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


[ID:874] From: Dr Hugh Downman / To: Dr William Cullen (Professor Cullen) / Regarding: Miss Anne Downman (Ann) (Patient) / 7 February 1774 / (Incoming)

Case note on 'Mistress A. Downman of the County of Devon', in Latin, by her brother, the physician and poet Hugh Downman. She has been suffering from grief, bouts of weeping, and prickling sensations like those of gorse, since the death of another brother in 1771. She has consulted Fothergill in London. She becomes angry if it is suggested that the cause is in her imagination.


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DOC ID 874
RCPE Catalogue Number CUL/1/2/140a
Main Language Latin
Document Direction Incoming
Date7 February 1774
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen No
Letter of Introduction No
Case Note No
Summary Case note on 'Mistress A. Downman of the County of Devon', in Latin, by her brother, the physician and poet Hugh Downman. She has been suffering from grief, bouts of weeping, and prickling sensations like those of gorse, since the death of another brother in 1771. She has consulted Fothergill in London. She becomes angry if it is suggested that the cause is in her imagination.
Manuscript Incomplete? No
Evidence of Commercial Posting No


Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:482]
Case of Miss Anne Downman, sister of Dr Hugh Downman, who has suffered from hysterical symptoms and urinary tract ailments since the death of a brother in 1771.

People linked to this document

Person IDRole in documentPerson
[PERS ID:455]AuthorDr Hugh Downman
[PERS ID:1]AddresseeDr William Cullen (Professor Cullen)
[PERS ID:456]PatientMiss Anne Downman (Ann)
[PERS ID:707]Patient's Physician / Surgeon / ApothecaryDr John Fothergill
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:5869]Patient's Relative / Spouse / FriendMr John Downman
[PERS ID:5876]Patient's Relative / Spouse / Friend
[PERS ID:5877]Patient's Relative / Spouse / FriendMr Hugh Downman (of Newton House, St. Cyrus)
[PERS ID:5878]Patient's Relative / Spouse / FriendMrs Anne Downman
[PERS ID:455]Patient's Relative / Spouse / FriendDr Hugh Downman

Places linked to this document

Role in document Specific Place Settlements / Areas Region Country Global Region Confidence
Place of Writing Exeter South-West England Europe certain
Destination of Letter Edinburgh Edinburgh and East Scotland Europe inferred
Mentioned / Other London London and South-East England Europe certain

Normalized Text

Mistress A. Downman, from the County of Devon
aged 28. At the beginning of 1771,
the known facts are, that she was afflicted with the utmost grief at the death of a favourite brother.
For weeks, indeed, for some months,
indulging in grief, she often shed tears during the day.
She received some solace from a young female relative,
and regained (so it seemed) her former state
of mind
. But also
in the middle of Summer 1772, at her parents',
she abandoned herself and succumbed again to sorrow.
Now, however, she responded to her friends'
enquiries that they were not to worry about her
on any account, but that the cause of her grief and tears
she attributed to certain pains, resembling
the prickling of gorse on
the skin
and diverse parts of the body.
Driven by these pains (true or imaginary), so she said,
she was perpetually in anxiety, sought solitude, often wept,
and begged the pity of her friends.

At first we turned a deaf ear to,
these complaints, which were surely light and of no great moment,
but because they were increased by her imagination
and fears, we took care of the tone of her general system
and the restoration of her mind. Therefore on alternate
days she was immersed in the sea, and, although it was
difficult to persuade her, often went riding.

However, as happens in cases of this type of Melancholy,
no rememdies are esteemed to be of use
save these proposed, we at length prescribed Gum pills,
[Castor?], Camphor, and common nervous tinctures;
at length, Tincture
of Mars
, Bark Extract, Vomits of Ipecacuanha,
Rhubarb, Rufus's Pills as required, with a certain absorbency,
and for a long space of time
Breadcrumb Pills. It must be noted that
after any new remedy, or medicine or different
ingredient, she would be better for a few days,
but then she wanted to try one thing or another.
It must also be noted that the Breadcrumb Pills
lasted longer (because of their goodness, so she said, and sensible effect),
and she conceived great hope of her cure.

By riding and sea-bathing, or
having left home to be with others,
things were better, but having returned home,
she was affected again with melancholy, and
sometimes even to the point of despair. In
some of her manuscripts found in her desk we read thus:
"Since these stinging pains have attacked first my feet and legs,
then my body, and afterwards my viscera, why
then do not they not at once attack my brain,
and drive me mad? If so much misfortune was to be hers, she entreated,
that her parents, while they lived, could not remove it,
she would afterwards entrusted herself to her brother's care;
and when he also died, to that of her sister."
She also often spoke of the burden of life,
and wished so strongly for death that she
aroused a great fear in her friends (if her religion
did not prevent it), that she would lay violent hands upon herself

Meanwhile, throughout this whole time
her appetite was full and good, the strength of her limbs
in no way diminished, her pulse regular,
her face with a healthy pink colour,
and she menstruated regularly; she never complained
of any other pain save those gorse-like pricklings mentioned earlier.
And with this pain her
grief, anxiety, and weeping returned:
she always strongly insists that this pain is not imaginary,
and is very angry if ever she hears any such suspicion. No instability
of her system is apparent, no globus,
or any other Hysteric symptom,
except sometimes a sudden urge to urinate,
with a copious limpid flow.

In April 1773 she consulted the renowned
Dr Fothergill, who prescribed
Aloetic pills and Calcified Antimony
to be taken every night; artificial spa water twice a day
with the addition of Peruvian Bark Tincture and Aromatic Tincture.
Also moderate Exercise and an unexceptional diet.
By this just advice and with happy hope
he tried to settle her spirits. While
she made the journey to London, grief and
anxiety scarcely often made their appearance,
and while she stayed in the city,
she remained cheerful and lively, and very rarely wept.
Thence she made for her sister's house, where either by
the wise support of the celebrated doctor,
or soothed by the change of scene, and delights of refined company,
for several few weeks she was calm,
and she did not shed tears at all.

However, in June, again despairing,
again we consulted Dr Fothergill
by letter. He prescribed in place of the Aloes
Cathartic Extract. and twice as much of the saline Laxative,
regular diet of vegetables and summer fruits, the Pill
of the Cathartic Extract
to produce one stool a day,
the saline laxative two.

H. Downman
Exeter 7th February 1774

Diplomatic Text

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Domina A: Downman ex agro Damno¬
niensi ætat. 28 Initio Anni 1771 de Fratris
Charissimi morte, certa facta, mærore maxima
afficiebatur. Per 7nas, immo menses aliquot
mærori indulgens sæpius de die lacrymas effu¬
. A Puellula sibi cognata solatium quoddam
accepit, et pristinam (ut videbatur) recuperavit
mentem. Sed Ista quoq ad Parentes suos
media æstate anni 1772 a se dimissa rursus
tristitia succubuit. Nunc autem amicis ex¬
hortantibus respondebat, se nequaquam idcirco
anxiam fore, sed causem mæroris et lacry¬
, doloribus attribuit quibusdam, genis¬
tæ spinosæ puncturi similibus salter
et in diversis corporis partibus. His do¬
loribus (an veris, an fictis) ut aiebat, Compulsa,
perpetuo anxii fuit animi, societatem au¬
fugiit, solitudinem petivit, sæpius flevit,
et amicorum misericordiam invocavit.

His querelis primo surdas præbemus
aures, levibus certe, nec magni momenti,
sed quia ab imaginatione sua et timoribus
augebantur, de tono systematis generalis, &
recreatione mentis consuluimus. Alternis
igitur diebus in mare immersa fuit, &
quamvis e difficultate suasa, sæpius equi¬

Quem vero, more id genus Melancho¬
, nisi remedia propinarentur, se
neglectam fore existimavit, prescripsimus
aliquando Pil. gummis. [Cast.?] Camph. Tinc¬
turas communas nervosas aliquando Tinct.
Extract. Cort. Vomitis ex Ipecac.
Rheum, Pil. Ruf. p. r. n. aliquando absor¬

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bentia quædam, et pro spatio magno temporis
Pil. ex mica Panis. Notandum est quod post
novam quod eunq remedium, vel formula vel
substantia diversam, melius per aliquot dies
se habuit, sed cito alia atq alia voluit
tentare. Notandum quaq est quod Pil. ex
mica Panis
longius ferebant aut ilium, et
ex istis (a bene istorum, ut dixit, et sensi¬
bili effectu) spem magnam curæ suæ con¬

Ab equitatione, & balneo marinis, vel
quoniam domo relicta inter alios versaretur,
res melius se habebant, sed domi reversa,
rediit Melancholica affectis, atq etiam ali¬
quando fere ad desperationem aucta. In
quibusdam ejus Manuscriptis in scrinio in¬
ventis hac legimus, viz: "Quod dolores hi
primo invaderant pedes et crura,
postea corpus, atq etiam viscera, quare
igitur non subito cerebrum occuparent,
et se maniacam redderent? Si tanta
foret sibi infelicitas, orabat, quod non
a Parentibus suis, dum Isti viverent, amo¬
veretur, postea cura fratris sui se
confidebat; et Isti quoq mortuo, sororis."
Sæpius quoq de pondere vitæ loquata fuit,
et mortem tam strenue optavit, quod
amicis suis metum incussit (ni religione
sua impediretur) ne in seipsam manus
violenter injiceret

Interea, per totum hoc tempus
appetitus plerumq bonus fuit, vis membro¬
rum haud diminuta, Pulsis regularis,
Facies roseo colore salutis tincta, recte
menstruavit; neq unquam de alio dolore
querebatur, nisi punctii quasi genistæ

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, ante memorato. Et huic dolori, mæsti¬
, anxietatem, et fletus referebat; per¬
petuo fortiter dimicans hunc dolorem non
esse imaginarium, et irata admodum, si
talem unquam audiret suspicionem. Nulla
systematis apparuit mobilitas, nullus
globus, vel alia symptomata Hysteriæ,
nisi ad urinam aliquando stimulus subi¬
, et copiosa limpidæ excretis.

Mense Aprilis 1773 Med. Celeb.
Fothergill consuluit Qui præscripsit
Pil. ex aloe et Calc. Antimon. omni
nocte sumend. Aq. Spad. bis die addendo
Tinct. Cort. & Tinct. Aromat. Exercitationem
quoq moderatam, diætam haud peculiarem.
Admonitione quoq justa et spe læta
animam stabilire tentavit. Dum iter
ad urbem Londiniens. fecit, Mæror &
anxietas vix apparuere, etiam frequenter
tunc, et dum in urbe mansit alacris
fuit Hilarisq: & perraro flevit. Exinde
sororis domum petiit, ubi vel Medici
Celeb. sagacitate freta, vel mutatione
scenæ, et societate Tenelluleram Dilectarum
{illeg} (↑Permulsa↑), per aliquot hebdomed. placida fuit,
neq quidam semel lacrymas fundebat.

Mense autem Junii rursus Despera¬
bunda, rursus D. Fothergill per litteras
consuluimus. Qui in loco Aloes prescripsit
Extract. Catharti et bis qua Laxativum
Salinum, diætam præcipue ex vegetabi¬
lilis & {illeg} fructibus æstivis. –– Pil. e
extract. Cathart.
unam de die provocavere
sedem. Laxativ. Salin. duas.

H. Downman
Exon. Feb. 7. 1774


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