Cullen

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

 

[ID:5965] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Colonel Maxwell (Patient) / 1775 / (Outgoing)

Reply, 'For Colonel Maxwell'.

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Metadata

FieldData
DOC ID 5965
RCPE Catalogue Number CUL/1/1/3/4
Main Language English
Document Direction Outgoing
Date1775
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen Yes
Letter of Introduction No
Case Note No
Summary Reply, 'For Colonel Maxwell'.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:480]
Case of Colonel Maxwell who is given directions for managing his weak stomach.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1319]PatientColonel Maxwell
[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 Colonel Maxwell


The Colonels ailments are sufficiently evident,
an originally weak Stomach, farther weakened by many
accidents and its action now farther interrupted by Costive¬
ness
. The consequence of the these ailments is, as usual
in all such cases, some oppression of his spirits but
they are attended with no danger not at all liable to
fever
and rather a security against it.


The entire cure of such ail¬
ments is hardly possible but it is very possible to render
them very tolerable and easy and I hope it may be done
by the following means.


1. With regard to his diet the
first rule is to keep his Stomach very light and to avoid
a full meal of whatever kind it may be but especially
if it is Animal food or in the least of a heavy kind.


At Breakfast he may con¬
tinue to take Balm sage or Cocoa tea but along with
them let him infuse a little Cinnamon, Ginger or some
other aromatic that is agreeable to him.


In place of these he
may sometimes try Beef Tea with a little mace boiled in it:
when he takes this he should put into it thirty drops of
the Stomachic Elixir ordered below.


At dinner the Colonel
may take a bit of any plain meat avoiding Bacon Pork
or any other very fat {illeg} meat. He may



[Page 2]

sometimes take a little fish but it ought to be seldom
and of the lighter kinds plain drest. Heavy sauces he
must always avoid. Mustard & spiceries he may take
freely but no kind of pickle is proper for him. He
must at no time make his dinner of flesh or fish
alone but take these sparingly and fill up his meal
with broth, pudding or vegetables. The last may
perhaps prove windy or ill to digest and in that
case he must be sparing of them but by all means
let him try them take them often & as much as
his Stomach can easily digest.


At Supper let the Colonel
contrive to take some kind of Milk Meat and
that alone. The fresher the milk is, the better. Well
baked bread a little toasted is lighter than any
kind of grain.


For ordinary drink wine & water
is the best. I am persuaded that red port or Madeira
are fitter for his Stomach than Malaga or other
sweet wine but the last are more laxative &
till the course of his belly is better established
I dare not advise the change of his wine.
Whatever wine he takes, but especially with a
sweet wine instead of common water let him
take the Hartfell Spaw, that is, supposing always
he does not take a great deal of drink. Much
drink is by no means proper for his stomach &
he may take half a muchkin of Hartfell Spaw
at a meal with a fourth part of wine. If he takes
any drink after his supper let it be a little weak
punch without any souring.




[Page 3]


Besides the drink he takes to wash down his
victuals he should every day after dinner take
three or four glasses of wine Port or Madeira
are the best but he should take a little water
along with them. Claret, Rhenish & all weak
wines are improper for him. Malt liquor he had
already learned to avoid.


2. There is nothing of more consequ¬
ence to him to avoid than avoiding Cold & particularly
and particularly of his feet and legs which ought to
be kept very warm & dry both by day & night. Over
his whole body he ought to have flannel next his skin.


3. Exercise is absolutely necessary to the Colonel
and riding on horseback is by much the best. He
should be employed in this way as often as
possible & need not be afraid of a little bad weather
if he keeps himself quite dry. What will do most
is service is pretty long rides with some errand at
the end of them. Tho he does not bear much bodily
exercise at present & much would not be proper
for him, he must not however give it up altogether.
He should walk out as often as the weather allows
& keeping within the bounds that he bears easily
he should endeavour to lengthen his walk every day.


The use of the flesh brush will be of service to
the Colonel & the morning is the best time for it
Let his thighs & legs particularly be well rubbed.


4. Some Company & amusement are very necessary
and even a moderate occupation would be proper



[Page 4]

proper but application to any business with the
least anxiety or for any length of time is very
improper. His going to bed early is very proper but
while he is liable to wake to early in the morning
as at present I think he might try to sit an hour
later at night. When he wakes early in the
morning
with some anxiety & dejection if turning
in bed will compose him it is well and he may
lye still but if he continues uneasy he must get
out of bed and walk about his chamber till his
spirits are a little relieved & then may try to
get another sleep. But broken morning slumbers
will always do harm & he will be better for quitting
his bed entirely and when the morning allows
he should walk out a little before breakfast.
If his uneasiness in the morning is any thing
considerable he may be relieved by a dish of Balm
tea
with twenty or thirty drops of spirit of
Hartshorn


5. These are the particulars of Regimen
which observed shall I hope be of service. I trust
much to it and would wish to employ as few medi¬
cines as possible but some are I think necessary
both for keeping his belly regular and for bracing
his stomach.


For keeping his belly regular I have
ordered below two different remedies. The one is some
pills of which one, two or at most three taken
at bed time will answer the purpose of keeping
him regular without purging. If three pills do
not answer I shall think them improper & would
have him try the oil also ordered below.



[Page 5]

The dose is a tablespoonful beat a little with
a tea spoonful of Rum and taken in the morning.
The Colonel may perhaps require a larger dose
of this & he may go to the length of a spoonful &
half or even to two spoonfuls but farther I would
not push it.


For bracing the Colonels stomach very
good medicines have been proposed but I am
certain that the long continued use of aromatics
& bitters is heating and drying and at length
destroys the tone of the stomach. I am therefore for
laying these aside for some time & would have him
try a steel Electuary which I hope may ↑be↑ as
effectual as any of them he is to take the bigness
of a nutmeg twice a day in the morning before
breakfast when he does not take the oil & when he
does, he is to take the Electuary half an hour before
dinner & at all times he is to take another dose
of the Electuary about eight at night Both doses
may be washed down with a glass of the Hartfell Spaw


The only other medicine
I have to propose is the Stomachic Elixir
of which he is to take thirty drops in his beef tea
when he takes that for breakfast he may take twenty
drops of the Elixir in a glass of water about half
an hour before dinner. When he is to take the Electuary
at this time he may wash it down with the Elixir
and water instead of the Hartfell Spaw.

Take two ounces of Elixir of Vitriolic Acid. Label: Stomachic Elixir.

Take a drachm each of Socotrine Aloes and Gentian Extract, a scruple of Polychrest Salts and enough Balsamic Syrup as to make a mass & c. Label: Laxative Pills, one two or three for a dose at bedtime.

Take four ounces of Castor Oil. Label: Laxative Oil.

Take an ounce of powdered Peruvian Bark, two drachms each of Cinnamon and prepared powdered Steel, half a drachm of Steel Salts, an ounce of Orange Conserve and enough Clove Syrup as to make an Electuary. Label: Steel Electuary & c.

Diplomatic Text

[Page 1]
For Col:l Maxwell


The Colonels ailments are sufficiently evident,
an originally weak Stomach, farther weakened by many
accidents and its action now farther interrupted by Costive¬
ness
. The consequence of the these ailments is, as usual
in all such cases, some oppression of his spirits but
they are attended with no danger not at all liable to
fever
and rather a security against it.


The entire cure of such ail¬
ments is hardly possible but it is very possible to render
them very tolerable and easy and I hope it may be done
by the following means.


1. With regard to his diet the
first rule is to keep his Stomach very light and to avoid
a full meal of whatever kind it may be but especially
if it is Animal food or in the least of a heavy kind.


At Breakfast he may con¬
tinue to take Balm sage or Cocoa tea but along with
them let him infuse a little Cinnamon, Ginger or some
other aromatic that is agreeable to him.


In place of these he
may sometimes try Beef Tea with a little mace boiled in it:
when he takes this he should put into it thirty drops of
the Stomachic Elixir ordered below.


At dinner the Colonel
may take a bit of any plain meat avoiding Bacon Pork
or any other very fat {illeg} meat. He may



[Page 2]

sometimes take a little fish but it ought to be seldom
and of the lighter kinds plain drest. Heavy sauces he
must always avoid. Mustard & spiceries he may take
freely but no kind of pickle is proper for him. He
must at no time make his dinner of flesh or fish
alone but take these sparingly and fill up his meal
with broth, pudding or vegetables. The last may
perhaps prove windy or ill to digest and in that
case he must be sparing of them but by all means
let him try them take them often & as much as
his Stomach can easily digest.


At Supper let the Colonel
contrive to take some kind of Milk Meat and
that alone. The fresher the milk is, the better. Well
baked bread a little toasted is lighter than any
kind of grain.


For ordinary drink wine & water
is the best. I am persuaded that red port or Madeira
are fitter for his Stomach than Malaga or other
sweet wine but the last are more laxative &
till the course of his belly is better established
I dare not advise the change of his wine.
Whatever wine he takes, but especially with a
sweet wine instead of common water let him
take the Hartfell Spaw, that is, supposing always
he does not take a great deal of drink. Much
drink is by no means proper for his stomach &
he may take half a muchkin of Hartfell Spaw
at a meal with a fourth part of wine. If he takes
any drink after his supper let it be a little weak
punch without any souring.




[Page 3]


Besides the drink he takes to wash down his
victuals he should every day after dinner take
three or four glasses of wine Port or Madeira
are the best but he should take a little water
along with them. Claret, Rhenish & all weak
wines are improper for him. Malt liquor he had
already learned to avoid.


2. There is nothing of more consequ¬
ence to him to avoid than avoiding Cold & particularly
and particularly of his feet and legs which ought to
be kept very warm & dry both by day & night. Over
his whole body he ought to have flannel next his skin.


3. Exercise is absolutely necessary to the Colonel
and riding on horseback is by much the best. He
should be employed in this way as often as
possible & need not be afraid of a little bad weather
if he keeps himself quite dry. What will do most
is service is pretty long rides with some errand at
the end of them. Tho he does not bear much bodily
exercise at present & much would not be proper
for him, he must not however give it up altogether.
He should walk out as often as the weather allows
& keeping within the bounds that he bears easily
he should endeavour to lengthen his walk every day.


The use of the flesh brush will be of service to
the Colonel & the morning is the best time for it
Let his thighs & legs particularly be well rubbed.


4. Some Company & amusement are very necessary
and even a moderate occupation would be proper



[Page 4]

proper but application to any business with the
least anxiety or for any length of time is very
improper. His going to bed early is very proper but
while he is liable to wake to early in the morning
as at present I think he might try to sit an hour
later at night. When he wakes early in the
morning
with some anxiety & dejection if turning
in bed will compose him it is well and he may
lye still but if he continues uneasy he must get
out of bed and walk about his chamber till his
spirits are a little relieved & then may try to
get another sleep. But broken morning slumbers
will always do harm & he will be better for quitting
his bed entirely and when the morning allows
he should walk out a little before breakfast.
If his uneasiness in the morning is any thing
considerable he may be relieved by a dish of Balm
tea
with twenty or thirty drops of spirit of
Hartshorn


5. These are the particulars of Regimen
which observed shall I hope be of service. I trust
much to it and would wish to employ as few medi¬
cines as possible but some are I think necessary
both for keeping his belly regular and for bracing
his stomach.


For keeping his belly regular I have
ordered below two different remedies. The one is some
pills of which one, two or at most three taken
at bed time will answer the purpose of keeping
him regular without purging. If three pills do
not answer I shall think them improper & would
have him try the oil also ordered below.



[Page 5]

The dose is a tablespoonful beat a little with
a tea spoonful of Rum and taken in the morning.
The Colonel may perhaps require a larger dose
of this & he may go to the length of a spoonful &
half or even to two spoonfuls but farther I would
not push it.


For bracing the Colonels stomach very
good medicines have been proposed but I am
certain that the long continued use of aromatics
& bitters is heating and drying and at length
destroys the tone of the stomach. I am therefore for
laying these aside for some time & would have him
try a steel Electuary which I hope may ↑be↑ as
effectual as any of them he is to take the bigness
of a nutmeg twice a day in the morning before
breakfast when he does not take the oil & when he
does, he is to take the Electuary half an hour before
dinner & at all times he is to take another dose
of the Electuary about eight at night Both doses
may be washed down with a glass of the Hartfell Spaw


The only other medicine
I have to propose is the Stomachic Elixir
of which he is to take thirty drops in his beef tea
when he takes that for breakfast he may take twenty
drops of the Elixir in a glass of water about half
an hour before dinner. When he is to take the Electuary
at this time he may wash it down with the Elixir
and water instead of the Hartfell Spaw.

Al. Socot. Extr. gent. @ ʒi Sal.
polychr.
℈i Syr. bals. q. s. ut f. massa & c Sig. Laxative Pills, one two or three for a dose at bedtime

Ol. Ricin. ℥iv Sign. Laxative Oil.

℞ p. Cort. Peruv. ℥i Cinnam. Lim. Mart. pp. @ ʒii Sal. Mart. ʒſs
Cons. Aurant. ℥i Syr. Caryoph. q. s. ut f. Elect. Sig. Steel Electuary & c.

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