape as shall {illeg}
to yourself but in neither Shape can you depend
upon it or indeed properly employ it as a laxative
I hope that you are well reconciled to the Castor Oil
in the shape I formerly proposed it but the effects
of its frequent use turns out differently in
different persons. In some the repeated use of it
renders it effectual in a less dose than was at
first necessary and if this is the Case with you
you can have no reason for declining the use of it
but in some persons the contrary happens and
the repeated use renders a larger and larger
dose continually necessary and if this has happened
to you I shall not be surprised if you wish for
a different kind of medicine. Till however I
know this more exactly I shall not prescribe


[Page 3]

another {illeg} shall only say that you may try to render
{illeg} it more effectual either by putting the tincture of
Senna
to it on the proportion of a third rather than
in a fourth as I formerly prescribed it, or, instead of
the tincture of Senna you may employ the tincture of
Jalap
in the proportion of a fourth or a third as you
may find necessary.


With respect to your diet to render it as little
flatulent as possible I have certainly wrote you
before as fully and clearly as I could. The Sum of it
is, that you should take chiefly Animal food and
very sparingly of Vegetables, that all fermented liquors
are hazardous but that good Porter with an equal
part of water is safer than water alone and that
of wines Madeira or good Sherry diluted with a
little water is safer than any weaker bodied



[Page 4]

wines and I think Claret except of the most [superior?]
kind absolutely improper.


With respect to your taking to a warmer Climate
if you had consulted me in the month of October
I should certainly have advised you to it, for though
I could not expect it to restore your Constitution
I think it might ↑have↑ Secured you against some
mischiefs to be apprehended from the Winter of
Britain but now the Winter is Set in and it
Sets in with us just now with uncommon severity
I think you could not be transported to a warm
Climate but with the utmost danger and therefore
you must make the best you can of your present
Situation by avoiding Cold with as much attention
and care as possible.


There is nothing puzzles me more than to



[Page 5]

relieve your headach because I do not know the
circumstance of it sufficiently, fully and exactly
but hope it is neither frequent nor violent and
that your attention to your general Regimen
will render it tolerable.


Your want of Sleep and the consequences
of this your frequent calls to make water might
be relieved by the use of Laudanum but I could
hardly advise this without being on the spot to
observe how far the use of it should increase
either fever
or Costiveness.


The itchiness on your Nose and Lips certainly
arises from your bowelsand will I hope be
relieved by your attention to the regularity of these
but in the mean time when the itching is
very urgent
it may possibly be relieved by



[Page 6]

touching it with a mixture of equal parts of Rum
and Vinegar Shaking them together in a Phial very
well before using it.


I have now I think touched every part of your
Subject as I wish upon this and every other occasion
to shew you that I am very earnestly


Dear Col.
Your most Obedient humble servant
William Cullen.

Edinr. 9th. Decr
1784

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