Cullen

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

 

[ID:535] From: Dr William Cullen (Professor Cullen) / To: Dr Robert Menzies (of Dura ) / Regarding: Mr David Bethune (of Kilconquhar; of Balfour) (Patient) / 30 April 1782 / (Outgoing)

reply with formal 'Directions for David Bethune', signed by Cullen and Joseph Black. They are of the clear opinion that costiveness is the source of the patient's complaints, and prescribe laxative medicines and enema recipes, along with dietary and exercise recommendations.

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Metadata

FieldData
DOC ID 535
RCPE Catalogue Number CUL/1/1/15/18
Main Language English
Document Direction Outgoing
Date30 April 1782
Annotation None
TypeMachine copy
Enclosure(s) Enclosure(s) present
Autopsy No
Recipe Yes
Regimen Yes
Letter of Introduction No
Case Note No
Summary reply with formal 'Directions for David Bethune', signed by Cullen and Joseph Black. They are of the clear opinion that costiveness is the source of the patient's complaints, and prescribe laxative medicines and enema recipes, along with dietary and exercise recommendations.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:260]
Case of Mr David Bethune of Balfour who consulted Cullen previously over stomach complaints (See Case 34). Now also has an eye problem, head-pains, abdominal pains and increasing weakness.
20


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:830]AddresseeDr Robert Menzies (of Dura )
[PERS ID:11]PatientMr David Bethune (of Kilconquhar; of Balfour)
[PERS ID:1003]Patient's Physician / Surgeon / ApothecaryDr Joseph Black
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:830]Patient's Physician / Surgeon / ApothecaryDr Robert Menzies (of Dura )
[PERS ID:1003]Supplemental AuthorDr Joseph Black

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 Kilconquhar House Kilconquhar Edinburgh and East Scotland Europe inferred

Normalized Text

[Page 1]
Directions for David Bethune Esq.r


We are clearly of opinion that Costiveness is
the Cause of the greater number of M.r Bethunes
present Complaints & that it is necessary for
him to pay constant attention to the state of
his Belly & keep it properly open –– For this
purpose a variety of laxatives may be needed
that when he tires of one or when by custom
it ceases to produce a proper effect he may
have recourse to another –– We have according¬
ly ordered a laxative mixture and a laxative
Pill
which along with the Rhubarb which
he has been accustomed to take will make for
the present a sufficient Variety ––


If at any time however, in consequence of his
having taken too small a dose, or of his Belly
being more bound up than ordinary, the Symptoms
proceeding from thence are very distressing, He
may have recourse to an Injection which af¬
fords the most immediate releif in such Cases
and for this Purpose we have ordered two kinds
of Injections
that may be depended on




[Page 2]



One of the most distressing effects of the Costive¬
ness
is the Collection of Wind in his Bowels which
oppresses him & raises the pains he so often com¬
plains of –– This when it occasionally encreases
to such a degree as entirely to deprive him of ease
& Rest must be alleviated by Cordials & anti¬
spasmodics
–– We have accordingly ordered some
Drops of this nature which he may take a dose
of occasionally without apprehending any in¬
convenient effect from them –––– Upon such
occasions he may also sometimes use the opiate
or anodyne Pill with which he is already pro¬
vided – but this should be used as seldom as
possible on account of its tendency to encrease
Costiveness and when it is used Care must be ta¬
ken to open the Belly after its operation –


Mr. Bethune has at present so little appetite
that there is scarcely any room for circumscribeing
his Diet & he must be allowed to eat what he can
We may observe however that a certain propor¬
tion of vegetables in food have a tendency to di¬
minish Costiveness and that malt liquors which
he is fond of are more laxative than wine or spirits
& water. –– But both the Vegetables and the
malt liquors are liable to prove flatulent in
weak Bowels and Mr Bethune must use



[Page 3]

them the more sparingly if he finds they en¬
crease that Symptom to any degree

William Cullen
Joseph Black
Edinburgh 30th April
1782



[Page 4]
For David Bethune Esq.r

Take 3 ounces of Castor Oil and an ounce of Daffy's Elixir. Mix. Label: The Laxative mixture, take one tablespoonfull, (or somewhat more if necessary) occasionally at bedtime shaking the glass

Take a drachm each of Aloetic Pills and Asafœtida. Mix to make 24 pills. Label: Laxative Pills, take two or three occasionally at Bedtime ––––

W.C.
J.B.
30 April
1782



[Page 5]

Take ½ an ounce of Asafœtida and 4 ounces of spring water. Mix to make a solution. Label: The solution one spoonfull of which is to be added to the Injection which was given lately, when there may be occasion to repeat it ––––

Take 8 ounces of the best Olive Oil. To be injected as an enema. This may be used sometimes as an Injection in place of the above ––––




[Page 6]

Take 2 ounces of Proprietary Elixir of Vitriol. Label: the antispasmodic drops, take one Teaspoonfull in a little spirits & water when the wind is very troublesome

W.C.
J.B.
30 April
1782

Diplomatic Text

[Page 1]
Directions for David Bethune Esq.r


We are clearly of opinion that Costiveness is
the Cause of the greater number of M.r Bethunes
present Complaints & that it is necessary for
him to pay constant attention to the state of
his Belly & keep it properly open –– For this
purpose a variety of laxatives may be needed
that when he tires of one or when by custom
it ceases to produce a proper effect he may
have recourse to another –– We have according¬
ly ordered a laxative mixture and a laxative
Pill
which along with the Rhubarb which
he has been accustomed to take will make for
the present a sufficient Variety ––


If at any time however, in consequence of his
having taken too small a dose, or of his Belly
being more bound up than ordinary, the Symptoms
proceeding from thence are very distressing, He
may have recourse to an Injection which af¬
fords the most immediate releif in such Cases
and for this Purpose we have ordered two kinds
of Injections
that may be depended on




[Page 2]



One of the most distressing effects of the Costive¬
ness
is the Collection of Wind in his Bowels which
oppresses him & raises the pains he so often com¬
plains of –– This when it occasionally encreases
to such a degree as entirely to deprive him of ease
& Rest must be alleviated by Cordials & anti¬
spasmodics
–– We have accordingly ordered some
Drops of this nature which he may take a dose
of occasionally without apprehending any in¬
convenient effect from them –––– Upon such
occasions he may also sometimes use the opiate
or anodyne Pill with which he is already pro¬
vided – but this should be used as seldom as
possible on account of its tendency to encrease
Costiveness and when it is used Care must be ta¬
ken to open the Belly after its operation –


Mr. Bethune has at present so little appetite
that there is scarcely any room for circumscribeing
his Diet & he must be allowed to eat what he can
We may observe however that a certain propor¬
tion of vegetables in food have a tendency to di¬
minish Costiveness and that malt liquors which
he is fond of are more laxative than wine or spirits
& water. –– But both the Vegetables and the
malt liquors are liable to prove flatulent in
weak Bowels and Mr Bethune must use



[Page 3]

them the more sparingly if he finds they en¬
crease that Symptom to any degree

William Cullen
Joseph Black
Edinburgh 30th April
1782



[Page 4]
For David Bethune Esq.r


Ol. Ricini unc. iij
Tinct Senna Comp. unc j
ℳ. Sig. The Laxative mixture, take one table
spoonfull, (or somewhat more if necessary) [and?]
occasionally at bedtime shaking the glass


Pilul. aloetic
assa fœtid @ dr. j
ℳ. f.t Pilulæ № xxiv
Sig. Laxative Pills, take two or three oc¬
casionally at Bedtime ––––

W.C.
J.B.
30 April
1782



[Page 5]


assæ fœtida ℥ſs
aq. fontan ℥jv
ℳ. f. solutio ––
Sig. The solution one spoonfull of which
is to be added to the Injection which was given
lately, when there may be occasion to re¬
peat it ––––


Ol. olivar. optimi ℥viij
Injiciatur pro Enemate ––––
This may be used sometimes as an Injection
in place of the above ––––




[Page 6]


Elixir Proprietat vitrioli ℥ij
Signa the antispasmodic drops, take one
Teaspoonfull in a little spirits & water
when the wind is very troublesome

W.C.
J.B.
30 April
1782

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