The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:4251] From: Dr William Cullen (Professor Cullen) / To: Dr Joseph Brandreth / Regarding: Mr T Dickson (Patient) / 31? May 1778 / (Outgoing)
Reply headed 'Dr John [an error for Joseph] Brandreth' [Vol. 10, pp.119-122, although labelled pp.111-4), concerning an unnamed patient (identified in earlier letters as a merchant's son, T. Dickson), and another unnamed patient previously treated by Brandreth for stammering.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 4 images for this document.
[Page 1]
[Page 2]
[Page 3]
[Page 4]
Metadata
| Field | Data |
|---|---|
| DOC ID | 4251 |
| RCPE Catalogue Number | CUL/1/1/10/108 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 31? May 1778 |
| Annotation | None |
| Type | Scribal copy ( includes Casebook Entry) |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | Yes |
| Regimen | No |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply headed 'Dr John [an error for Joseph] Brandreth' [Vol. 10, pp.119-122, although labelled pp.111-4), concerning an unnamed patient (identified in earlier letters as a merchant's son, T. Dickson), and another unnamed patient previously treated by Brandreth for stammering. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:1022] |
Case of Mr T. Dickson, an impetuous young man who suffers pains in his face and costiveness and who rides from his home in Liverpool to Cheltenham and on to Bath and then Bristol, and then Harrogate taking the waters in pursuit of health. |
5 |
| [Case ID:2157] |
Case of an unnamed patient, a ten year old boy, treated for stammering. |
2 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:2312] | Addressee | Dr Joseph Brandreth |
| [PERS ID:2243] | Patient | Mr T Dickson |
| [PERS ID:2312] | Patient's Physician / Surgeon / Apothecary | Dr Joseph Brandreth |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr 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 |
| Destination of Letter | Liverpool | North-West | England | Europe | inferred |
Normalized Text
Dr John Brandreth
You do me a great deal of honour in sending me your difficulties,
and you may depend upon my attention in relieving you as well
as I can and I shall be proud if I can clear up what has puzled
you, tho I cannot expect always to succeed in it. The Case
you send me is certainly a difficult one. I cannot find in your
distinct and I believe very complete relation any marks of topical
affection or what we may call a particular Disease and it
seems to be a State of the whole habit which it is often difficult
to explain and always difficult to cure.
Tho his Complexion and Colour of Hair does not mark it,
I think every other circumstance marks pretty strongly a Mel¬
ancholy Temperament and a considerable Torpor of the nervous
power. How this operates in the Brain and what peculiar state
exists there I dare not determine, but the effects of Torpor appear
especially and as usually in the Alimentary Canal, occasioning
both want of appetite and a very Slow Belly and it is possible,
that this last may be the whole sole cause of the Symptoms
which appear about the head.
This is all I can say about the Pathology of this Case
[Page 2]
and I wish I could be more clear and certain with respect to
the cure. You have certainly done right in studying to remove
the costiveness. I am sorry that his Stomach has rejected the
Castor Oil. Have you tried it with Rum or Juice of Lemon?
Failing the Castor Oil you have tried what was next most pro¬
bable, that is the Aloetics but if these dont answer in a small
dose I seldom find benefit by enlarging it, or by adding the more
Drastic Purgatives especially when a lage dose of these
is also necessary. You made a probable trial also by Sea
Water, and you now also propose a proper measure in the
trial of the Cheltenham, but I must say, that after the fail¬
ing of the Salt Water, I shall not be certain of the Cheltenham
succeeding. However it is not far off and he will be the better
of the journey and for being removed from business. If the
Cheltenham fails I would advise him to try the Harriwgate
which is certainly more powerfull and I have had very great
success with it in correcting some obstinately costive habits
and headachs depending upon it, and if you had not already
advised the Cheltenham I should have advised the Chelten¬
ham first.
Whither he employs the Cheltenham or the Harrigate
if they do not operate in a moderate quantity not exceeding
three Pints, I would not advise him to persist in the use
of them; but at the same, he must not despair till he has
tried them for a week or two at least. I mean to say that
if they have any effect at all he must not despair of
their effects in changing his habits, till he has tried them
for the time I have mentioned.
For otherwise mending his constitution I would ↑would↑
advise of his taking advantage of this Season to quit business
very entirely, and therefore to remove to the Country & to take
gentel Exercise on horseback, but always withing the bounds
of any fatigue and therefore never to the length of Journeys
[Page 3]
you have mentioned his lately trying.
Every Evening or every second evening between six and seven
o, Clock I would have him to go into a warm bath heated
to 90 deg. Farenheit. and let him remain in this from half
an hour to an hour, taking care that when he remains
in it long, the Temperature of the bath be kept up to
the due degree. After coming out of this bath let him
have his skin well dried and put on his ordinary Clothes
but keep to his Chambers for the rest of the Evening.
Please observe that these measures of avoiding business
of riding and bathing are very compatible with his trying
of other Chiltenham or Harrigate and I only mean, that he
takes to a Country habitation when these trials are over.
If in these trails he shall find that there these Saline
Waters are effectual and usefull Laxatives he may in any
part of the Country continue the same remedy by employing
the following Solutions. -
Take Soluble Tartar and Glauber's Salts, two ounces of each; an ounce of Spanish sea-Salt, twelve ounces of spring Water. Dissolve and strain through paper. Two, three or four spoonfuls in a quart of Spring water every morning.
I hope this exercise will give him more appetite & I shall think that his eating
fully to what his appetite & Stomach will admitt of will be of service to his Bowels
and that his eating 3 or 4 times a day will answer better than less frequent meals. Let
part of his meal be generally a little pretty strong soup & if his digestion admitts of it
he should always have some Vegetables such as the season presents boiled with his
Soup. In such constitutions the Effect of Vegetables is uncertain but I expect they
will agree with him and if they do I would have him to use them freely & those
especially which he finds Laxative as I find Spinach to be with most people for the
rest he may take at Dinner a bit of any plain meat he likes best, & after it he
may take of any fruit the Seeson affords but with a little wine rather than
milk - for Drink at Dinner he should take small Beer or fresh drawn Cows milk whey
For Breakfast he may Tea & Bread&butter as usual. Tea & not too strong maybe
taken largely both in the morning & afternoon. When I say that Tea is not to
be taken strong you will understand that I make little difference between Green
and Bohea but the last is the Safest for supper let him take from a pint to
a quart of new drawn Cows milk whey with what bread is agreeable I would
choose some kind of sweet bread as Spunge bisquet or Diet loaf providing
[Page 4]
this diet I proved upon the supposition that he is troubled with no dyspeptic
Symptoms as you have taken no notice of them in your State of the
case. If it is otherways I would perhaps make some change in my
advice with respect to diet. In no part of my advice I have said how
long the particular measures recommended are to be continued because I
think that must be entirely regulated bu the Effects and the [effects?]
too if you shall please to advise me of them may also enable
me to make a more proper Judgement. I am obliged to you for
communicating to me your judicious management of the case of irritability
I have frequently found growing lads irritable and liable to Symptoms
of Chorea and your patients Stammering was of that kind Zinc
has proved with me an uncertain remedy but the Cold baths I have
always found usefull.
Diplomatic Text
Dr John Brandreth
You do me a great deal of honour in sending me your difficulties,
and you may depend upon my attention in relieving you as well
as I can and I shall be proud if I can clear up what has puzled
you, tho I cannot expect always to succeed in it. The Case
you send me is certainly a difficult one. I cannot find in your
distinct and I believe very complete relation any marks of topical
affection or what we may call a particular Disease and it
seems to be a State of the whole habit which it is often difficult
to explain and always difficult to cure.
Tho his Complexion and Colour of Hair does not mark it,
I think every other circumstance marks pretty strongly a Mel¬
ancholy Temperament and a considerable Torpor of the nervous
power. How this operates in the Brain and what peculiar state
exists there I dare not determine, but the effects of Torpor appear
especially and as usually in the Alimentary Canal, occasioning
both want of appetite and a very Slow Belly and it is possible,
that this last may be the whole sole cause of the Symptoms
which appear about the head.
This is all I can say about the Pathology of this Case
[Page 2]
and I wish I could be more clear and certain with respect to
the cure. You have certainly done right in studying to remove
the costiveness. I am sorry that his Stomach has rejected the
Castor Oil. Have you tried it with Rum or Juice of Lemon?
Failing the Castor Oil you have tried what was next most pro¬
bable, that is the Aloetics but if these dont answer in a small
dose I seldom find benefit by enlarging it, or by adding the more
Drastic Purgatives especially when a lage dose of these
is also necessary. You made a probable trial also by Sea
Water, and you now also propose a proper measure in the
trial of the Cheltenham, but I must say, that after the fail¬
ing of the Salt Water, I shall not be certain of the Cheltenham
succeeding. However it is not far off and he will be the better
of the journey and for being removed from business. If the
Cheltenham fails I would advise him to try the Harriwgate
which is certainly more powerfull and I have had very great
success with it in correcting some obstinately costive habits
and headachs depending upon it, and if you had not already
advised the Cheltenham I should have advised the Chelten¬
ham first.
Whither he employs the Cheltenham or the Harrigate
if they do not operate in a moderate quantity not exceeding
three Pints, I would not advise him to persist in the use
of them; but at the same, he must not despair till he has
tried them for a week or two at least. I mean to say that
if they have any effect at all he must not despair of
their effects in changing his habits, till he has tried them
for the time I have mentioned.
For otherwise mending his constitution I would ↑would↑
advise of his taking advantage of this Season to quit business
very entirely, and therefore to remove to the Country & to take
gentel Exercise on horseback, but always withing the bounds
of any fatigue and therefore never to the length of Journeys
[Page 3]
you have mentioned his lately trying.
Every Evening or every second evening between six and seven
o, Clock I would have him to go into a warm bath heated
to 90 deg. Farenheit. and let him remain in this from half
an hour to an hour, taking care that when he remains
in it long, the Temperature of the bath be kept up to
the due degree. After coming out of this bath let him
have his skin well dried and put on his ordinary Clothes
but keep to his Chambers for the rest of the Evening.
Please observe that these measures of avoiding business
of riding and bathing are very compatible with his trying
of other Chiltenham or Harrigate and I only mean, that he
takes to a Country habitation when these trials are over.
If in these trails he shall find that there these Saline
Waters are effectual and usefull Laxatives he may in any
part of the Country continue the same remedy by employing
the following Solutions. -
℞ Tart. Sol. Sal. Gl. @ ℥ij Sal. marin
Hispan ℥j Aq. font. ℥xii. Solve et per chartam cola - 2 3 or 4 spfulls
in a quart of Spring water every morg. --------
I hope this exercise will give him more appetite & I shall think that his eating
fully to what his appetite & Stomach will admitt of will be of service to his Bowels
and that his eating 3 or 4 times a day will ansr. better than less frequent meals. Let
part of his meal be generally a little pretty strong soup & if his digestion admitts of it
he should always have some Vegetables such as the season presents boiled wt. his
Soup. In such constitutions the Effect of Vegetables is uncertain but I expect they
will agree with him and if they do I would have him to use them freely & those
especially which he finds Laxative as I find Spinach to be with most people for the
rest he may take at Dinner a bit of any plain meat he likes best, & after it he
may take of any fruit the Seeson affords but with a little wine rather than
milk - for Drink at Dinner he should take small Beer or fresh drawn Cows milk whey
For Breakfast he may Tea & Bread&butter as usual. Tea & not too strong maybe
taken largely both in the morng & afternoon. When I say that Tea is not to
be taken strong you will understand that I make little difference between Green
and Bohea but the last is the Safest for supper let him take from a pint to
a quart of new drawn Cows milk whey with what bread is agreeable I would
choose some kind of sweet bread as Spunge bisquet or Diet loaf providing
[Page 4]
this diet I proved upon the supposition that he is troubled wt. no dyspeptic
Symptoms as you have taken no notice of them in your State of the
case. If it is otherways I would perhaps make some change in my
advice with respect to diet. In no part of my advice I have said how
long the particular measures recommended are to be continued because I
think that must be entirely regulated bu the Effects and the [effects?]
too if you shall please to advise me of them may also enable
me to make a more proper Judgement. I am obliged to you for
communicating to me your judicious management of the case of irritability
I have frequently found growing lads irritable and liable to Symptoms
of Chorea and your patients Stammering was of that kind Zinc
has proved with me an uncertain remedy but the Cold baths I have
always found usefull.
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