Cullen

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

 

[ID:900] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mr Malcolm MacNeill (of Carskey) (Patient) / 14 April 1774 / (Outgoing)

Directions 'For Mr McNeil' of Carskiey in the form of a very neat, autograph document. This is almost certainly the original of the case-book retention ([DOC ID:3757]), which McNeil sent back to Cullen as an enclosure with ([DOC ID:936]), as a reminder. This is a rare example where an original set of directions as delivered to a patient has returned to the archive allowing us to compare it with the case-book transcript. Carskiey is linked as the document's inferred, original destination.

Facsimile

There are 6 images for this document.

[Page 1]


 

[Page 2]


 

[Page 3]


 

[Page 4]


 

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[Page 6]


 
 

Metadata

FieldData
DOC ID 900
RCPE Catalogue Number CUL/1/2/165
Main Language English
Document Direction Outgoing
Date14 April 1774
Annotation None
TypeAuthorial original
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen Yes
Letter of Introduction No
Case Note No
Summary Directions 'For Mr McNeil' of Carskiey in the form of a very neat, autograph document. This is almost certainly the original of the case-book retention ([DOC ID:3757]), which McNeil sent back to Cullen as an enclosure with ([DOC ID:936]), as a reminder. This is a rare example where an original set of directions as delivered to a patient has returned to the archive allowing us to compare it with the case-book transcript. Carskiey is linked as the document's inferred, original destination.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Draft versions for this document exist:

1. [DOC ID:3757]

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:138]
Case of Malcolm Macneil [MacNeill] Esqr. at Carskey whose two-year disorder, first diagnosed in April 1774, is considered 'rheumatick'.
5


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:451]PatientMr Malcolm MacNeill (of Carskey)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)

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 Carskiey House Carskiey West Highlands Scotland Europe inferred

Normalized Text

[Page 1]
For Mr McNeil


Having attentively considered the whole of
his complaints I am clearly of opinion that the
whole of them are Rheumatick. It is a disease
which when it has been allowed to take hold of a
young person for some time it is often difficult
to be removed and not without attention and
pains bestowed for some time. I hope however
that Mr McNeil may get the better of it entirely
by the following measures.


1. His first & constant care must be to gaurd
up against cold. He should put on a flannel shirt
and wear it next his skin both night and day. He
should not lay it aside even in summer unless
he is very entirely relieved from all his complaints
and however well he may be he should certainly



[Page 2]

put it on for next winter. Besides the flannel
shirt he ought to be otherwise warmly cloathed
and particularly should take care to have his feet
and legs always warm and dry. He must avoid all
damp and moist weather and must avoid the
cold of the mornings & more especially ↑of↑ the eve¬
nings for some time to come In short it is of
the utmost consequence for him to avoid catching
any fresh cold and for that purpose he must
avoid his ever being much heated by exercise
or ↑by↑ sitting in a warm chamber.


2. His next care must be to avoid his bloods
being heated by meat or drink. It will be right
for him till he is entirely free from his pains
to avoid all animal food and to betake himself
entirely to milk and grain. It is more necessary
still for him to abstain from all kinds of strong drink



[Page 3]

whither ale wine or spirits and to take nothing
but water whey or butter milk.


3. Frequent gentle exercise is very proper
for him but he should be moderate in walking
and it should never be to the length of heating or fati¬
guing him. Riding on horseback is better for him
and when the weather is tolerable he should be
very much employed in this way, taking care how¬
ever that he does not get wet and at least that
he does not remain in damp cloathes after his
exercise is over.


4. He will be much the better for the frequent
use of the flesh brush. When he is about to get out
of bed in a morning he should have his feet & legs
very well rubbed and when he gets up he may have
his body and arms also very well brushed. It is not
necessary that the rubbing should be hard but rather
gentle & long continued.




[Page 4]


5 These are the measures that I depend upon
for his relief and if they are not observed no
medicines can be of much service to him and if these
measures are faithfully followed he will have little
occasion for any medicines at all. However to
hasten his cure I have ordered below some pills
that I hope will be of great service to him. He is
to take two of them every second night at bed time.
At first they may make him a little sick but that
will do him service and it will soon wear off, but
if it should continue to be uneasy to him he may
take only one pill for a dose, but on the contrary
if the two pills should not affect his stomach or guts
he should take three for a dose


Edinburgh14th April
1774
William Cullen



[Page 5]
For Mr McNeil

Take four scruples of James's powder, four scruples of Extract of gentian, and a sufficient quantity of Mucilaginous Gum Arabic, and [dissolve well?]. Divide the mass into thirty-two pills.


14th April
1774
W. C.



[Page 6]


Mr McNeil
14th April 1774
Vol. 11. p37

Diplomatic Text

[Page 1]
For Mr McNeil


Having attentively considered the whole of
his complaints I am clearly of opinion that the
whole of them are Rheumatick. It is a disease
which when it has been allowed to take hold of a
young person for some time it is often difficult
to be removed and not without attention and
pains bestowed for some time. I hope however
that Mr McNeil may get the better of it entirely
by the following measures.


1. His first & constant care must be to gaurd
up against cold. He should put on a flannel shirt
and wear it next his skin both night and day. He
should not lay it aside even in summer unless
he is very entirely relieved from all his complaints
and however well he may be he should certainly



[Page 2]

put it on for next winter. Besides the flannel
shirt he ought to be otherwise warmly cloathed
and particularly should take care to have his feet
and legs always warm and dry. He must avoid all
damp and moist weather and must avoid the
cold of the mornings & more especially ↑of↑ the eve¬
nings for some time to come In short it is of
the utmost consequence for him to avoid catching
any fresh cold and for that purpose he must
avoid his ever being much heated by exercise
or ↑by↑ sitting in a warm chamber.


2. His next care must be to avoid his bloods
being heated by meat or drink. It will be right
for him till he is entirely free from his pains
to avoid all animal food and to betake himself
entirely to milk and grain. It is more necessary
still for him to abstain from all kinds of strong drink



[Page 3]

whither ale wine or spirits and to take nothing
but water whey or butter milk.


3. Frequent gentle exercise is very proper
for him but he should be moderate in walking
and it should never be to the length of heating or fati¬
guing him. Riding on horseback is better for him
and when the weather is tolerable he should be
very much employed in this way, taking care how¬
ever that he does not get wet and at least that
he does not remain in damp cloathes after his
exercise is over.


4. He will be much the better for the frequent
use of the flesh brush. When he is about to get out
of bed in a morning he should have his feet & legs
very well rubbed and when he gets up he may have
his body and arms also very well brushed. It is not
necessary that the rubbing should be hard but rather
gentle & long continued.




[Page 4]


5 These are the measures that I depend upon
for his relief and if they are not observed no
medicines can be of much service to him and if these
measures are faithfully followed he will have little
occasion for any medicines at all. However to
hasten his cure I have ordered below some pills
that I hope will be of great service to him. He is
to take two of them every second night at bed time.
At first they may make him a little sick but that
will do him service and it will soon wear off, but
if it should continue to be uneasy to him he may
take only one pill for a dose, but on the contrary
if the two pills should not affect his stomach or guts
he should take three for a dose


Edinr.14th April
1774
William Cullen



[Page 5]
For Mr McNeil


pulv. Jacob. ℈iv
Extract gentian. ℈iv
Mucliagin. gumm. Arabic. q. s. ut fiat bene
subigens massa dividenda in pilulas №
xxxij


14th April
1774
W. C.



[Page 6]


Mr McNeil
14th April 1774
Vol. 11. p37

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