Cullen

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

 

[ID:397] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mrs Cochran (Cochrane) (Patient) / 13 July 1768 / (Outgoing)

Reply 'For Mrs Cochran'. Much on diet and regimen with Stomachic medicines prescribed.

Facsimile

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Metadata

FieldData
DOC ID 397
RCPE Catalogue Number CUL/1/1/2/18
Main Language English
Document Direction Outgoing
Date13 July 1768
Annotation None
TypeScribal copy ( includes Casebook Entry)
Enclosure(s) No enclosure(s)
Autopsy No
Recipe Yes
Regimen No
Letter of Introduction No
Case Note No
Summary Reply 'For Mrs Cochran'. Much on diet and regimen with Stomachic medicines prescribed.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:247]
Case of Mrs Cochrane who is recovered but is told she has a weak stomach and nerves which will need care.
1


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:1244]PatientMrs Cochran (Cochrane)
[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
Therapeutic Recommendation London London and South-East England Europe certain

Normalized Text

[Page 1]
For Mrs Cochran


After considering attentively the whole history of Mrs Cochrans
constitution and ailments I am perswaded that the worst is now over & that
for the rest of her life which may be very long she may have very little trouble.


Her Nerves can never be quite firm & her stomach which is now
the cheif subject of ailment cannot be so well restored but that from various
accidents it may be exposed to some trouble; but I am perswaded that by
good management such trouble may be prevented or when it happens easily
cured. What I take to be her proper managment is the following. ---------


She must take care in diet never either to load or disturb her stomach.
The quantity whatever it is must always be within bounds & tho it is probable
that Mrs Cochrans apetite is very moderate & that she truly takes little, yet
she must consider that what is not half enough to another, may be an overload



[Page 2]

to her & she must always keep within the bounds of her appetite whatever
it is.


Much however will depend upon the nature of her food & every thing that
is heavy or that she knows from her own experience to prove heavy on her
stomach must be carefully avoided. In general I take beef, mutton, & white
fowl to be the most proper & generally more proper for such stomachs than
veal, lamb, or chiken. She should take nothing but plain roasted or boiled & a¬
void frying, baking, & all made dishes & heavy sauces. Fish she should take
sparingly & only of the lighter kinds boiled & without a sauce. A little salted
meat if it is a little only is improper. I need not be more particular for every
stomach has more or less peculiarities & Mrs Cochran must by this time know her
her own & govern herself accordingly but I am certain of this that the lighter she
keeps her stomach it will be the less liable to disorder. Vegetables she has already
learned to abstain from & it is generally necessary to such stomachs, but it may go too
far. There are times when the stomach is tolerably firm & will digest some vegetab¬
les very well. If Mrs Cochran can discern these times & take a little of the more ten¬
der kinds as very young pease, very young turnip, or Colliflower she may be the
better for them, only she must at all times avoid the colder vegetables as sal¬
lad & Cucumber & the more windy kinds as Cabbage & Colworts & all vegetables
of older growth.


For ordinary drink I hold water with a little strong Wine in it as the best
& I think all kinds of Malt Liquor improper. Spirits & water which so many weak stom¬
achs
have recourse to I woul have avoided as long as possible. Mrs Cochran
may take a little plain Wine every day especialy if she is in the habit of doing so but
I say that the less the better. A weak stomach may be relived by {illeg} of that kind
but is not stren↑g↑thened by it. In Winter it is more necessary & allowable than in Summer



[Page 3]

With this man↑a↑gement of diet Mrs cochran must take every opportunity
of fresh air & exercise which of all others is the best strengthener of the Nerves &
stomach. Moderate walking in the open air will do service but it must never go
the length fatigue Riding on horseback is the best of all other Exercises & Mrs Cochrans
should take pains to employ a great past of the summer in this way, & the more
she changes the air & scene the better. If riding is not convenient or agreable a Car¬
riage must be employed & with respect to weather has some advantages. If at any
time Mrs Cochrans ailments should be severe in sumer a voyage to London & bak
again is likly to be an excellent remedy.


In taking exercise & all other times it is of the utmost consequence
to Mrs cochran to avoid cold which will always do much harm. Even in summer
she should not be without her flannel shirt & in every other respect she should
be very attentive in avoiding


Sitting up late at night & lying long abed is common to most people
of weak nerves & is very bad for them.


It is of consequence also to such persons to keep their minds easy &
Mrs Cochran ought as much as possible to avoid situations that may expose her
to any flurry of her spirits These are the particulars of Managment in which
I can give her advice & I would depend on her observance of these as much as on
on any medicine. But I shall not leave Mrs Cochran without some assistance
in this way also. I have on the other page given a prescription for two medicines.


The one is a stomachick Tincture of which she is to take a tea spoon¬
full or two in a glass of water about an hour before dinner. This she may do when
she finds her stomach particularly disorderd, & may then continue to take for a 1



[Page 4]

I have on the other page given a prescription for two
medicines that may be of use for her.


The one is a Stomachic Tincture of which she is to take
a teaspoonful or two in a glass of water about an hour or half an
hour before dinner This she may do when she finds her stomach
particularly disorderly & may then continue to tak it for a [fortnight?]
together but she should never take it long at any time & never
but when her stomach is more than ysual affected It will generally
be more necessary in winter than in summer


The other Medicin is a stomachic pill to be
[(or more/?] violent pains and cramps in the stomach These are to
be take [for a dose?] & they may taken at any time when the pains are
severe but the best time is at going to bed they should be taken only
when very necessary but when they are frequently repeated
The dose must be encreased to 4 or 5


The only other remedy I would recommend is the use of
a mineral water towards the approach of Winter the Hartfell spaw
is as good as any & Mrs C should take a wine glass full of this
before each meal but before taking it a glass of warm water must
be put to the mineral The water is to be of such warmth that to
take of entirely the Coldness of the Mineral or a little more. The
course of the Mineral water may be continued for a month or
six weeks in the month of November & beginning of december
& another course of the same lenght towards the spring ----




[Page 5]


I have now nothing more to add but with regard the
{illeg} which I think proceeds from the Stomach and
is of no consequence. I hope it will readily yeald to another [bolus?]
or to the stomach tincture.

W C

Edinburgh ↑th↑13 July
1768
For Mrs Cochran

Take two ounces of stomachic elixir and [one?] ounce of elixir of vitriol. Mix. Label: Stomachic Tincture, a teaspoonful or two for a dose.

Take two scruples each of camphor and myrrh, and one scruple of extract of gentian. [Turn?] the myrrh to powder then add [spirit of vitriol?]. {illeg} [then to either the myrrh or the?] camphor add the extract of Gentian and with a sufficient quantity of mucilaginous gum tragacanth and make a mass. Divide into single pills [of one grain?]. Label: Stomachic Pills, three for a dose.




[Page 6]


fortnight together, 2 but she should never take it long at any time, & never
but when her stomach is more than usualy affected. It will generally be more neces¬
sary in winter than in summer.


The other Medicine is stomachic pill to be for more violent
pains and cramps on the stomach. These are to be taken for a dose. They may be tak¬
en at any time when the pains are severe, but the best time is at going to bed. They
should be taken only when very necessary, but when they are frequently repeated
the dose must be increased to four or five --


The only other remedy I would recommend is the use of a mine¬
ral water
towards the approach of winter the Hartfell spaw is as good as any

Notes:

1: The following two pages of text are on a tipped-in sheet added to the case-book, with some brief overlap of text. The added section suggests an expansion to the original, but it is unclear if this was missed-out by the copyist or is a later revision on Cullen's part, added by way of an "after-thought".

2: This is where the text reverts to the original case-book entry (see note 1. above).

Diplomatic Text

[Page 1]
For Mrs Cochran


After considering attentively the whole history of Mrs Cochrans
constitution and ailments I am perswaded that the worst is now over & that
for the rest of her life which may be very long she may have very little trouble.


Her Nerves can never be quite firm & her stomach which is now
the cheif subject of ailment cannot be so well restored but that from various
accidents it may be exposed to some trouble; but I am perswaded that by
good management such trouble may be prevented or when it happens easily
cured. What I take to be her proper managment is the following. ---------


She must take care in diet never either to load or disturb her stomach.
The quantity whatever it is must always be within bounds & tho it is probable
that Mrs Cochrans apetite is very moderate & that she truly takes little, yet
she must consider that what is not half enough to another, may be an overload



[Page 2]

to her & she must always keep within the bounds of her appetite whatever
it is.


Much however will depend upon the nature of her food & every thing that
is heavy or that she knows from her own experience to prove heavy on her
stomach must be carefully avoided. In general I take beef, mutton, & white
fowl to be the most proper & generally more proper for such stomachs than
veal, lamb, or chiken. She should take nothing but plain roasted or boiled & a¬
void frying, baking, & all made dishes & heavy sauces. Fish she should take
sparingly & only of the lighter kinds boiled & without a sauce. A little salted
meat if it is a little only is improper. I need not be more particular for every
stomach has more or less peculiarities & Mrs Cochran must by this time know her
her own & govern herself accordingly but I am certain of this that the lighter she
keeps her stomach it will be the less liable to disorder. Vegetables she has already
learned to abstain from & it is generally necessary to such stomachs, but it may go too
far. There are times when the stomach is tolerably firm & will digest some vegetab¬
les very well. If Mrs Cochran can discern these times & take a little of the more ten¬
der kinds as very young pease, very young turnip, or Colliflower she may be the
better for them, only she must at all times avoid the colder vegetables as sal¬
lad & Cucumber & the more windy kinds as Cabbage & Colworts & all vegetables
of older growth.


For ordinary drink I hold water with a little strong Wine in it as the best
& I think all kinds of Malt Liquor improper. Spirits & water which so many weak stom¬
achs
have recourse to I woul have avoided as long as possible. Mrs Cochran
may take a little plain Wine every day especialy if she is in the habit of doing so but
I say that the less the better. A weak stomach may be relived by {illeg} of that kind
but is not stren↑g↑thened by it. In Winter it is more necessary & allowable than in Summer



[Page 3]

With this man↑a↑gement of diet Mrs cochran must take every opportunity
of fresh air & exercise which of all others is the best strengthener of the Nerves &
stomach. Moderate walking in the open air will do service but it must never go
the length fatigue Riding on horseback is the best of all other Exercises & Mrs Cochrans
should take pains to employ a great past of the summer in this way, & the more
she changes the air & scene the better. If riding is not convenient or agreable a Car¬
riage must be employed & with respect to weather has some advantages. If at any
time Mrs Cochrans ailments should be severe in sumer a voyage to London & bak
again is likly to be an excellent remedy.


In taking exercise & all other times it is of the utmost consequence
to Mrs cochran to avoid cold which will always do much harm. Even in summer
she should not be without her flannel shirt & in every other respect she should
be very attentive in avoiding


Sitting up late at night & lying long abed is common to most people
of weak nerves & is very bad for them.


It is of consequence also to such persons to keep their minds easy &
Mrs Cochran ought as much as possible to avoid situations that may expose her
to any flurry of her spirits These are the particulars of Managment in which
I can give her advice & I would depend on her observance of these as much as on
on any medicine. But I shall not leave Mrs Cochran without some assistance
in this way also. I have on the other page given a prescription for two medicines.


The one is a stomachick Tincture of which she is to take a tea spoon¬
full or two in a glass of water about an hour before dinner. This she may do when
she finds her stomach particularly disorderd, & may then continue to take for a 1



[Page 4]

I have on the other page given a prescription for two
medicines that may be of use for her.


The one is a Stomachic Tincture of which she is to take
a teaspoonful or two in a glass of water about an hour or half an
hour before dinner This she may do when she finds her stomach
particularly disorderly & may then continue to tak it for a [fortnight?]
together but she should never take it long at any time & never
but when her stomach is more than ysual affected It will generally
be more necessary in winter than in summer


The other Medicin is a stomachic pill to be
[(or more/?] violent pains and cramps in the stomach These are to
be take [for a dose?] & they may taken at any time when the pains are
severe but the best time is at going to bed they should be taken only
when very necessary but when they are frequently repeated
The dose must be encreased to 4 or 5


The only other remedy I would recommend is the use of
a mineral water towards the approach of Winter the Hartfell spaw
is as good as any & Mrs C should take a wine glass full of this
before each meal but before taking it a glass of warm water must
be put to the mineral The water is to be of such warmth that to
take of entirely the Coldness of the Mineral or a little more. The
course of the Mineral water may be continued for a month or
six weeks in the month of November & beginning of december
& another course of the same lenght towards the spring ----




[Page 5]


I have now nothing more to add but with regard the
{illeg} which I think proceeds from the Stomach and
is of no consequence. I hope it will readily yeald to another [bolus?]
or to the stomach tincture.

W C

Edin ↑th↑13 July
1768
For Mrs Cochran


℞ Elix stomachic ℥ij
Elix Vitriol. acid ℥
ℳ Signa sto. Tincture a teaspoonful or two for a
a dose


Camphor
Myrrh @ ℈ij
Extract Gentian ℈j
Tento [Myrrham?] in pulverem & dein adjecta [Sp. ViR?]
gatheacema vel altera Teriot [Myrham?] [y?] Camphor adde
Extractina et cum Mucilag G Tracacanth q. s. f Massa
dividenda in pil sing [Granen?] signa Sto Pills three [f?]
f a dose




[Page 6]


fortnight together, 2 but she should never take it long at any time, & never
but when her stomach is more than usualy affected. It will generally be more neces¬
sary in winter than in summer.


The other Medicine is stomachic pill to be for more violent
pains and cramps on the stomach. These are to be taken for a dose. They may be tak¬
en at any time when the pains are severe, but the best time is at going to bed. They
should be taken only when very necessary, but when they are frequently repeated
the dose must be increased to four or five --


The only other remedy I would recommend is the use of a mine¬
ral water
towards the approach of winter the Hartfell spaw is as good as any

Notes:

1: The following two pages of text are on a tipped-in sheet added to the case-book, with some brief overlap of text. The added section suggests an expansion to the original, but it is unclear if this was missed-out by the copyist or is a later revision on Cullen's part, added by way of an "after-thought".

2: This is where the text reverts to the original case-book entry (see note 1. above).

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