Cullen

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

 

[ID:4664] From: Dr William Cullen (Professor Cullen) / To: Dr James Hamilton / Regarding: Mr Alexander? Drysdale (Patient) / 21 July 1783 / (Outgoing)

Reply, for 'Mr Drysdale'. Addressed to Dr Hamilton, concerning Mr Drysdale, in whose case 'Phthisis is to be apprehended'. He recommends a voyage or journey: 'what I think is a grea[t] temptation to his immediately trying it is the opportunity he has of his Brothers company during the course of it greatly preferable to that of his spouse' (his brother John Drysdale being a surgeon). Cullen gives dietary advice and pectoral and laxative recipes.

Facsimile

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Metadata

FieldData
DOC ID 4664
RCPE Catalogue Number CUL/1/1/16/68
Main Language English
Document Direction Outgoing
Date21 July 1783
Annotation None
TypeMachine copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply, for 'Mr Drysdale'. Addressed to Dr Hamilton, concerning Mr Drysdale, in whose case 'Phthisis is to be apprehended'. He recommends a voyage or journey: 'what I think is a grea[t] temptation to his immediately trying it is the opportunity he has of his Brothers company during the course of it greatly preferable to that of his spouse' (his brother John Drysdale being a surgeon). Cullen gives dietary advice and pectoral and laxative recipes.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:648]
Case of Mr Drysdale declining from a feverish chest complaint and 'a putrid ulcer in his chest'.
7


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:812]AddresseeDr James Hamilton
[PERS ID:3001]PatientMr Alexander? Drysdale
[PERS ID:812]Patient's Physician / Surgeon / ApothecaryDr James Hamilton
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:3003]Patient's Relative / Spouse / FriendMr John Drysdale (of Ruchlaw House, East Lothian)
[PERS ID:3014]Patient's Relative / Spouse / FriendMrs Drysdale

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 Dunbar Borders Scotland Europe inferred

Normalized Text

[Page 1]
Mr Drysdale
Dear Sir


I was favoured with yours concerning Mr
Drysdale and afterwards examined the Case with all possible
attention. I am of your opinion that ↑a↑ Phthisis is to be appre¬
hended
but I differ from you a good deal with respect to the
degree to which it is advanced. I think there is no clear
evidence of an Ulceration yet formed. The expectoration I have
seen
does not appear to me to be Purulent and what I consider
more than all other tests he is not yet hectic. His Pulse in
the morning is hardly above 80, and at night not much
above 90 and at both times it is quite soft and not small
.
He has no night Sweats, not much emaciated, not much
weakened, lies easily on either side, and has a good appetite.


But supposing the worst, What is to be done? I have
no faith in cicuta and I think Mercury does harm.
I own however that the doses you propose of either of
them could neither do good nor ill. In all such cases



[Page 2]

what I depend upon, is a vegetable diet with a voyage o[r]
a journey. As it is uncertain what opportunity or conven¬
iency Mr Drysdale might have for a voyage I have
advised him immediately to try a journey, and I think
you will not disaprove of it, and what I think is a grea[t]
temptation to his immediately trying it is the opportunity
he has of his Brothers company during the course of it,
greatly preferable to that of his spouse. Allow me to
through you to offer him some advice for the conduct
of it. He should begin with moderate journeys but
should gradually increase them till he can go from
thirty to forty miles a day, and beyond this they
should never be increased. At this season he should
travel only in the mornings and Evenings, and rest
three or four hours in the middle of the day. At this
time he may walk about a little in the shade but


[Page 3]

his walking, should be always very gentle, never fast,
[n]ever up hill, nor ever long at one time. His diet even on
his journey should be chiefly vegetable or with milk
[w]hen he can get it, but after he has traveled for some time
[a]nd finds his appetite and strength mended, he may
[ta]ke a little light broth at Dinner & even a little boiled
meat, but still this with caution, and at his Brothers
discretion. With respect to drinking he should take water
[o]r watery liquors only, as water Gruel or Barley Water, &
I would have him abstain from all fermented or spirituous
[l]iquors, except in one case that he finds the drinking
Water with the traveling makes him very Costive;
[a]nd in that case he may take for ordinary drink a
[g]ood small beer, or rather two parts of Water with one
[o]f strong Beer or Porter. Among other liquors he may take
weak Bohea Tea, taking it always very cool, but strong
[g]reen Tea in any shape is very improper, and at breakfast
Cocoa Tea would be better than any other kind. Whilst


[Page 4]

he is in the course of Traveling, it cannot be convenient &
I hope it will not be necessary for him to take medicines, &
I would advise only one, which is supposed to be useful in
resolving obstructions of the breast and which I have accord¬
inly prescribed in the inclosed paper. There is however one
case in which a medicine may be necessary, and that is in the
case of great costiveness
which should never be allowed to
go far, & whenever it threatens to do so should be removed
by a medicine. The medicine I would prefer is the oil
prescribed in the inclosed paper, but if that does not sit
easy on his stomach, he may take a dose either of
Cream of Tartar or of Polychrest Salt, or if it shall
not prove easy to measure the operation of these, he
must take an Aloetic Pill. He should always go early
to bed and get up pretty early in the morning, that he may
have his choise of the day for the first part of his journey.
You have proposed what might be very proper remedy


[Page 5]

for him, that is, a seton in his side, but it might be
troublesome in the journey and I hope it is not absolutely
necessary, but I must say that if the pain of his side is at
present troublesome, I would by all means advise him
before he sets out on his journey to apply a blister on
the pained part, and to let it heal up in course
, which I
hope will not detain him above two or three days.
It is possible he might be the better of an Infusion of the
Red Bark
, but not to say that it is an ambiguous
remedy I think a little of it, would be of no service
and taking much of it would be very troublesome
upon the journey. I have only to add that the journey
conducted as above should be continued for three or four
weeks at least, and that must be left to his Brothers
discretion. In reading over this letter I find that I have


[Page 6]

omitted to say anything about guarding against Cold
which is indeed extremely necessary, but so much a
matter of common discretion, that I did not & do not
think it needfull to say much of it here. Please
communicate all this to Mr John Drysdale, and so
much of it as is proper to our patient. With my
compliments to all concerned, believe me to be with
great regard


Dear Dr
your most obedient servant
William Cullen

Edinburgh 21st July.
1783.



[Page 7]
For MrDrysdale

Take three drachms of liquorice Extract and one drachm of best Myrrh. Having chopped the Extract into small pieces, pour over enough hot water to soften it and crush it into a pulp, to which add the Myrrh, already ground into a fine powder, and with a sufficient quantity of water to make a mass to be divided into single pills of five grains each. Label: Pectoral Pills two to be taken every night at bedtime

Take three ounces of the best castor Oil, and one ounce of the Edinburgh Pharmacœpia's compound Tincture of Senna. Mix. Label: Laxative Oil a table spoonfull more or less to be taken for a dose either at bedtime or in the morning, shaking the phial always exceedingly well before pouring out.

W.C.

20th July
1783.

Diplomatic Text

[Page 1]
Mr Drysdale
Dear Sir


I was favoured with yours concerning Mr
Drysdale and afterwards examined the Case with all possible
attention. I am of your opinion that ↑a↑ Phthisis is to be appre¬
hended
but I differ from you a good deal with respect to the
degree to which it is advanced. I think there is no clear
evidence of an Ulceration yet formed. The expectoration I have
seen
does not appear to me to be Purulent and what I consider
more than all other tests he is not yet hectic. His Pulse in
the morning is hardly above 80, and at night not much
above 90 and at both times it is quite soft and not small
.
He has no night Sweats, not much emaciated, not much
weakened, lies easily on either side, and has a good appetite.


But supposing the worst, What is to be done? I have
no faith in cicuta and I think Mercury does harm.
I own however that the doses you propose of either of
them could neither do good nor ill. In all such cases



[Page 2]

what I depend upon, is a vegetable diet with a voyage o[r]
a journey. As it is uncertain what opportunity or conven¬
iency Mr Drysdale might have for a voyage I have
advised him immediately to try a journey, and I think
you will not disaprove of it, and what I think is a grea[t]
temptation to his immediately trying it is the opportunity
he has of his Brothers company during the course of it,
greatly preferable to that of his spouse. Allow me to
through you to offer him some advice for the conduct
of it. He should begin with moderate journeys but
should gradually increase them till he can go from
thirty to forty miles a day, and beyond this they
should never be increased. At this season he should
travel only in the mornings and Evenings, and rest
three or four hours in the middle of the day. At this
time he may walk about a little in the shade but


[Page 3]

his walking, should be always very gentle, never fast,
[n]ever up hill, nor ever long at one time. His diet even on
his journey should be chiefly vegetable or with milk
[w]hen he can get it, but after he has traveled for some time
[a]nd finds his appetite and strength mended, he may
[ta]ke a little light broth at Dinner & even a little boiled
meat, but still this with caution, and at his Brothers
discretion. With respect to drinking he should take water
[o]r watery liquors only, as water Gruel or Barley Water, &
I would have him abstain from all fermented or spirituous
[l]iquors, except in one case that he finds the drinking
Water with the traveling makes him very Costive;
[a]nd in that case he may take for ordinary drink a
[g]ood small beer, or rather two parts of Water with one
[o]f strong Beer or Porter. Among other liquors he may take
weak Bohea Tea, taking it always very cool, but strong
[g]reen Tea in any shape is very improper, and at breakfast
Cocoa Tea would be better than any other kind. Whilst


[Page 4]

he is in the course of Traveling, it cannot be convenient &
I hope it will not be necessary for him to take medicines, &
I would advise only one, which is supposed to be useful in
resolving obstructions of the breast and which I have accord¬
inly prescribed in the inclosed paper. There is however one
case in which a medicine may be necessary, and that is in the
case of great costiveness
which should never be allowed to
go far, & whenever it threatens to do so should be removed
by a medicine. The medicine I would prefer is the oil
prescribed in the inclosed paper, but if that does not sit
easy on his stomach, he may take a dose either of
Cream of Tartar or of Polychrest Salt, or if it shall
not prove easy to measure the operation of these, he
must take an Aloetic Pill. He should always go early
to bed and get up pretty early in the morning, that he may
have his choise of the day for the first part of his journey.
You have proposed what might be very proper remedy


[Page 5]

for him, that is, a seton in his side, but it might be
troublesome in the journey and I hope it is not absolutely
necessary, but I must say that if the pain of his side is at
present troublesome, I would by all means advise him
before he sets out on his journey to apply a blister on
the pained part, and to let it heal up in course
, which I
hope will not detain him above two or three days.
It is possible he might be the better of an Infusion of the
Red Bark
, but not to say that it is an ambiguous
remedy I think a little of it, would be of no service
and taking much of it would be very troublesome
upon the journey. I have only to add that the journey
conducted as above should be continued for three or four
weeks at least, and that must be left to his Brothers
discretion. In reading over this letter I find that I have


[Page 6]

omitted to say anything about guarding against Cold
which is indeed extremely necessary, but so much a
matter of common discretion, that I did not & do not
think it needfull to say much of it here. Please
communicate all this to Mr John Drysdale, and so
much of it as is proper to our patient. With my
compliments to all concerned, believe me to be with
great regard


Dear Dr
your most obedient servant
William Cullen

Edinr. 21st July.
1783.



[Page 7]
For MrDrysdale


Extract. glycyrrhiz. ʒiij
Myrrh. opt. ʒj
Extracto in frustula conciso affunde aquæ fervent. q. s.
ut mollescat et in pulpam contundatur cui adde
Myrrham prius in pulverem tenuem tritam et
cum aquæ q. s. fiat massa dividenda in pilulas ––
Singulas granorum quinque
Signa Pectoral Pills two to be taken
every night at bedtime


Ol. ricin. opt. ℥iij
Tinct. Senn. comp. Ph. Ed. ℥j
ℳ. Signa Laxative Oil a table spoonfull more or
less to be taken for a dose either at bedtime or in
the morning, shaking the phial always exceedingly
well before pouring out

W.C.

20th July
1783.

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