The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:5169] From: Dr William Cullen (Professor Cullen) / To: Dr / Regarding: Mr Morris (Patient) / 6 November 1785 / (Outgoing)
Reply 'For Mr Morris'.
- Facsimile
- Normalized Text
- Diplomatic Text
- Metadata
- Case
- People
- Places
Facsimile
There are 11 images for this document.
[Page 1]
[Page 2]
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[Page 7]
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Metadata
| Field | Data |
|---|---|
| DOC ID | 5169 |
| RCPE Catalogue Number | CUL/1/1/18/149 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 6 November 1785 |
| Annotation | None |
| Type | Machine scribal copy |
| Enclosure(s) | No enclosure(s) |
| Autopsy | No |
| Recipe | Yes |
| Regimen | Yes |
| Letter of Introduction | No |
| Case Note | No |
| Summary | Reply 'For Mr Morris'. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:106] |
Case of Mr Morris who is given advice on travelling to Lisbun to relieve a 'paralytic' condition. |
1 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:2737] | Addressee | Dr |
| [PERS ID:2736] | Patient | Mr Morris |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:2737] | Patient's Physician / Surgeon / Apothecary | Dr |
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 | Lisburn | North Ireland | Ireland | Europe | certain |
Normalized Text
For Mr. Morris
The nature of his disease so sufficiently obvi¬
ous, fundamentally Paralytic, but accompanied
with more Spasmodic affection than is common
in Paralytic Cases. The cure of such diseases
is commonly difficult and in the present Case
from its long Standing, and from its having
baffled the many remedies already employed
the difficulty must be still greater. An Abso¬
lute Cure therefore I cannot promise but am
persuaded that the Symptoms may still
admitt of much relief, and hope it may be
obtained by the following measures.
[1] Travelling in a carriage promises to be
{illeg} and I therefore advise he [setts??]
{illeg} immediately on a journey to Ireland
[Page 2]
managing it so as that he may have a good length
of journey every day, without however it going
to the length of much fatigue.
2 When he Shall get to Lisburn, or other
place of [fixed?] abode I would have him continue
to take Exercise in a Carriage every day that is
tolerably fair, taking care by warm Cloathing
and otherwise to avoid being affected by
any degree of cold.
3 I have a high opinion of the use of the
flesh brush when properly applied, but few
people have the patience for it that is ne¬
cessary. I would Advise Mr. Morris to use
{illeg} this manner. To employ it on lying
the morning and on a single limb only at
[bed?] time. For the purpose before he come
out of bed, let him lay out on {illeg}
[Page 3]
for that to be {illeg} by his Servant, the [remedy?]
may be gentle, but should be continued for ten
minutes or rather a quarter of an hour
upon each limb, taking care to have a warm
flannel sleeve, or soft worsted Stocking to
draw upon the Arm or leg as soon as the
rubbing of it is finished, and taking the limb
under the bed Cloaths till the friction of
the other limbs is finished When the whole
is done he should lye abed for a quarter of
an hour and then get up to be dressed in
his ordinary manner.
4 Though Mr. Morris was of opinion
that Electuary formerly applied was rather
hurtful to him and possibly it might
have been so, yet I am persuaded that under
proper management it may still be very
useful and I offer on that Subject the
[Page 4]
following {illeg} of Sparks in
the case of {illeg} it may be enough (↑of Service↑)
but in the {illeg}the System it is rather
tedious than useful. I advise therefore the
giving Shocks, but that these shocks should
be of the most gentle kind and I have always
found more benefit from these often repeated
than from shocks of any great force. I find
it of consequence to have the gentle Shocks
at one sitting repeated from ten to twenty
times, and that such sittings be repeated
at least twice a day, and I think it further
very necessary to advise that even these
gentle Shocks be always kept away from
the head, and that they be directed to pass
thro' a single limb only, but successively
thro' the several limbs. Bath with respect
to friction and Electricity I have advised
[Page 5]
the application to all the several limbs [cand?] tho'
in the case of Mr. Morris as in most others
one Side is more affected than the other, yet
in his particular case there is enough of
ground for a general application.
5 I have observed above that Spasmodic
affections are a speciality in this Case and
is is Such a Speciality only that admitts
the employment of opiates. I believe that
they are the only certain means of relief
and therefore that they must be frequently
employed, but it is with reluctance that
I allow of this as I believe they are rather
hurtful to the fundamental disease and
I would wish if possible by other Anti¬
spasmodics to superseede the frequent use
of the Opium. For this purpose I have
{illeg} the use of Ether in a better form
[Page 6]
than had been employed before and I still advise
the pushing this same remedy farther than
{illeg} yet been ↑done↑ If it should even then fail I
would advise the trial of some very good
Musk if it can be procured, for the Musk
that is common the employment of it is
commonly lost labour and expence. I have
no opinion of the use of Camphire in this Case
6 The nature of the disease and perhaps
of the Constitution with the frequent use of
Opiates in this Case renders Costiveness fre¬
quent and troublesome and it often happens
that the Aloetic pill is not sufficient for
relieving it, but laxatives are absolutely
necessary and others therefore are to be em¬
ployed, and on the pafane mentioned (↑last Shock off [Sleep?]↑) I have given
a formula for two different laxatives {illeg}
I hope may be found to Answer.
[Page 7]
7 In such a Case a very nice attention to diet
is not very necessary, but in several particulars
I would advise it. I think all kinds of Indian
tea improper, and would advise his using a
tea made of Rosemary [tops?]. This may not
be agreeable at first, but a little repetition
will soon render it so. Coffee is safer than
tea, but by no means very proper, especially
when of the best kind and taken strong.
At dinner every day he may take a little
Animal food, but it ought to be the lightest
and the least filling up always a great
part of his Meal with broths light pudding
and Vegetable.
At Supper he should take no Animal
food and only some kind of farinacea and
fruit.
8 The ordinary drink may be good
[Page 8]
small beer or good porter with two parts of water
for plain water will be too binding for him.
Every day at dinner he may take two
or three glasses of plain wine and of any
kind he likes best but farther he cannot
go with safety, for his being in the least
heated with the strong drink of any kind would
certainly be hurtful.
9. I should have said above that in
his diet he may take Mustard freely and
of Spiceries moderately, but all kinds of
pickles, Vinegar and Acids are to be carefully
avoided.
If I had been advised more [early?] in
the disease I should certainly have ordered a
Setan or Pea Issue to be put into the nape
of the Neck, but in the present {illeg}
I would not insist upon {illeg}
there
[Page 9]
there should be at any time any return of
Paralytic Stroke. I would certainly advise
two a pea issue to be put in to (↑on each side of↑) the Nape of
the Neck in those places precisely at which
we commonly bring out the ends of the seton
11 When Speaking of a Paralytic Stroke
I cannot omitt observing that tho' such an
accident should happen I would by no
means advise the employment of any warm
bathing which I suspect to have already
done mischief.
12 I cannot at present Advise much
medicine for Mr. Morris, tho' I think
those which have been employed, have been
employed in a very imperfect manner
and the only one I could now propose is
the Guaiacum to be used in one or other
of the ways prescribed in the {illeg}
[Page 10]
{illeg}
William Cullen --
Edinburgh 6.th November
1785
[Page 11]
For Mr. Morris
Take from half an ounce to one ounce of [Sal Rupetans?], half an ounce of the best manna, four ounces of boiling water. Dissolve, and to the strained liquid add from half an ounce to one ounce of Senna tincture as described in the Pharmacopoeia Edinburgensis. Mix. Label: Laxative Solution to be taken at two or three draughts in the morning.
Take three ounces of the best Castor Oil, one ounce of Jallop tincture as described in the Pharmacopoeia Edinburgensis. Mix and label Laxative Oil, a table spoonful or two to be taken in the morning, taking care to shake the Phial excedingly well before pouring out.
Take two drachms of Gum Guaiacum and three drachms of the purest White Sugar. Crush them in a fine powder, to which you add three ounces of raw Arabic Gum mucillage. Crush again carefully, and while you crush pour over it half an ounce of Volatile Elixir of Guaiac, one ounce of Tincture of Sennna as described in the Pharmacopoeia Edinburgensis, three ounces of Cinnamon Water and three ounces of Peppermint. Mix and label as Diaphoretic Solution. A tablespoon to be taken every night at bedtime shaking the Phial always very well before pouring out.
Take two drachms of Volatile Elixir of Guaiac and one drachm of egg Yolk. Mix them together carefully, and little by little pour over it one drachm of Peppermint Water and three drachms of Simple Syrup. Mix and let there be made [haust. less Sumendo?].
W.C.
Diplomatic Text
For Mr. Morris
The nature of his disease so sufficiently obvi¬
ous, fundamentally Paralytic, but accompanied
with more Spasmodic affection than is common
in Paralytic Cases. The cure of such diseases
is commonly difficult and in the present Case
from its long Standing, and from its having
baffled the many remedies already employed
the difficulty must be still greater. An Abso¬
lute Cure therefore I cannot promise but am
persuaded that the Symptoms may still
admitt of much relief, and hope it may be
obtained by the following measures.
[1] Travelling in a carriage promises to be
{illeg} and I therefore advise he [setts??]
{illeg} immediately on a journey to Ireland
[Page 2]
managing it so as that he may have a good length
of journey every day, without however it going
to the length of much fatigue.
2 When he Shall get to Lisburn, or other
place of [fixed?] abode I would have him continue
to take Exercise in a Carriage every day that is
tolerably fair, taking care by warm Cloathing
and otherwise to avoid being affected by
any degree of cold.
3 I have a high opinion of the use of the
flesh brush when properly applied, but few
people have the patience for it that is ne¬
cessary. I would Advise Mr. Morris to use
{illeg} this manner. To employ it on lying
the morning and on a single limb only at
[bed?] time. For the purpose before he come
out of bed, let him lay out on {illeg}
[Page 3]
for that to be {illeg} by his Servant, the [remedy?]
may be gentle, but should be continued for ten
minutes or rather a quarter of an hour
upon each limb, taking care to have a warm
flannel sleeve, or soft worsted Stocking to
draw upon the Arm or leg as soon as the
rubbing of it is finished, and taking the limb
under the bed Cloaths till the friction of
the other limbs is finished When the whole
is done he should lye abed for a quarter of
an hour and then get up to be dressed in
his ordinary manner.
4 Though Mr. Morris was of opinion
that Electuary formerly applied was rather
hurtful to him and possibly it might
have been so, yet I am persuaded that under
proper management it may still be very
useful and I offer on that Subject the
[Page 4]
following {illeg} of Sparks in
the case of {illeg} it may be enough (↑of Service↑)
but in the {illeg}the System it is rather
tedious than useful. I advise therefore the
giving Shocks, but that these shocks should
be of the most gentle kind and I have always
found more benefit from these often repeated
than from shocks of any great force. I find
it of consequence to have the gentle Shocks
at one sitting repeated from ten to twenty
times, and that such sittings be repeated
at least twice a day, and I think it further
very necessary to advise that even these
gentle Shocks be always kept away from
the head, and that they be directed to pass
thro' a single limb only, but successively
thro' the several limbs. Bath with respect
to friction and Electricity I have advised
[Page 5]
the application to all the several limbs [cand?] tho'
in the case of Mr. Morris as in most others
one Side is more affected than the other, yet
in his particular case there is enough of
ground for a general application.
5 I have observed above that Spasmodic
affections are a speciality in this Case and
is is Such a Speciality only that admitts
the employment of opiates. I believe that
they are the only certain means of relief
and therefore that they must be frequently
employed, but it is with reluctance that
I allow of this as I believe they are rather
hurtful to the fundamental disease and
I would wish if possible by other Anti¬
spasmodics to superseede the frequent use
of the Opium. For this purpose I have
{illeg} the use of Ether in a better form
[Page 6]
than had been employed before and I still advise
the pushing this same remedy farther than
{illeg} yet been ↑done↑ If it should even then fail I
would advise the trial of some very good
Musk if it can be procured, for the Musk
that is common the employment of it is
commonly lost labour and expence. I have
no opinion of the use of Camphire in this Case
6 The nature of the disease and perhaps
of the Constitution with the frequent use of
Opiates in this Case renders Costiveness fre¬
quent and troublesome and it often happens
that the Aloetic pill is not sufficient for
relieving it, but laxatives are absolutely
necessary and others therefore are to be em¬
ployed, and on the pafane mentioned (↑last Shock off [Sleep?]↑) I have given
a formula for two different laxatives {illeg}
I hope may be found to Answer.
[Page 7]
7 In such a Case a very nice attention to diet
is not very necessary, but in several particulars
I would advise it. I think all kinds of Indian
tea improper, and would advise his using a
tea made of Rosemary [tops?]. This may not
be agreeable at first, but a little repetition
will soon render it so. Coffee is safer than
tea, but by no means very proper, especially
when of the best kind and taken strong.
At dinner every day he may take a little
Animal food, but it ought to be the lightest
and the least filling up always a great
part of his Meal with broths light pudding
and Vegetable.
At Supper he should take no Animal
food and only some kind of farinacea and
fruit.
8 The ordinary drink may be good
[Page 8]
small beer or good porter with two parts of water
for plain water will be too binding for him.
Every day at dinner he may take two
or three glasses of plain wine and of any
kind he likes best but farther he cannot
go with safety, for his being in the least
heated with the strong drink of any kind would
certainly be hurtful.
9. I should have said above that in
his diet he may take Mustard freely and
of Spiceries moderately, but all kinds of
pickles, Vinegar and Acids are to be carefully
avoided.
If I had been advised more [early?] in
the disease I should certainly have ordered a
Setan or Pea Issue to be put into the nape
of the Neck, but in the present {illeg}
I would not insist upon {illeg}
there
[Page 9]
there should be at any time any return of
Paralytic Stroke. I would certainly advise
two a pea issue to be put in to (↑on each side of↑) the Nape of
the Neck in those places precisely at which
we commonly bring out the ends of the seton
11 When Speaking of a Paralytic Stroke
I cannot omitt observing that tho' such an
accident should happen I would by no
means advise the employment of any warm
bathing which I suspect to have already
done mischief.
12 I cannot at present Advise much
medicine for Mr. Morris, tho' I think
those which have been employed, have been
employed in a very imperfect manner
and the only one I could now propose is
the Guaiacum to be used in one or other
of the ways prescribed in the {illeg}
[Page 10]
{illeg}
William Cullen --
Edin.r 6.th Nov.r
1785
[Page 11]
For Mr. Morris
℞ [Sal Rupetans?] ℥ fs @ ℥j
mann. opt. ℥fs
Aq. fervent. ℥iv
Solve et colatura adde
Tinct. Senn. comp. Pharm. Edin. ℥fs @ ℥j
ℳ. Laxative Solution to be taken at two or three draughts
in the morning.
℞ Ol. ricin. opt. ℥iij
Tinct. jalap. Pharm. Edin. ℥j
ℳ. Sig. Laxative Oil a table spoonful or two to be taken
in the morning taking care to shake the Phial excedingly
well before pouring out
℞ Gum. Guaiac. ʒij. Sacchar alb. puriss. ʒiij
terito Simul in pulverem tenuem cui adde
Mucilag. G. Arab. crass. ℥iij
terito iterum diligenter et dum teritur paulatim affunde
Elix. Guaiac. Volat. ℥fs. Tinct. Senn. comp. Ph. Ed. ℥j
Aq. Cinnam. Simpl. Menth pip. @ ℥iij ℳ. Sig.
Diaphoretic Solution a table spoonful to be taken every
night at bed time shaking the Phial always very well
before pouring out.
℞ Elixir Guaiac. Volat. ʒij Vitell. ovi ʒj Terito Simul diligenter.
et paulatim affunde Aq. Menth. pip. ℥j. Syr. Simpl. ʒiij ℳ. f. [haust.
less Sumendo?]
W.C.
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