Cullen

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

 

[ID:1173] From: Dr William Cullen (Professor Cullen) / To: Mr James Wood (of Berwick) / Regarding: Mr Potts (Patient) / 8 October 1775 / (Outgoing)

Reply 'For Mr Potts', whose stomach ailments Cullen considers arise from 'a Gouty disposition'. Cold bathing is not advised, but he tentatively suggests Buxton in the summer. Recipes are attached for laxative pills and stomach drops. Probably sent to James Wood, surgeon in Berwick. This is a neater copy of [DOC ID:343] with minor variations.

Facsimile

There are 9 images for this document.

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Metadata

FieldData
DOC ID 1173
RCPE Catalogue Number CUL/1/2/274
Main Language English
Document Direction Outgoing
Date8 October 1775
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) Enclosure(s) present
Autopsy No
Recipe Yes
Regimen Yes
Letter of Introduction No
Case Note No
Summary Reply 'For Mr Potts', whose stomach ailments Cullen considers arise from 'a Gouty disposition'. Cold bathing is not advised, but he tentatively suggests Buxton in the summer. Recipes are attached for laxative pills and stomach drops. Probably sent to James Wood, surgeon in Berwick. This is a neater copy of [DOC ID:343] with minor variations.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Draft versions for this document exist:

1. [DOC ID:343]

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:521]
Case of Mr Potts who may have gout.
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:408]AddresseeMr James Wood (of Berwick)
[PERS ID:1534]PatientMr Potts
[PERS ID:408]Patient's Physician / Surgeon / ApothecaryMr James Wood (of Berwick)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:1535]Other Physician / SurgeonDr Nicolson

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 Berwick-upon-Tweed (Berwick) North-East England Europe inferred
Therapeutic Recommendation Buxton Midlands England Europe certain

Normalized Text

[Page 1]
For Mr Potts.


After considering all the circumstances and
whole history of Mr Potts complaints I am of opi¬
nion that they depend upon a gouty disposition,
which has not taken its proper course from various
accidents happening to weaken his stomach. It
is very doubtfull if ever he will have the gout
properly formed, but it is to be hoped that his
complaints may be obviated and in a great mea¬
sure removed by the following measures.


1. His diet must be regulated very exactly.
He may take every day at dinner some ani¬
mal food, but should avoid the heavier kinds
as Pork, Bacon or any very fat meat, and should
avoid all heavy and greasy sauces. He may take
any kind of light white fish, but should take
these seldom. His dinner may thus consist
chiefly of animal food, but he should take



[Page 2]

great care never to make a full meal of it,
but when his appetite requires, he should fill
up his meal with a great deal of bread, a light
bread pudding or some vegetables. In these last
some caution is necessary and he must avoid
the cold and flatulent kinds. For the winter
season, Potatoes of a dry and mealy kind
are the safest he can employ. If his stomach
will admit of any kind of liquid food, a
plain and not too strong ↑a↑ broth taken with
bread, will save his taking too much animal
food.


At breakfast, he may take Cocoa tea or
any tea of home growth, the Indian teas and
coffee being very improper. Honey and all
kinds of sweatmeats are very bad for him.


The less supper he takes, the better, and
if any, it should be, a little milk meat, if
he can digest it; but if he does not digest



[Page 3]

milk he may take, Rice, Barley or Sago, pre¬
pared without milk. He may take a few Raisins
or Currants, with his Rice or Barley, and he may
take a little boiled Pear or baked Apple, but
of these or any kind of fruit very sparingly.
Acids of all kinds are bad for him and therefore
he should take no kind of Pickles. Spiceries of
any kind he may take but allways moderately


2. For ordinary drink, he must take water
alone. No kind of malt liquor, whether weak or
st↑r↑ong is safe for him. A little good Porter is the
safest, but even that should be taken very sparing¬
ly. Wines too of all kinds are uncertain with res¬
pect to his stomach, and there is none, but a
little very good Madeira I would admit of. The
only strong drink, that is safe for him, is Rum
or Brandy, with a large proportion of water.


3. While his diet is thus regulated, he must
give a constant attention to avoiding Costiveness.



[Page 4]

But at the same time purging is very improper.
He must therefore have a Medicine that will keep
his belly regular, without purging. For this
purpose I have ordered some pills on a paper
apart, and I expect that one or at most two
taken over night will have the proper effect.
I would not however have him persist long
in the use of these, but after, three or four weeks
he may return to the use of Doctor Nicolsons
Electuary, which after that intermission, may
recover its force.


4. It appears that his stomach is from
time to time liable to accumulate Phlegm
and when that has gone to a certain length
there is nothing that will ↑so↑ certainly recover
it, as vomiting, and therefore I cannot abso¬
lutely forbid him to take ↑at times↑ a Camomile puke.
But at the same time I must observe that fre¬
quent vomiting weakens the stomach and in¬



[Page 5]

creases the disease it is intended to cure. I would
therefore wish to avoid frequent vomiting and endea¬
vour to remove the disorders of the stomach by
other means. One means may be the drinking of
Lime water or Seltzer water, and of either of these
he may take half a pint twice a day, that is
about an hour before dinner and four or five
hours after it, and this he may do for a week
about the time he thinks the disorder of his
stomach is breeding. Another means of correc¬
ting the disorder of his stomach is the use
of the Drops ordered on the paper apart. He
is to take fifty or sixty, droped on a bit of sugar
The time of taking them, is when threatened or
affected with pains of his stomach, and then
he may take them two or three times a day, but
they should be reserved for these occasions, as a
frequent repetition will render them useless.
They may be washed down, with a little spirits &


[Page 6]

water, which on that occasion may be a little
stronger than usual.


5. Mr Potts will be the better for being
much in the fresh air and in gentle exercise.
Moderate walking is very proper, but it should
be always moderate and never go so far as either
to heat or fatigue him. The most usefull exer¬
cise will be going on horseback, but even this
must be moderate and particularly the motion
should be as smooth and easy as possible.


At all times he should take great care to
avoid cold and particularly in his feet & legs.
I shall think it very proper for him against
winter to change his cotton into a flannel
shirt. If at any time his feet become cold,
he should have them immediately restored to their
warmth, and if he is liable to any coldness of
his
feet in the night, he should have them well
chafed with warm flannel
before lying down
and



[Page 7]

wearing woollen footsocks during the night.


6. After again looking over Mr Potts
paper I find a question or two still unanswe¬
red. I think any kind of cold bathing would
be dangerous. At any rate seabathing, could
not be attempted at this season. It is possible
that in Summer some bathing may be tried, and
I would have him begin with Buxton, but I
would not speak positively of this, till I should
know the circumstances of his complaints, to¬
wards the beginning of next summer.


Eggs and shell fish are both improper for
him, a few raw oisters, would be the most
safe.

William Cullen
Edinburgh October 8th
1775.



[Page 8]


Directions for
Mr Potts Octr 1775
Vol IV p. 55




[Page 9]
For Mr Potts.

Take a drachm each of Socotrine Aloes and Gentian Extract, 15 grains of Chalybeate Salts and enough Simple Syrup as to make a mass to be divided into pills of 5 grains each. Label: Laxative Pills one or two to be taken for a dose at bedtime

Take an ounce of Proprietary Vitriolic Elixir. Label: Stomachic drops fifty or sixty for a dose to be taken dropt on a bit of sugar.

W.C.
8th October
1775

Diplomatic Text

[Page 1]
For Mr Potts.


After considering all the circumstances and
whole history of Mr Potts complaints I am of opi¬
nion that they depend upon a gouty disposition,
which has not taken its proper course from various
accidents happening to weaken his stomach. It
is very doubtfull if ever he will have the gout
properly formed, but it is to be hoped that his
complaints may be obviated and in a great mea¬
sure removed by the following measures.


1. His diet must be regulated very exactly.
He may take every day at dinner some ani¬
mal food, but should avoid the heavier kinds
as Pork, Bacon or any very fat meat, and should
avoid all heavy and greasy sauces. He may take
any kind of light white fish, but should take
these seldom. His dinner may thus consist
chiefly of animal food, but he should take



[Page 2]

great care never to make a full meal of it,
but when his appetite requires, he should fill
up his meal with a great deal of bread, a light
bread pudding or some vegetables. In these last
some caution is necessary and he must avoid
the cold and flatulent kinds. For the winter
season, Potatoes of a dry and mealy kind
are the safest he can employ. If his stomach
will admit of any kind of liquid food, a
plain and not too strong ↑a↑ broth taken with
bread, will save his taking too much animal
food.


At breakfast, he may take Cocoa tea or
any tea of home growth, the Indian teas and
coffee being very improper. Honey and all
kinds of sweatmeats are very bad for him.


The less supper he takes, the better, and
if any, it should be, a little milk meat, if
he can digest it; but if he does not digest



[Page 3]

milk he may take, Rice, Barley or Sago, pre¬
pared without milk. He may take a few Raisins
or Currants, with his Rice or Barley, and he may
take a little boiled Pear or baked Apple, but
of these or any kind of fruit very sparingly.
Acids of all kinds are bad for him and therefore
he should take no kind of Pickles. Spiceries of
any kind he may take but allways moderately


2. For ordinary drink, he must take water
alone. No kind of malt liquor, whether weak or
st↑r↑ong is safe for him. A little good Porter is the
safest, but even that should be taken very sparing¬
ly. Wines too of all kinds are uncertain with res¬
pect to his stomach, and there is none, but a
little very good Madeira I would admit of. The
only strong drink, that is safe for him, is Rum
or Brandy, with a large proportion of water.


3. While his diet is thus regulated, he must
give a constant attention to avoiding Costiveness.



[Page 4]

But at the same time purging is very improper.
He must therefore have a Medicine that will keep
his belly regular, without purging. For this
purpose I have ordered some pills on a paper
apart, and I expect that one or at most two
taken over night will have the proper effect.
I would not however have him persist long
in the use of these, but after, three or four weeks
he may return to the use of Doctor Nicolsons
Electuary, which after that intermission, may
recover its force.


4. It appears that his stomach is from
time to time liable to accumulate Phlegm
and when that has gone to a certain length
there is nothing that will ↑so↑ certainly recover
it, as vomiting, and therefore I cannot abso¬
lutely forbid him to take ↑at times↑ a Camomile puke.
But at the same time I must observe that fre¬
quent vomiting weakens the stomach and in¬



[Page 5]

creases the disease it is intended to cure. I would
therefore wish to avoid frequent vomiting and endea¬
vour to remove the disorders of the stomach by
other means. One means may be the drinking of
Lime water or Seltzer water, and of either of these
he may take half a pint twice a day, that is
about an hour before dinner and four or five
hours after it, and this he may do for a week
about the time he thinks the disorder of his
stomach is breeding. Another means of correc¬
ting the disorder of his stomach is the use
of the Drops ordered on the paper apart. He
is to take fifty or sixty, droped on a bit of sugar
The time of taking them, is when threatened or
affected with pains of his stomach, and then
he may take them two or three times a day, but
they should be reserved for these occasions, as a
frequent repetition will render them useless.
They may be washed down, with a little spirits &


[Page 6]

water, which on that occasion may be a little
stronger than usual.


5. Mr Potts will be the better for being
much in the fresh air and in gentle exercise.
Moderate walking is very proper, but it should
be always moderate and never go so far as either
to heat or fatigue him. The most usefull exer¬
cise will be going on horseback, but even this
must be moderate and particularly the motion
should be as smooth and easy as possible.


At all times he should take great care to
avoid cold and particularly in his feet & legs.
I shall think it very proper for him against
winter to change his cotton into a flannel
shirt. If at any time his feet become cold,
he should have them immediately restored to their
warmth, and if he is liable to any coldness of
his
feet in the night, he should have them well
chafed with warm flannel
before lying down
and



[Page 7]

wearing woollen footsocks during the night.


6. After again looking over Mr Potts
paper I find a question or two still unanswe¬
red. I think any kind of cold bathing would
be dangerous. At any rate seabathing, could
not be attempted at this season. It is possible
that in Summer some bathing may be tried, and
I would have him begin with Buxton, but I
would not speak positively of this, till I should
know the circumstances of his complaints, to¬
wards the beginning of next summer.


Eggs and shell fish are both improper for
him, a few raw oisters, would be the most
safe.

William Cullen
Edin.r Oct.r 8th
1775.



[Page 8]


Directions for
Mr Potts Octr 1775
Vol IV p. 55




[Page 9]
For Mr Potts.


Aloes socotorin.
Extract. gentian @ ʒi
Sal. chalyb. gr. xv
Syr. simpl. q. s. ut f. massa dividendam in
pil. sing. gr. v.
Sig. Laxative Pills one or two to be taken for a
dose at bedtime


Elix. propriet. vitriolic. ℥i.
Sig. Stomachic Drops fifty or sixty for a dose to
be taken dropt on a bit of sugar.

W.C.
8th Octor.
1775

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