Cullen

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

 

[ID:4644] From: Dr William Cullen (Professor Cullen) / To: Dr William Hamilton (in Glasgow) / Regarding: Mr Thomas Alston (Patient), Mr John Alston (of Overhall) (Patient) / 9 June 1783 / (Outgoing)

Reply, 'Mr Alston', concerning the cases of Messrs Thomas and John Alston. Cullen describes at length the regimen Thomas Alston should follow if he goes to Crieff for a goat whey cure. He also suggests treatment for Thomas's father John Alston, whom he suspects to have a bladder stone.

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Metadata

FieldData
DOC ID 4644
RCPE Catalogue Number CUL/1/1/16/49
Main Language English
Document Direction Outgoing
Date9 June 1783
Annotation None
TypeMachine scribal copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe No
Regimen Yes
Letter of Introduction No
Case Note No
Summary Reply, 'Mr Alston', concerning the cases of Messrs Thomas and John Alston. Cullen describes at length the regimen Thomas Alston should follow if he goes to Crieff for a goat whey cure. He also suggests treatment for Thomas's father John Alston, whom he suspects to have a bladder stone.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:671]
Case of Mr Thomas Alston who spits blood and consequently has a poor prognosis and whose case eventually proves fatal.
13
[Case ID:2040]
Case of Mr John Alston of Overhall who has a kidney or bladder stone.
3


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:175]AddresseeDr William Hamilton (in Glasgow)
[PERS ID:1938]PatientMr John Alston (of Overhall)
[PERS ID:554]PatientMr Thomas Alston
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:175]Patient's Physician / Surgeon / ApothecaryDr William Hamilton (in Glasgow)
[PERS ID:1938]Patient's Relative / Spouse / FriendMr John Alston (of Overhall)
[PERS ID:554]Patient's Relative / Spouse / FriendMr Thomas Alston

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 Glasgow Glasgow and West Scotland Europe inferred
Therapeutic Recommendation Crieff Mid Scotland Scotland Europe certain

Normalized Text

[Page 1]
Mr Alston
Dear Sir


I am favoured with yours concerning Mr.
Alston and should have answered it some days ago,
but have been prevented by unavoidable accidents.


It gives me great pleasure to think that Mr.
Alston is better and I hope that a Goat whey course
has a chance to relieve him from all his complaints.


I think Crief is a proper enough place though
it is not the very best as it is not so near the
Goats as I would wish my patients to be. The
carrying the milk from any distance that requires
it to be heated over the fire before the rennet is put
to it is with some disadvantage and if Mr. Alston
can get the milk yearned with the heat it has
from the Goats I would wish him to have it done
but it requires such attention and apparatus that
I cannot insist upon it and for the rest of the conduct
I offer the following directions.




[Page 2]


The whey need only to be drunk in the morning for
drinking the cold whey at other times of day is improper
and drinking it in the Evening after various other
matter have been taken into the stomach is hardly of
any service.


He should begin to take the whey by degrees hardly
above half a muchkin at two draughts for the first day
and increasing only by a Gill every day after till he
takes what quantity his stomach easily bears and
generally a Chopin is as much as is proper. The
going faster or gorging the stomach with too great a
quantity often prevents its being at all properly digested.


He should always take it in divided draughts
never above half a mutckin at once. He may begin
pretty early and he may take his first draught abed
but I would wish him to be up before he takes the
second. The draughts may be taken at the interval
of half an hour and he should walk about ↑gently↑ during
that interval if the weather allows of it but in cold



[Page 3]

and moist weather he should keep within doors
[o]r perhaps ly a bed till he has taken a second draught.
He should not take Breakfast for an hour after finishing
the whey and in that interval he should walk out if
possible.


If taking the whey hurts very much his appetite
for Breakfast or if he finds the whey does not pass fully
the urine and moderately by stool, he should judge that
he takes it too largely and therefore should diminish
the quantity but if the contrary of these happens he may
indulge in it a little more than I have mentioned. It
is particularly to be observed that if it proves remar¬
kably purgative
it may do much harm and he must
perhaps abstain from it altogether.


At Breakfast he may take Cocoa Tea with dry
toast and a very little Butter and at least a little of
this will be safer than Currant Jelly, marmalade
or other sweet things.


At Dinner he may have some Beef tea and



[Page 4]

Bread or some Chicken Broth with very fine Barley
or Rice but besides these Broths I would hardly have
him to take any other kind of Animal food. For the
rest of his Dinner and also for his Supper he may
take Cows Milk and farinacea of every kind and va¬
rously prepared as he may like best. Much Garden
things do not commonly agree well with Goat whey
but a little young Turnips, a few young Pease or a little
↑well↑ boiled Collyflower he may take now and then.


His drink must be plain water. Malt liquor
of any kind is improper and neither wine nor Spirits
and water can be quite safe for him but the latter in
very moderate quantity is the only one that can be
admitted for correcting the flatulency of the whey.


A great part of the benefit Mr. Alston can receive
from the Highlands must depend upon his being much
in the open air and in gentle exercise. He may walk
out as often as neither rain, cold winds or great heat
of the Sun do not prevent it and that he can always
find a perfectly dry walk but he must always walk



[Page 5]

very gently never long up hill nor ever long at one time
so as in a ever in any way to be heated or fatigued by
his exercise. He would be greatly the better for going
on horseback but there are some doubts of his (↑its↑) being
perfectly safe in his Case and certainly it must not
be tried without his having a Servant Riding or
walking by him. Whether he can have the use of a
Carriage at Crief I am doubtful and whether he
can carry a carriage along with him I leave you to
Judge. I think it would be of so much use for him
that the expence of it should be admitted. I need hardly
say that he should give the utmost attention and take
every precaution against cold and amongst the rest
that his flannel shirt should be continued during
the whole of Summer.


I can hardly think of any medicines that can
be necessary or proper to mix with his course of Goat
whey. The only remedy that I can suspect might
be occasionally proper is the taking a little blood from



[Page 6]

his arm but the occasions for this I must leave you to Judge
of as you have had many more opportunities of Judging in
this matter and always managed them with propriety &
success.


I am very willing to give the best advice I can to
my old acquaintance Mr Alston Senior. I am persuaded his
Case is a Stone in the bladder and I think you should propos[e]
to have the matter ascertained in one way or another by the
Catheter
. In the mean time I think you are using very
proper remedies in the Lime water and Bear Berry and
if these seem to have little effect, especially after giving
the Bear Berry for some time in double the present quan¬
tity you must have recourse to the Lixivium and if a
stone should be actually found
you know the only certain
remedy and which I hope his Constitution is very fit to
bear. With my Compliments to all the Family I am
most sincerely

Dear William
your very humble servant
William Cullen
Edinburgh 9th. June
1783

Diplomatic Text

[Page 1]
Mr Alston
Dear Sir


I am favoured with yours concerning Mr.
Alston and should have answered it some days ago,
but have been prevented by unavoidable accidents.


It gives me great pleasure to think that Mr.
Alston is better and I hope that a Goat whey course
has a chance to relieve him from all his complaints.


I think Crief is a proper enough place though
it is not the very best as it is not so near the
Goats as I would wish my patients to be. The
carrying the milk from any distance that requires
it to be heated over the fire before the rennet is put
to it is with some disadvantage and if Mr. Alston
can get the milk yearned with the heat it has
from the Goats I would wish him to have it done
but it requires such attention and apparatus that
I cannot insist upon it and for the rest of the conduct
I offer the following directions.




[Page 2]


The whey need only to be drunk in the morning for
drinking the cold whey at other times of day is improper
and drinking it in the Evening after various other
matter have been taken into the stomach is hardly of
any service.


He should begin to take the whey by degrees hardly
above half a muchkin at two draughts for the first day
and increasing only by a Gill every day after till he
takes what quantity his stomach easily bears and
generally a Chopin is as much as is proper. The
going faster or gorging the stomach with too great a
quantity often prevents its being at all properly digested.


He should always take it in divided draughts
never above half a mutckin at once. He may begin
pretty early and he may take his first draught abed
but I would wish him to be up before he takes the
second. The draughts may be taken at the interval
of half an hour and he should walk about ↑gently↑ during
that interval if the weather allows of it but in cold



[Page 3]

and moist weather he should keep within doors
[o]r perhaps ly a bed till he has taken a second draught.
He should not take Breakfast for an hour after finishing
the whey and in that interval he should walk out if
possible.


If taking the whey hurts very much his appetite
for Breakfast or if he finds the whey does not pass fully
the urine and moderately by stool, he should judge that
he takes it too largely and therefore should diminish
the quantity but if the contrary of these happens he may
indulge in it a little more than I have mentioned. It
is particularly to be observed that if it proves remar¬
kably purgative
it may do much harm and he must
perhaps abstain from it altogether.


At Breakfast he may take Cocoa Tea with dry
toast and a very little Butter and at least a little of
this will be safer than Currant Jelly, marmalade
or other sweet things.


At Dinner he may have some Beef tea and



[Page 4]

Bread or some Chicken Broth with very fine Barley
or Rice but besides these Broths I would hardly have
him to take any other kind of Animal food. For the
rest of his Dinner and also for his Supper he may
take Cows Milk and farinacea of every kind and va¬
rously prepared as he may like best. Much Garden
things do not commonly agree well with Goat whey
but a little young Turnips, a few young Pease or a little
↑well↑ boiled Collyflower he may take now and then.


His drink must be plain water. Malt liquor
of any kind is improper and neither wine nor Spirits
and water can be quite safe for him but the latter in
very moderate quantity is the only one that can be
admitted for correcting the flatulency of the whey.


A great part of the benefit Mr. Alston can receive
from the Highlands must depend upon his being much
in the open air and in gentle exercise. He may walk
out as often as neither rain, cold winds or great heat
of the Sun do not prevent it and that he can always
find a perfectly dry walk but he must always walk



[Page 5]

very gently never long up hill nor ever long at one time
so as in a ever in any way to be heated or fatigued by
his exercise. He would be greatly the better for going
on horseback but there are some doubts of his (↑its↑) being
perfectly safe in his Case and certainly it must not
be tried without his having a Servant Riding or
walking by him. Whether he can have the use of a
Carriage at Crief I am doubtful and whether he
can carry a carriage along with him I leave you to
Judge. I think it would be of so much use for him
that the expence of it should be admitted. I need hardly
say that he should give the utmost attention and take
every precaution against cold and amongst the rest
that his flannel shirt should be continued during
the whole of Summer.


I can hardly think of any medicines that can
be necessary or proper to mix with his course of Goat
whey. The only remedy that I can suspect might
be occasionally proper is the taking a little blood from



[Page 6]

his arm but the occasions for this I must leave you to Judge
of as you have had many more opportunities of Judging in
this matter and always managed them with propriety &
success.


I am very willing to give the best advice I can to
my old acquaintance Mr Alston Senior. I am persuaded his
Case is a Stone in the bladder and I think you should propos[e]
to have the matter ascertained in one way or another by the
Catheter
. In the mean time I think you are using very
proper remedies in the Lime water and Uva Ursi and
if these seem to have little effect, especially after giving
the Uva Ursi for some time in double the present quan¬
tity you must have recourse to the Lixivium and if a
stone should be actually found
you know the only certain
remedy and which I hope his Constitution is very fit to
bear. With my Compliments to all the Family I am
most sincerely

Dear William
your very humble servant
William Cullen
Edinr. 9th. June
1783

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