Cullen

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

 

[ID:343] 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 draft of [DOC ID:1173].

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Metadata

FieldData
DOC ID 343
RCPE Catalogue Number CUL/1/1/6/42
Main Language English
Document Direction Outgoing
Date8 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 '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 draft of [DOC ID:1173].
Manuscript Incomplete? No
Evidence of Commercial Posting No

This is the draft of:

1. [DOC ID:1173]

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 M.r Potts.


After considering all the circumstances and whole history of M.r
Potts complaints I am of opinion that they depend upon a Gouty dis¬
position
which has not taken its proper course from various accidents



[Page 2]

happening to weaken his stomach. It is very doubtful if ever he will have the
Gout
properly formed, but it is to be hoped that his complaints may be ob¬
viated and in a great measure removed by the following measures --


1. His diet must be regulated very exactly. He must take every day at
dinner some animal food, but should avoid the heavier kinds as Pork, Ba¬
con or any other fat meat, and should avoid all heavy and greasy sauces.
He may take any kind of light white fish, but should take these sel¬
dom. His dinner may thus chiefly consist of animal food, but he should
take 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 saftest 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 im¬
proper. Honey and all kinds of sweat meats are very bad for him. --
The less supper he takes the better, and if any, it should be, a little meat
if he can digest it; but he does not digest milk he may take Rice,
Barley or Sago, prepared 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 always
moderately


2. For ordinary drink he must take water alone. No kind
of malt liquor whether weak or strong is safe for him, a little
good Porter is the safest, but even that should be taken very sparingly
Wines too of all kinds are uncertain with respect to his stomach
and there is none but a little very good Madeira I would admit
of. The only strong drink that is good for him is Rum or Brandy
with a large proportion of water ---- While his diet is thus
regulated he must give a constant attention to avoiding costiveness
But at the same time purging is very improper. He must



[Page 3]

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 least two taken every over night will
have the proper Effect. I would not have him however persist
long in the use of these, but often, three or four weeks he may
return to the use of Dr Nicolsons Electuary which after that
intermission may recover its force – 4. It appears that his sto¬
mach
is from 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 absolutely forbid him to take
at times a Camomile Puke. But at the same time I must observe
that frequent vomiting weakens the stomach and increases the disease
it is intended to cure. I would wish therefore to avoid frequent
vomiting
and endeavour to remove the disorders of the sto¬
mach
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 about a week
about the time he thinks the disorder of his stomach is
breeding. Another means of correcting the disorder of his stomach
is the use of the Drops ordered in the paper apart. He is to take
fifety or sixty drops 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 and water
which on that occasion may be a little stronger than usual.


5. M.r Potts will be the better for being much in the fresh air
and in gentle exercise, moderate walking is proper, but it should
be always moderate and never go so far as either to heat or fatigue
him – The most useful exercise will be going on horseback



[Page 4]

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 and legs. I
shall think it very proper for him against Winter to change his cot¬
ton 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 wear
woolen foot stocks during the night ---- 6. After looking over
M.r Potts paper I find a question or two still unanswered. I
think any kind of cold bathing would be dangerous. At any rate
sea bathing 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 towards
the beginning of next summer. ---- Eggs and shell fish are
both improper for him, a few raw Oisters would be the most safe

October 8.th 1775

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: Stomach drops fifety or sixty for a dose to be taken dropt on a bit of sugar.

Diplomatic Text

[Page 1]
For M.r Potts.


After considering all the circumstances and whole history of M.r
Potts complaints I am of opinion that they depend upon a Gouty dis¬
position
which has not taken its proper course from various accidents



[Page 2]

happening to weaken his stomach. It is very doubtful if ever he will have the
Gout
properly formed, but it is to be hoped that his complaints may be ob¬
viated and in a great measure removed by the following measures --


1. His diet must be regulated very exactly. He must take every day at
dinner some animal food, but should avoid the heavier kinds as Pork, Ba¬
con or any other fat meat, and should avoid all heavy and greasy sauces.
He may take any kind of light white fish, but should take these sel¬
dom. His dinner may thus chiefly consist of animal food, but he should
take 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 saftest 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 im¬
proper. Honey and all kinds of sweat meats are very bad for him. --
The less supper he takes the better, and if any, it should be, a little meat
if he can digest it; but he does not digest milk he may take Rice,
Barley or Sago, prepared 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 always
moderately


2. For ordinary drink he must take water alone. No kind
of malt liquor whether weak or strong is safe for him, a little
good Porter is the safest, but even that should be taken very sparingly
Wines too of all kinds are uncertain with respect to his stomach
and there is none but a little very good Madeira I would admit
of. The only strong drink that is good for him is Rum or Brandy
with a large proportion of water ---- While his diet is thus
regulated he must give a constant attention to avoiding costiveness
But at the same time purging is very improper. He must



[Page 3]

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 least two taken every over night will
have the proper Effect. I would not have him however persist
long in the use of these, but often, three or four weeks he may
return to the use of Dr Nicolsons Electuary which after that
intermission may recover its force – 4. It appears that his sto¬
mach
is from 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 absolutely forbid him to take
at times a Camomile Puke. But at the same time I must observe
that freq.t vomiting weakens the stomach and increases the disease
it is intended to cure. I would wish therefore to avoid frequent
vomiting
and endeavour to remove the disorders of the sto¬
mach
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 about a week
about the time he thinks the disorder of his stomach is
breeding. Another means of correcting the disorder of his stomach
is the use of the Drops ordered in the paper apart. He is to take
fifety or sixty drops 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 freq.t repetition will render
them useless. They may be washed ↑down↑ with a little spirits and water
which on that occasion may be a little stronger than usual.


5. M.r Potts will be the better for being much in the fresh air
and in gentle exercise, moderate walking is proper, but it should
be always moderate and never go so far as either to heat or fatigue
him – The most useful exercise will be going on horseback



[Page 4]

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 and legs. I
shall think it very proper for him against Winter to change his cot¬
ton 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 wear
woolen foot stocks during the night ---- 6. After looking over
M.r Potts paper I find a question or two still unanswered. I
think any kind of cold bathing would be dangerous. At any rate
sea bathing 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 towards
the beginning of next summer. ---- Eggs and shell fish are
both improper for him, a few raw Oisters would be the most safe

Oct.r 8.th 1775


Aloes socotorin Extract Gentian @ ʒi sal Chalyb g.r xv
Syr. simpl. q. s. ut f. massa dividenda in pil. sing. g.r v. Sig.
laxative pills one or two to be taken for a dose at bedtime -----


Elix. propriet vitriolic ℥i. Sig. Stomach drops fifety or
sixty for a dose to be taken dropt on a bit of sugar.

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