Cullen

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

 

[ID:341] From: Dr William Cullen (Professor Cullen) / To: (Miss Aiton's physician or surgeon) / Regarding: Miss Aiton (Patient) / 4 October 1775 / (Outgoing)

Reply providing numbered directions for Miss Aiton regarding menstrual problems, for which a foot-bath, aperients and water injections are advised. She is also threatened with a respiratory disorder. The directions are in the form of a numbered list, and concern diet, exercise, and the avoidance of damp and moisture. A blister and perpetual issue on the painful part of her side are advised for her chest complaint. A Mr Eason has previously been consulted. A recipe for 'aperient pills' is included.

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Metadata

FieldData
DOC ID 341
RCPE Catalogue Number CUL/1/1/6/40
Main Language English
Document Direction Outgoing
Date4 October 1775
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 providing numbered directions for Miss Aiton regarding menstrual problems, for which a foot-bath, aperients and water injections are advised. She is also threatened with a respiratory disorder. The directions are in the form of a numbered list, and concern diet, exercise, and the avoidance of damp and moisture. A blister and perpetual issue on the painful part of her side are advised for her chest complaint. A Mr Eason has previously been consulted. A recipe for 'aperient pills' is included.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:520]
Case of Miss Aiton with various symptoms attributed to her menstrual problems.
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1585]Addressee (Miss Aiton's physician or surgeon)
[PERS ID:1519]PatientMiss Aiton
[PERS ID:1585]Patient's Physician / Surgeon / Apothecary (Miss Aiton's physician or surgeon)
[PERS ID:1638]Patient's Physician / Surgeon / ApothecaryMr Eason
[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 Miss Aiton


As the trouble which occurs monthly is the greatest distress
so I believe it is the foundation of all her other complaints and
therefore our first care must be to relieve that principal ailment.
For this purpose the following measures are to be pursued ––


1. For three or four night before a period she should every night
a little before going to bed have her feet and part of her legs set
in warm water
for half an hour, taking care after that to have
them very well dried and kept very warm for sometime after
she lies down –– 2. She is at all times to avoid costiveness
and take care that she goes once a day, and this will be best
secured by the use of the Castor oil which she should get always
fresh from Edinburgh by four ounces at a time. When she
gets it let her put it into a vial; a tablespoonful of double
Rum
, and when she is to pour any of it out let it be very
well shaken. From half a table spoonful to a whole one will
be generally sufficient for a dose to be taken in the morning



[Page 2]

but she will learn by a trial or two to adjust the dose exactly which
should be just so much as to move her once. –– This is to her ordi¬
nary management for avoiding costiveness, but the approach of a period
she should take once or twice a dose of the aperient pills ordered below. They
are to be taken at bedtime, and they should operate next day not above
once or twice, and for this I think one pill will be sufficient but two
may be taken if necessary. –– 3. When the period actually comes on,
neither of the above laxatives are to be employed, but instead of them
an injection of warm water should be employed every evening unless the
belly
is open. The injection should be a pint english of water with two
or three table spoonfuls of eating oil –– 4. At a period or at the ap¬
proach of a period as soon as any pains come on she should take a
dose of Laudanum not less than thirty drops, and this is to be re¬
peated once or twice a day according to the urgency of the pains
which nothing else but the laudanum can relieve, and therefore
the doses are taken larger and more frequent as the pains require.
It will at the same time be obvious that as the laudanum is
more employed, the water injections will be the more necessary ––
5. These are the measures for relieving the pains which Miss Aiton
has so frequently suffered, but more must be done to prevent their
recurrence and this is to be done by preserving the full & free cir¬
culation in the lower extremities. Let her limbs therefore from the
haunches
downwards be rubbed every morning with a flesh brush. The
rubbing should be gentle but pretty long continued. After the limbs
are rubbed let the feet be rubbed and chafed with warm flannel till
they feel warm. Great pains must be taken to keep them con¬
stantly in this condition by wearing worsted under stockings in
the day, and worsted foot stocks in the night. If at any time the
feet become cold pains must be taken to restore their heat by
rubbing them on warm bricks or bottles of warm water, or by toast¬
ing them before the fire, and at bedtime if they feel cold they should


[Page 3]

be chafed with warm flannel as in the morning –– 6 While these
measures are pursued it will be proper also to take measures to relieve
the ailments which threaten the breast, and the first to be taken is to ap¬
ply a blistering plaister of four inches by three to the pained part of the side
and let about the size of a crown piece 1 of this be kept open as a perpe¬
tual Issue
for some time, that is, till the pain of the side by considerably
relieved. If before this happens the perpetual Issue proves very painfull
or gives any strangury, it must be changed for a seton or pea Issue.
7. While the pain in the side remains Miss Aiton will not
bear any brisk motion but as long as the weather is tolerable
she should be often in the fresh air and take what exercise on
horseback or in a carriage she can easily bear. Her exercise however
must be confined to these ways, for all bodily exercise is likely to do much
harm, and her walking therefore must be always very moderate, on
level ground only and never fast nor long at one time –– 8. Tho' I re¬
commend fresh air I would have Miss Aiton very carefull in avoiding
cold. Let her wear a flannel shirt next her skin. Let her avoid warm
chambers or being otherwise heated which is both very hurtfull to her
breast
and will render her readily affected with cold. Let her also avoid
all damp & moisture, and therefore being abroad in the evening and
lastly to avoid cold let her avoid sitting in any stream of cool air. ––
9. The safety of Miss Aiton's breast will depend very much on the
management of her diet. I am clearly of opinion that every kind
of animal food may do her harm, and therefore would desire
her to be extremely moderate in this article. A little weak
scotch broth she may take frequently and sometimes at dinner a
bit of chicken, rabbit or tripe or a little of the lighter white fish,
but of these the seldomer the better, and for the most part her
diet should consist of milk, grain, fruit & other vegetables. If she
does not digest milk easily let her try it diluted with an


[Page 4]

equal portion of water gruel and well sweetened with sugar,
and in this way either by itself or with any thing else she may
take it very freely except at the approach or during the continuance
of a period –– 10. I am of opinion ↑that↑ she should confine that for
drink she should confine herself to water & watery liquors alone, ex¬
cept at the times of a period when she may have a little weak
negus or white wine whey at bedtime.


It has been omitted above to say, that the water
Injections
proposed in № 3. may be improved by adding to
them about a Gill of the decoction of [Cumise?] 2 seeds and assafœ¬
tida
formerly advised by Mr Eason.


It has likewise been omitted that meat suppers
are totally inadmissible

Take half a drachm each of Socotrine Aloes and Gentian Extract, 10 grains of Calomel and 5 grains of Polychrest Salts. Rub the Calomel in with the Salts, then the Aloes, and let them be rubbed together into a powder; to this add the Extract, and then enough Gum Arabic paste as to make a mass to be divided into pills of 5 grains each. Label: Aperient pills.

4th October 1775

Notes:

1: A crown was a British coin of the value of five shillings, by this date made of silver, and about 38mm in diameter.

2: Probably a copying error for 'Cumin'.

Diplomatic Text

[Page 1]
For Miss Aiton


As the trouble which occurs monthly is the greatest distress
so I believe it is the foundation of all her other complaints and
therefore our first care must be to relieve that principal ailment.
For this purpose the following measures are to be pursued ––


1. For three or four night before a period she should every night
a little before going to bed have her feet and part of her legs set
in warm water
for half an hour, taking care after that to have
them very well dried and kept very warm for sometime after
she lies down –– 2. She is at all times to avoid costiveness
and take care that she goes once a day, and this will be best
secured by the use of the Castor oil which she should get always
fresh from Edinburgh by four ounces at a time. When she
gets it let her put it into a vial; a tablespoonful of double
Rum
, and when she is to pour any of it out let it be very
well shaken. From half a table spoonful to a whole one will
be generally sufficient for a dose to be taken in the morning



[Page 2]

but she will learn by a trial or two to adjust the dose exactly which
should be just so much as to move her once. –– This is to her ordi¬
nary management for avoiding costiveness, but the approach of a period
she should take once or twice a dose of the aperient pills ordered below. They
are to be taken at bedtime, and they should operate next day not above
once or twice, and for this I think one pill will be sufficient but two
may be taken if necessary. –– 3. When the period actually comes on,
neither of the above laxatives are to be employed, but instead of them
an injection of warm water should be employed every evening unless the
belly
is open. The injection should be a pint english of water with two
or three table spoonfuls of eating oil –– 4. At a period or at the ap¬
proach of a period as soon as any pains come on she should take a
dose of Laudanum not less than thirty drops, and this is to be re¬
peated once or twice a day according to the urgency of the pains
which nothing else but the laudanum can relieve, and therefore
the doses are taken larger and more frequent as the pains require.
It will at the same time be obvious that as the laudanum is
more employed, the water injections will be the more necessary ––
5. These are the measures for relieving the pains which Miss Aiton
has so frequently suffered, but more must be done to prevent their
recurrence and this is to be done by preserving the full & free cir¬
culation in the lower extremities. Let her limbs therefore from the
haunches
downwards be rubbed every morning with a flesh brush. The
rubbing should be gentle but pretty long continued. After the limbs
are rubbed let the feet be rubbed and chafed with warm flannel till
they feel warm. Great pains must be taken to keep them con¬
stantly in this condition by wearing worsted under stockings in
the day, and worsted foot stocks in the night. If at any time the
feet become cold pains must be taken to restore their heat by
rubbing them on warm bricks or bottles of warm water, or by toast¬
ing them before the fire, and at bedtime if they feel cold they should


[Page 3]

be chafed with warm flannel as in the morning –– 6 While these
measures are pursued it will be proper also to take measures to relieve
the ailments which threaten the breast, and the first to be taken is to ap¬
ply a blistering plaister of four inches by three to the pained part of the side
and let about the size of a crown piece 1 of this be kept open as a perpe¬
tual Issue
for some time, that is, till the pain of the side by considerably
relieved. If before this happens the perpetual Issue proves very painfull
or gives any strangury, it must be changed for a seton or pea Issue.
7. While the pain in the side remains Miss Aiton will not
bear any brisk motion but as long as the weather is tolerable
she should be often in the fresh air and take what exercise on
horseback or in a carriage she can easily bear. Her exercise however
must be confined to these ways, for all bodily exercise is likely to do much
harm, and her walking therefore must be always very moderate, on
level ground only and never fast nor long at one time –– 8. Tho' I re¬
commend fresh air I would have Miss Aiton very carefull in avoiding
cold. Let her wear a flannel shirt next her skin. Let her avoid warm
chambers or being otherwise heated which is both very hurtfull to her
breast
and will render her readily affected with cold. Let her also avoid
all damp & moisture, and therefore being abroad in the evening and
lastly to avoid cold let her avoid sitting in any stream of cool air. ––
9. The safety of Miss Aiton's breast will depend very much on the
management of her diet. I am clearly of opinion that every kind
of animal food may do her harm, and therefore would desire
her to be extremely moderate in this article. A little weak
scotch broth she may take frequently and sometimes at dinner a
bit of chicken, rabbit or tripe or a little of the lighter white fish,
but of these the seldomer the better, and for the most part her
diet should consist of milk, grain, fruit & other vegetables. If she
does not digest milk easily let her try it diluted with an


[Page 4]

equal portion of water gruel and well sweetened with sugar,
and in this way either by itself or with any thing else she may
take it very freely except at the approach or during the continuance
of a period –– 10. I am of opinion ↑that↑ she should confine that for
drink she should confine herself to water & watery liquors alone, ex¬
cept at the times of a period when she may have a little weak
negus or white wine whey at bedtime.


It has been omitted above to say, that the water
Injections
proposed in № 3. may be improved by adding to
them about a Gill of the decoction of [Cumise?] 2 seeds and assafœ¬
tida
formerly advised by Mr Eason.


It has likewise been omitted that meat suppers
are totally inadmissible


aloes socotor extract. gentian: @ ʒſs Calomel. gr X Sal.
polychrest.
gr. V. Tere Calomalas cum sale, dein [aleun?] et terantur
simul in pulverem; cui admisse extractum, et num mucil:
G. Arab.
q. s. fiet massa, dividenda in pil. sing gr. V Sig.
Aperient pills

4th Oct.r 1775

Notes:

1: A crown was a British coin of the value of five shillings, by this date made of silver, and about 38mm in diameter.

2: Probably a copying error for 'Cumin'.

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