Cullen

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

 

[ID:594] From: Dr William Cullen (Professor Cullen) / To: Mr William Stewart (Stuart) / Regarding: Mr Robert Orr (Patient) / 1 July 1782 / (Outgoing)

Reply, for 'Mr Robert Orr'. Letter regarding Mr Robert Orr, in whom Cullen diagnoses 'a strong tendency to Consumption'. He suggests purgatives, exercise, and a 'cooling mixture'. He gives advice on how to prepare Tussilago.

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Metadata

FieldData
DOC ID 594
RCPE Catalogue Number CUL/1/1/15/79
Main Language English
Document Direction Outgoing
Date1 July 1782
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 Robert Orr'. Letter regarding Mr Robert Orr, in whom Cullen diagnoses 'a strong tendency to Consumption'. He suggests purgatives, exercise, and a 'cooling mixture'. He gives advice on how to prepare Tussilago.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:782]
Case of Robert Orr, who is consumptive.
7


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1089]AddresseeMr William Stewart (Stuart)
[PERS ID:2019]PatientMr Robert Orr
[PERS ID:1829]Patient's Physician / Surgeon / ApothecaryDr Robert Marshall
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:1089]Patient's Physician / Surgeon / ApothecaryMr William Stewart (Stuart)

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 Paisley Glasgow and West Scotland Europe inferred

Normalized Text

[Page 1]
Mr Robert Orr
Dear Sir


I was favoured with yours yesterday
by Mr Orr and have had a full conversation with
himself. Upon considering the whole history it is plain
that there is a strong tendency to Consumption but
considering how long that tendency has subsisted, what
intervals of entire health he has had, and his commonly
having taken a good deal of animal food I think it is
sufficiently probable that he has had no, at least no
considerable tubercles formed
which must have long ago
brought on a fatal event. In such a case therefore the
prognostic is much more favorable than it is common¬
ly in others; but this must by no means slacken
our attention and prudence requires that we should
still suspect the tendency, suspect even that at present
it has gone farther than ever before and therefore that
every precaution against the usual consequences is
to be taken. The urgent symptom [at?] present is



[Page 2]

the sweating and for this whether the cough continues
or not
I would employ the following.

Take three ounces of Rosewater and half an ounce each of Syrup of dried roses and Spiritus vitrioli tenuis. Mix. Label: Cooling Mixture a tea spoonfull to be taken in an ordinary wine glassfull of Water four times in the course of twenty-four hours. In the day time the water may be cold but in the night it should not be quite cold.


I am not for employing any
bark at present as half a dram can do little good and a
larger quantity might do harm. I hope his Journey
hither and back again has done service to his cough but
if it shall still continue let him take a gentle vomit
early in the evening so that the agitation may be quite
over before bedtime. If the cough continues in any degree
violent I am clear for applying the large blister Dr Mar¬
shall proposes but let it be applied in the morning so
that it may be dressed before bedtime. When he comes home
to you if the cough is considerable I would have the vomit
and blister to be the first measures and the cooling mixture
to come afterwards but if the cough is much abated he may



[Page 3]

immediately enter upon the cooling mixture, I must say that
the cough is by no means to be neglected but I would be glad to
remove or at least to moderate the sweatings before any other
measures are employed. Besides the cooling mixture there is
a remedy equally adapted to the sweatings and the Cough and
that is gentle exercise in fresh Air. If he can bear riding ea¬
sily his exercise may be in that way but the exercise which
I am certain of being of most service is going in a single
horse ↑chaise↑ which he drives himself. In taking exercise he must
avoid the heat of the sun & therefore in riding he must in
warm weather employ only the mornings or evenings but in
a single horse chaise he will be under less restraint. In
diet Mr Orr has employed a great deal of animal food and
contrary to my expectation with impunity. I hope he may
continue to do so but I would just ↑now↑ for a week or two have
him abstain entirely from animal food and to live entirely
upon milk and farinacea and even to take more of buttermilk
and whey than of plain milk. If he finds that this mends
either his sweatings or cough he will probably choose to con¬
tinue it for the summer but if he shall after a proper trial


[Page 4]

find that it does no service I shall consent to his returning
to the same proportion of animal food as formerly. In the
business of drinking I think it is indifferent whether he takes
a glass or two of wine at dinner or not dinner I think it best
for him to abstain but the taking it can do little harm. ––


Besides his exercise and regimen with the remedies mentioned
above I have but one other medicine to advise which I hav the
present season affords and which I have found of much more
service than you would imagine. It is the fresh juice of the
folia (not the flores) Tussilaginis
. Let a few of the leaves be
gathered early in the morning, cut them very small and in a
tea ↑pot↑ pour ↑upon them↑ as much boiling water as will just wet them. Let them
remain an hour in that situation, throw then throw them
into a stone or wooden mortar to be very well bruised, put them
so bruised into a linnen bag & by means of ↑a↑ press let the juice be
squeezed out. Of this juice let him at first take two table
spoonfulls before breakfast and again between seven & eight of
the evening. This dose is to be gradually increased as his
stomach bears it to six or eight spoonfulls for a dose. He may
take a little sugar with it if he chooses. The juice should be



[Page 5]

fresh expressed every day or at least every second day. Whatever
is set by from one day to another or even from morning to
evening should be close corked up & set in a cold place. ––


I am very desirous to be of as much service to the Orr family
as I possibly can and therefore beg to have a report on Mr
Roberts ↑Case↑ as soon as you have made some proper trials. In
the mean time I find only one thing omitted which was to
say that his sweating is not to be encouraged in the morning
which frequent slumbers will generally do. Let him there¬
fore after his sound sleep is well over get out of bed if it
is not so very early in the morning that he cannot be sup¬
posed to bear rising so early. With my best Compliments
to him and brothers I am with great regard Dear Sir

your most obedient servant
William Cullen

Edinburgh July 1st
1782 ––

Diplomatic Text

[Page 1]
Mr Robert Orr
Dear Sir


I was favoured with yours yesterday
by Mr Orr and have had a full conversation with
himself. Upon considering the whole history it is plain
that there is a strong tendency to Consumption but
considering how long that tendency has subsisted, what
intervals of entire health he has had, and his commonly
having taken a good deal of animal food I think it is
sufficiently probable that he has had no, at least no
considerable tubercles formed
which must have long ago
brought on a fatal event. In such a case therefore the
prognostic is much more favorable than it is common¬
ly in others; but this must by no means slacken
our attention and prudence requires that we should
still suspect the tendency, suspect even that at present
it has gone farther than ever before and therefore that
every precaution against the usual consequences is
to be taken. The urgent symptom [at?] present is



[Page 2]

the sweating and for this whether the cough continues
or not
I would employ the following.


Aq. rosar. ℥iij
Syr. e ros. sicc. Spir. vitriol. ten. @ ℥ſs. ℳ. Signa
Cooling Mixture a tea spoonfull to be taken in an ordinary
wine glass ↑full↑ of Water four times in the course of 24 hours.
In the day time the water may be cold but in the night it
should not be quite cold.


I am not for employing any
bark at present as half a dram can do little good and a
larger quantity might do harm. I hope his Journey
hither and back again has done service to his cough but
if it shall still continue let him take a gentle vomit
early in the evening so that the agitation may be quite
over before bedtime. If the cough continues in any degree
violent I am clear for applying the large blister Dr Mar¬
shall proposes but let it be applied in the morning so
that it may be dressed before bedtime. When he comes home
to you if the cough is considerable I would have the vomit
and blister to be the first measures and the cooling mixture
to come afterwards but if the cough is much abated he may



[Page 3]

immediately enter upon the cooling mixture, I must say that
the cough is by no means to be neglected but I would be glad to
remove or at least to moderate the sweatings before any other
measures are employed. Besides the cooling mixture there is
a remedy equally adapted to the sweatings and the Cough and
that is gentle exercise in fresh Air. If he can bear riding ea¬
sily his exercise may be in that way but the exercise which
I am certain of being of most service is going in a single
horse ↑chaise↑ which he drives himself. In taking exercise he must
avoid the heat of the sun & therefore in riding he must in
warm weather employ only the mornings or evenings but in
a single horse chaise he will be under less restraint. In
diet Mr Orr has employed a great deal of animal food and
contrary to my expectation with impunity. I hope he may
continue to do so but I would just ↑now↑ for a week or two have
him abstain entirely from animal food and to live entirely
upon milk and farinacea and even to take more of buttermilk
and whey than of plain milk. If he finds that this mends
either his sweatings or cough he will probably choose to con¬
tinue it for the summer but if he shall after a proper trial


[Page 4]

find that it does no service I shall consent to his returning
to the same proportion of animal food as formerly. In the
business of drinking I think it is indifferent whether he takes
a glass or two of wine at dinner or not dinner I think it best
for him to abstain but the taking it can do little harm. ––


Besides his exercise and regimen with the remedies mentioned
above I have but one other medicine to advise which I hav the
present season affords and which I have found of much more
service than you would imagine. It is the fresh juice of the
folia (not the flores) Tussilaginis
. Let a few of the leaves be
gathered early in the morning, cut them very small and in a
tea ↑pot↑ pour ↑upon them↑ as much boiling water as will just wet them. Let them
remain an hour in that situation, throw then throw them
into a stone or wooden mortar to be very well bruised, put them
so bruised into a linnen bag & by means of ↑a↑ press let the juice be
squeezed out. Of this juice let him at first take two table
spoonfulls before breakfast and again between seven & eight of
the evening. This dose is to be gradually increased as his
stomach bears it to six or eight spoonfulls for a dose. He may
take a little sugar with it if he chooses. The juice should be



[Page 5]

fresh expressed every day or at least every second day. Whatever
is set by from one day to another or even from morning to
evening should be close corked up & set in a cold place. ––


I am very desirous to be of as much service to the Orr family
as I possibly can and therefore beg to have a report on Mr
Roberts ↑Case↑ as soon as you have made some proper trials. In
the mean time I find only one thing omitted which was to
say that his sweating is not to be encouraged in the morning
which frequent slumbers will generally do. Let him there¬
fore after his sound sleep is well over get out of bed if it
is not so very early in the morning that he cannot be sup¬
posed to bear rising so early. With my best Compliments
to him and brothers I am with great regard Dear Sir

your most obedient servant
William Cullen

Edinr. July 1st
1782 ––

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