Cullen

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

 

[ID:5022] From: Dr William Cullen (Professor Cullen) / To: Dr Richard Milnes / Regarding: Mr Darrel (Patient) / 3 April 1785 / (Outgoing)

Reply, 'Dr Richd. Milnes C[oncerning] _____'

Facsimile

There are 6 images for this document.

[Page 1]


 

[Page 2]


 

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Metadata

FieldData
DOC ID 5022
RCPE Catalogue Number CUL/1/1/18/7
Main Language English
Document Direction Outgoing
Date3 April 1785
Annotation None
TypeMachine scribal copy
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply, 'Dr Richd. Milnes C[oncerning] _____'
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1780]
Case of Mr Darrell who has various symptoms including a skin complaint, a cold, feverishness and a nephritic condition.
22


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:3641]AddresseeDr Richard Milnes
[PERS ID:3642]PatientMr Darrel
[PERS ID:3641]Patient's Physician / Surgeon / ApothecaryDr Richard Milnes
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:707]Patient's Physician / Surgeon / ApothecaryDr John Fothergill

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 Chesterfield Midlands England Europe inferred

Normalized Text

[Page 1]

Dr. Richard Milnes Concerning

Sir,


I had the letter of yours of the 22d past some
days ago but some {illeg} precautions prevented my having
so much time as I thought necessary to be employed in
such a difficult Case and therefore I am later in my
Answer than I wished and than I commonly am.


After frequent consideration I think his {illeg}
may be said to be a Dyspepsia but I dont think it
has proceeded from any original weakness of his [Stomach?]
or [System?] but probably has been produced ↑or it has often brought↑ by a
Gouty diathesis appearing only as Atonic. The account
which happened to him about Seven years ago is
both for and against this opinion. Its coming into
his right foot and afterwards into his knees must
have been Owing either to Gout or Rheumatism
but the Rheumatism has commonly [an evident?]
cause of Strain or Cold which is not here taken
notice while the whole circumstances of his Constitution



[Page 2]

and Complaints give {illeg} of Gout and {illeg}
opinion and advice of my Old {illeg} fellow Dr.
Fothergill seems to have proceeded upon this suppo¬
sition. It is true that on the other side a doubt
may arise from hence that a supposed paroxysm
did not give relief to his Dyspeptic Symptoms
that ↑as↑ a fit of the Gout commonly does. This indeed
is a little puzzling but I fancy it may be accounted
for from the pains taken by fomentations and
poultices to relieve the inflammation and pain
depending upon it discussing the Gouty inflamma¬
tion too soon and rendering it retrocedent and {illeg}
This reasoning may be a little uncertain but
I adhere to my opinion chiefly for the reason
that in such habits and Constitution as you
mention this Gentleman to be of I have found
Dyspepsia to be more frequently dependent
upon Atonic Gout than upon any other Cause.




[Page 3]


{illeg}
{illeg} I have had
{illeg}


I must advise him to try the Tincture of
Guaiac
made by taking One Ounce of Gum Guaiac
and rubbing it {illeg} with an equal part
of double refined Sugar and pouring upon these
a quart of {illeg} Rum and after frequently
Shaking them to other during three days
digestion filtrating the tincture for use. It may
be filtrated or poured off clear as it is {illeg}
used. Of this tincture a table Spoonful is to be
taken every morning and repeated for weeks or
months afterwards. This is the favourite reme¬
dy at present but from what you tell me
of your Patients irritable Constitution and his
being easily hurt by Spirituous {illeg} I suspect
he may not bear this tincture of Guaiac even
though very well diluted and I think I have



[Page 4]

had as much benefit from the watery Solution
which your Patient will certainly bear better
than the other. My [formula?] is the following

Take two drachms of Gum Guaiacum and two drachms of the purest white sugar. Crush them together into a fine powder, to which you add one ounce of raw gum Arabic mucilage. Crush it again diligently and pour over it, slowly, one drachm of Volatile Elixir Guaiacum, one ounce of nutmeg Waterm two ounces of Simple Cinnamon Water and two ounces of mint. Mix. Of this I give a tablespoon every night and morning, taking care to shake the phial very well before pouring out.


This dose
commonly keeps the belly regular but if it
gives more I diminish the dose or give it only
once a day. If even the two doses of Guaiac
do not keep the belly regular I would allow
your patient to take his dose of fresh whey
though I am otherwise not fond of that [account?]
laxative.


I am to propose no other medicine to your



[Page 5]

Patient {illeg} Guaiacum {illeg} the above {illeg} and when
he has taken it for three or four weeks I shall
beg to ha[ve] from you, for according to your report
then I shall have some further advice to other.
At present I have only to add that whatever
has been reported of the powers of Guaiacum
I know that it will do little good unless it is
accompanied with a proper Regimen. With regard
to which your observation and your Patients expe¬
rience have pretty well ascertained what is
most proper and I must leave it to your good
judgement to adjust it more exactly and shall
say only in a word or two that what I would
chiefly depend upon are the following particu[lars].


Moderate Application to business, frequent exer¬
cise on horseback, the utmost care taken to avoid
cold, a Diet of light Animal food with very
little of [account?] and flatulent {illeg} and



[Page 6]

the very moderate use of {illeg} least {illeg}
kinds.


I cannot conclude without Saying that it is
highly agreeable to me to correspond with a Person
of so much accuracy and Judgement as you have
discovered on the present Case and I do not grudge
the trouble of receiving from, or in writing long
letters to such a Gentleman. It flatters me
very much that such a person {illeg}
Writings and puts any value upon them. Your
Expression upon this Subject gives me a strong
temptation to gratify your inclination for a fifth
Volume but my present time of life {illeg}
{illeg} in {illeg} and my many {illeg}
{illeg} allow me [carpere?] {illeg} I am [with]
very great regard


Sir
Your most Obedient [Servant]

William Cullen

Edinburgh 3d. April
1785

Diplomatic Text

[Page 1]

Dr. Richd. Milnes C.

Sir,


I had the letter of yours of the 22d past some
days ago but some {illeg} precautions prevented my having
so much time as I thought necessary to be employed in
such a difficult Case and therefore I am later in my
Answer than I wished and than I commonly am.


After frequent consideration I think his {illeg}
may be said to be a Dyspepsia but I dont think it
has proceeded from any original weakness of his [Stomach?]
or [System?] but probably has been produced ↑or it has often brought↑ by a
Gouty diathesis appearing only as Atonic. The account
which happened to him about Seven years ago is
both for and against this opinion. Its coming into
his right foot and afterwards into his knees must
have been Owing either to Gout or Rheumatism
but the Rheumatism has commonly [an evident?]
cause of Strain or Cold which is not here taken
notice while the whole circumstances of his Constitution



[Page 2]

and Complaints give {illeg} of Gout and {illeg}
opinion and advice of my Old {illeg} fellow Dr.
Fothergill seems to have proceeded upon this suppo¬
sition. It is true that on the other side a doubt
may arise from hence that a supposed paroxysm
did not give relief to his Dyspeptic Symptoms
that ↑as↑ a fit of the Gout commonly does. This indeed
is a little puzzling but I fancy it may be accounted
for from the pains taken by fomentations and
poultices to relieve the inflammation and pain
depending upon it discussing the Gouty inflamma¬
tion too soon and rendering it retrocedent and {illeg}
This reasoning may be a little uncertain but
I adhere to my opinion chiefly for the reason
that in such habits and Constitution as you
mention this Gentleman to be of I have found
Dyspepsia to be more frequently dependent
upon Atonic Gout than upon any other Cause.




[Page 3]


{illeg}
{illeg} I have had
{illeg}


I must advise him to try the Tincture of
Guaiac
made by taking One Ounce of Gum Guaiac
and rubbing it {illeg} with an equal part
of double refined Sugar and pouring upon these
a quart of {illeg} Rum and after frequently
Shaking them to other during three days
digestion filtrating the tincture for use. It may
be filtrated or poured off clear as it is {illeg}
used. Of this tincture a table Spoonful is to be
taken every morning and repeated for weeks or
months afterwards. This is the favourite reme¬
dy at present but from what you tell me
of your Patients irritable Constitution and his
being easily hurt by Spirituous {illeg} I suspect
he may not bear this tincture of Guaiac even
though very well diluted and I think I have



[Page 4]

had as much benefit from the watery Solution
which your Patient will certainly bear better
than the other. My [formula?] is the following


Gum Guaiac. Sacchar alb. puriss. @ʒij Terito simul
in pulverem tenuem cui adde mucilag. gum. Arab.
crass.
℥j. Terito iterum diligenter affunde pau¬
latim Elix. Guaiac. Volat ʒj Aq. nuc. mosch. ℥j
Aq. Cinnam. Simpl. Aq. menth. piper. @℥ij
ℳ. Of this I give a table Spoonful every
night and morning taking care to shake the
Phial very well before pouring out.


This dose
commonly keeps the belly regular but if it
gives more I diminish the dose or give it only
once a day. If even the two doses of Guaiac
do not keep the belly regular I would allow
your patient to take his dose of fresh whey
though I am otherwise not fond of that [account?]
laxative.


I am to propose no other medicine to your



[Page 5]

Patient {illeg} Guaiacum {illeg} the above {illeg} and when
he has taken it for three or four weeks I shall
beg to ha[ve] from you, for according to your report
then I shall have some further advice to other.
At present I have only to add that whatever
has been reported of the powers of Guaiacum
I know that it will do little good unless it is
accompanied with a proper Regimen. With regard
to which your observation and your Patients expe¬
rience have pretty well ascertained what is
most proper and I must leave it to your good
judgement to adjust it more exactly and shall
say only in a word or two that what I would
chiefly depend upon are the following particu[lars].


Moderate Application to business, frequent exer¬
cise on horseback, the utmost care taken to avoid
cold, a Diet of light Animal food with very
little of [account?] and flatulent {illeg} and



[Page 6]

the very moderate use of {illeg} least {illeg}
kinds.


I cannot conclude without Saying that it is
highly agreeable to me to correspond with a Person
of so much accuracy and Judgement as you have
discovered on the present Case and I do not grudge
the trouble of receiving from, or in writing long
letters to such a Gentleman. It flatters me
very much that such a person {illeg}
Writings and puts any value upon them. Your
Expression upon this Subject gives me a strong
temptation to gratify your inclination for a fifth
Volume but my present time of life {illeg}
{illeg} in {illeg} and my many {illeg}
{illeg} allow me [carpere?] {illeg} I am [with]
very great regard


Sir
Your most Obedient [Servant]

William Cullen

Edinr. 3d. April
1785

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