Cullen

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

 

[ID:4626] From: Dr William Cullen (Professor Cullen) / To: Dr / Regarding: Colonel George Clerk (Clarke, Clark) (Patient) / 7 May 1783 / (Outgoing)

Reply 'For Colonel Clarke'; Cullen mentions a letter written by the Colonel to his brother, describing his case.

Facsimile

There are 7 images for this document.

[Page 1]


 

[Page 2]


 

[Page 3]


 

[Page 4]


 

[Page 5]


 

[Page 6]


 

[Page 7]


 
 

Metadata

FieldData
DOC ID 4626
RCPE Catalogue Number CUL/1/1/16/31
Main Language English
Document Direction Outgoing
Date7 May 1783
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 'For Colonel Clarke'; Cullen mentions a letter written by the Colonel to his brother, describing his case.
Manuscript Incomplete? No
Evidence of Commercial Posting No

Case

Cases that this document belongs to:

Case ID Description Num Docs
[Case ID:1473]
Case of Colonel George Clerk [Clark, Clarke, Clerke] who becomes excessively weak and feeble from chronic costiveness, breathlessness, and other chronic complaints. In New York he has a perpetual fever and stomach complaint and mentions consulting Cullen before but no firm evidence traced unless he is the same patient as Case 283 in 1768.
24


People linked to this document

Person IDRole in documentPerson
[PERS ID:1]AuthorDr William Cullen (Professor Cullen)
[PERS ID:5686]AddresseeDr
[PERS ID:2507]PatientColonel George Clerk (Clarke, Clark)
[PERS ID:1]Patient's Physician / Surgeon / ApothecaryDr William Cullen (Professor Cullen)
[PERS ID:5686]Patient's Physician / Surgeon / ApothecaryDr
[PERS ID:3181]Patient's Relative / Spouse / FriendMr Robert Clerk (Clarke; Clerke; of Mavisbank)

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 Godstone London and South-East England Europe inferred
Therapeutic Recommendation Buxton Midlands England Europe certain
Mentioned / Other Bath South-West England Europe certain

Normalized Text

[Page 1]
For Colonel Clarke


I have carefully considered the Colonels complaints
as he has been pleased to communicate them in the letter
to his Brother and recollecting what I formerly knew
of his constitution I clearly perceive a considerable
and various disorder in his Nerves but cannot per¬
ceive any grounds for supposing that either tumour
or Abcess ↑is↑ forming within him.


In the present general and variously disordered
state of his constitution I think few medicines can
be of service to him and the only remedy I can re¬
commend is Drinking and Bathing at Buxton and
for which the present Season is the most proper
I think the Waters of Bath would be too warm for
him and at least the tryal would be hazardous and
I could not advise it till he had first tried the
water Bath at Buxton. Even at Buxton he must




[Page 2]


proceed very cautiously. At first stepping into the
Bath there the water feels a little cold but after a few
minutes the water feels presently but moderately
warm and continues to be so far all the time that
a person remains in it. By these circumstances
the Colonel has it in his power to proceed very
gradually and I advise him to do so. Going into
the Bath at first for five minutes only and after¬
wards lengthening the time as he shall be found to
bear it and if he can come to bear it every day
from half an hour to an hour I dont doubt of his
receiving much benefit from it. In going into the
Bath he should take assistance in moving and
exert his own strength as little as possible and he
should have a Stool to sit upon in the Bath and
while he sits there he should have another person




[Page 3]


gently but very gently to rub his Breast, Back
and Sides. After coming out of the Bath and being
well dried and cloathed he should ly along upon a
Bed for an hour.


At the same time that he Bathes in this
manner he may drink some of the Buxton water
beginning this also with a small quantity and in¬
creasing it afterwards as his Stomach shall be
found to bear it. I expect it will be of service both
to his Appetite and digestion.


While he remains at Buxton he should take
daily some gentle exercise in a Carriage not so much
for the sake of exercise which should be very smooth
and easy but for the purpose of being much in
the open air when the weather is tolerably mild and
dry.


In respect to Diet I could wish that the Colonel
could be directed by his own experience but as that




[Page 4]


has not been very decisive it is my opinion that while
a full diet would certainly be improper a very low diet
would as certainly do him much harm. As far as his
Appetite will allow him let him take both Meat and
wine but both very moderately. In respect to wine
I think a little strong wine such as Madeira, Strong
or Red Port diluted with water will be much safer
than any weak bodied wine that would be more ready
to ferment on his stomach.


There is nothing more unlucky than the Costiveness
which the Colonels constitution is so much disposed to
and it should be obviated as much as possible. If the
Colonel can perceive that any particular diet is favou¬
rable to keeping his belly open this he should employ
as often as he conveniently can. If he has ever tried
Whey of any kind and finds that it does not grow
sour or windy on his stomach I think he may try for




[Page 5]


the first part of Summer at least to take a draught
or two of fresh drawn Cow milk whey every morning
an hour or more before his Breakfast and if it
shall save him from the frequent use of Purgative
medicines
it will be of great advantage. It may
however happen that neither this nor any mana¬
gement of diet shall be sufficient to obviate
costiveness and as this should never be allowed
to go far it will be absolutely necessary for him
to have recourse to medicines. He seems to have
been in this circumstance for a long time past and
probably has tried some variety of laxative. I
must allow him to employ these which he has found
to answer best but there is one which I should
think well suited to his Constitution and if he has
not tried it before or tried it in the shape in which
I am now to advise it I would desire him to try




[Page 6]


it in the form I have now prescribed it on the
other page and I shall also mention still another
laxative which I hope may answer well.


If he finds he can bear to take about a
pint of whey and he should never take above a
Quart in the morning it may make the whey sit
better on his stomach and prove more certainly
laxative if he takes two three times a week in the
first draught of the whey from a quarter to half
an Ounce of Rochelle Salt.


If this advice shall give occasion to the Colonel
to move any doubts or put any questions I shall
always be ready to Answer them and to add and
alter as well as I can.

William Cullen

Edinburgh 7th. May
1783



[Page 7]
For Colonel Clerk

Take three ounces of fresh Russian castor oil and one ounce of Daffy's Elixir. Mix. Label: Laxative Oil. A tablespoonful, more or less, for a dose to be taken in the morning, shaking the vial always very well before pouring out and swallowing the dose immediately after

W. C.

7th May
1783.


N. B. If the above is to be prepared in any part
of England let care be taken that the Tincture be
of the proper kind.

Diplomatic Text

[Page 1]
For Colonel Clarke


I have carefully considered the Colonels complaints
as he has been pleased to communicate them in the letter
to his Brother and recollecting what I formerly knew
of his constitution I clearly perceive a considerable
and various disorder in his Nerves but cannot per¬
ceive any grounds for supposing that either tumour
or Abcess ↑is↑ forming within him.


In the present general and variously disordered
state of his constitution I think few medicines can
be of service to him and the only remedy I can re¬
commend is Drinking and Bathing at Buxton and
for which the present Season is the most proper
I think the Waters of Bath would be too warm for
him and at least the tryal would be hazardous and
I could not advise it till he had first tried the
water Bath at Buxton. Even at Buxton he must




[Page 2]


proceed very cautiously. At first stepping into the
Bath there the water feels a little cold but after a few
minutes the water feels presently but moderately
warm and continues to be so far all the time that
a person remains in it. By these circumstances
the Colonel has it in his power to proceed very
gradually and I advise him to do so. Going into
the Bath at first for five minutes only and after¬
wards lengthening the time as he shall be found to
bear it and if he can come to bear it every day
from half an hour to an hour I dont doubt of his
receiving much benefit from it. In going into the
Bath he should take assistance in moving and
exert his own strength as little as possible and he
should have a Stool to sit upon in the Bath and
while he sits there he should have another person




[Page 3]


gently but very gently to rub his Breast, Back
and Sides. After coming out of the Bath and being
well dried and cloathed he should ly along upon a
Bed for an hour.


At the same time that he Bathes in this
manner he may drink some of the Buxton water
beginning this also with a small quantity and in¬
creasing it afterwards as his Stomach shall be
found to bear it. I expect it will be of service both
to his Appetite and digestion.


While he remains at Buxton he should take
daily some gentle exercise in a Carriage not so much
for the sake of exercise which should be very smooth
and easy but for the purpose of being much in
the open air when the weather is tolerably mild and
dry.


In respect to Diet I could wish that the Colonel
could be directed by his own experience but as that




[Page 4]


has not been very decisive it is my opinion that while
a full diet would certainly be improper a very low diet
would as certainly do him much harm. As far as his
Appetite will allow him let him take both Meat and
wine but both very moderately. In respect to wine
I think a little strong wine such as Madeira, Strong
or Red Port diluted with water will be much safer
than any weak bodied wine that would be more ready
to ferment on his stomach.


There is nothing more unlucky than the Costiveness
which the Colonels constitution is so much disposed to
and it should be obviated as much as possible. If the
Colonel can perceive that any particular diet is favou¬
rable to keeping his belly open this he should employ
as often as he conveniently can. If he has ever tried
Whey of any kind and finds that it does not grow
sour or windy on his stomach I think he may try for




[Page 5]


the first part of Summer at least to take a draught
or two of fresh drawn Cow milk whey every morning
an hour or more before his Breakfast and if it
shall save him from the frequent use of Purgative
medicines
it will be of great advantage. It may
however happen that neither this nor any mana¬
gement of diet shall be sufficient to obviate
costiveness and as this should never be allowed
to go far it will be absolutely necessary for him
to have recourse to medicines. He seems to have
been in this circumstance for a long time past and
probably has tried some variety of laxative. I
must allow him to employ these which he has found
to answer best but there is one which I should
think well suited to his Constitution and if he has
not tried it before or tried it in the shape in which
I am now to advise it I would desire him to try




[Page 6]


it in the form I have now prescribed it on the
other page and I shall also mention still another
laxative which I hope may answer well.


If he finds he can bear to take about a
pint of whey and he should never take above a
Quart in the morning it may make the whey sit
better on his stomach and prove more certainly
laxative if he takes two three times a week in the
first draught of the whey from a quarter to half
an Ounce of Rochelle Salt.


If this advice shall give occasion to the Colonel
to move any doubts or put any questions I shall
always be ready to Answer them and to add and
alter as well as I can.

William Cullen

Edinr. 7th. May
1783



[Page 7]
For Coll. Clerk


Ol. ricin. recent. ℥iij
Tinct. e Senn. comp. Ph. Ed. ℥j
ℳ. Sig. Laxative Oil a table spoonfull more or
less for a dose to be taken in the morning, shaking
the vial always very well before pouring out and
swallowing the dose immediately after

W. C.

7th May
1783.


N. B. If the above is to be prepared in any part
of England let care be taken that the Tincture be
of the proper kind.

XML

XML file not yet available.

Feedback

Send us specfic feeback about this document [DOC ID:4626]

Type
Comments
 

Please note that the Cullen Project team have now disbanded but your comments will be logged in our system and we will look at them one day...