The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:535] From: Dr William Cullen (Professor Cullen) / To: Dr Robert Menzies (of Dura ) / Regarding: Mr David Bethune (of Kilconquhar; of Balfour) (Patient) / 30 April 1782 / (Outgoing)
reply with formal 'Directions for David Bethune', signed by Cullen and Joseph Black. They are of the clear opinion that costiveness is the source of the patient's complaints, and prescribe laxative medicines and enema recipes, along with dietary and exercise recommendations.
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- Normalized Text
- Diplomatic Text
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Facsimile
There are 6 images for this document.
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Metadata
| Field | Data |
|---|---|
| DOC ID | 535 |
| RCPE Catalogue Number | CUL/1/1/15/18 |
| Main Language | English |
| Document Direction | Outgoing |
| Date | 30 April 1782 |
| Annotation | None |
| Type | Machine copy |
| Enclosure(s) | Enclosure(s) present |
| Autopsy | No |
| Recipe | Yes |
| Regimen | Yes |
| Letter of Introduction | No |
| Case Note | No |
| Summary | reply with formal 'Directions for David Bethune', signed by Cullen and Joseph Black. They are of the clear opinion that costiveness is the source of the patient's complaints, and prescribe laxative medicines and enema recipes, along with dietary and exercise recommendations. |
| Manuscript Incomplete? | No |
| Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
| Case ID | Description | Num Docs |
|---|---|---|
| [Case ID:260] |
Case of Mr David Bethune of Balfour who consulted Cullen previously over stomach complaints (See Case 34). Now also has an eye problem, head-pains, abdominal pains and increasing weakness. |
20 |
People linked to this document
| Person ID | Role in document | Person |
|---|---|---|
| [PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
| [PERS ID:830] | Addressee | Dr Robert Menzies (of Dura ) |
| [PERS ID:11] | Patient | Mr David Bethune (of Kilconquhar; of Balfour) |
| [PERS ID:830] | Patient's Physician / Surgeon / Apothecary | Dr Robert Menzies (of Dura ) |
| [PERS ID:1003] | Patient's Physician / Surgeon / Apothecary | Dr Joseph Black |
| [PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
| [PERS ID:1003] | Supplemental Author | Dr Joseph Black |
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 | Kilconquhar House | Kilconquhar | Edinburgh and East | Scotland | Europe | inferred |
Normalized Text
Directions for David Bethune Esq.r
We are clearly of opinion that Costiveness is
the Cause of the greater number of M.r Bethunes
present Complaints & that it is necessary for
him to pay constant attention to the state of
his Belly & keep it properly open –– For this
purpose a variety of laxatives may be needed
that when he tires of one or when by custom
it ceases to produce a proper effect he may
have recourse to another –– We have according¬
ly ordered a laxative mixture and a laxative
Pill which along with the Rhubarb which
he has been accustomed to take will make for
the present a sufficient Variety ––
If at any time however, in consequence of his
having taken too small a dose, or of his Belly
being more bound up than ordinary, the Symptoms
proceeding from thence are very distressing, He
may have recourse to an Injection which af¬
fords the most immediate releif in such Cases
and for this Purpose we have ordered two kinds
of Injections that may be depended on
[Page 2]
One of the most distressing effects of the Costive¬
ness is the Collection of Wind in his Bowels which
oppresses him & raises the pains he so often com¬
plains of –– This when it occasionally encreases
to such a degree as entirely to deprive him of ease
& Rest must be alleviated by Cordials & anti¬
spasmodics –– We have accordingly ordered some
Drops of this nature which he may take a dose
of occasionally without apprehending any in¬
convenient effect from them –––– Upon such
occasions he may also sometimes use the opiate
or anodyne Pill with which he is already pro¬
vided – but this should be used as seldom as
possible on account of its tendency to encrease
Costiveness and when it is used Care must be ta¬
ken to open the Belly after its operation –
Mr. Bethune has at present so little appetite
that there is scarcely any room for circumscribeing
his Diet & he must be allowed to eat what he can
We may observe however that a certain propor¬
tion of vegetables in food have a tendency to di¬
minish Costiveness and that malt liquors which
he is fond of are more laxative than wine or spirits
& water. –– But both the Vegetables and the
malt liquors are liable to prove flatulent in
weak Bowels and Mr Bethune must use
[Page 3]
them the more sparingly if he finds they en¬
crease that Symptom to any degree
1782
[Page 4]
For David Bethune Esq.r
Take 3 ounces of Castor Oil and an ounce of Daffy's Elixir. Mix. Label: The Laxative mixture, take one tablespoonfull, (or somewhat more if necessary) occasionally at bedtime shaking the glass
Take a drachm each of Aloetic Pills and Asafœtida. Mix to make 24 pills. Label: Laxative Pills, take two or three occasionally at Bedtime ––––
1782
[Page 5]
Take ½ an ounce of Asafœtida and 4 ounces of spring water. Mix to make a solution. Label: The solution one spoonfull of which is to be added to the Injection which was given lately, when there may be occasion to repeat it ––––
Take 8 ounces of the best Olive Oil. To be injected as an enema. This may be used sometimes as an Injection in place of the above ––––
[Page 6]
Take 2 ounces of Proprietary Elixir of Vitriol. Label: the antispasmodic drops, take one Teaspoonfull in a little spirits & water when the wind is very troublesome
1782
Diplomatic Text
Directions for David Bethune Esq.r
We are clearly of opinion that Costiveness is
the Cause of the greater number of M.r Bethunes
present Complaints & that it is necessary for
him to pay constant attention to the state of
his Belly & keep it properly open –– For this
purpose a variety of laxatives may be needed
that when he tires of one or when by custom
it ceases to produce a proper effect he may
have recourse to another –– We have according¬
ly ordered a laxative mixture and a laxative
Pill which along with the Rhubarb which
he has been accustomed to take will make for
the present a sufficient Variety ––
If at any time however, in consequence of his
having taken too small a dose, or of his Belly
being more bound up than ordinary, the Symptoms
proceeding from thence are very distressing, He
may have recourse to an Injection which af¬
fords the most immediate releif in such Cases
and for this Purpose we have ordered two kinds
of Injections that may be depended on
[Page 2]
One of the most distressing effects of the Costive¬
ness is the Collection of Wind in his Bowels which
oppresses him & raises the pains he so often com¬
plains of –– This when it occasionally encreases
to such a degree as entirely to deprive him of ease
& Rest must be alleviated by Cordials & anti¬
spasmodics –– We have accordingly ordered some
Drops of this nature which he may take a dose
of occasionally without apprehending any in¬
convenient effect from them –––– Upon such
occasions he may also sometimes use the opiate
or anodyne Pill with which he is already pro¬
vided – but this should be used as seldom as
possible on account of its tendency to encrease
Costiveness and when it is used Care must be ta¬
ken to open the Belly after its operation –
Mr. Bethune has at present so little appetite
that there is scarcely any room for circumscribeing
his Diet & he must be allowed to eat what he can
We may observe however that a certain propor¬
tion of vegetables in food have a tendency to di¬
minish Costiveness and that malt liquors which
he is fond of are more laxative than wine or spirits
& water. –– But both the Vegetables and the
malt liquors are liable to prove flatulent in
weak Bowels and Mr Bethune must use
[Page 3]
them the more sparingly if he finds they en¬
crease that Symptom to any degree
1782
[Page 4]
For David Bethune Esq.r
℞ Ol. Ricini unc. iij
Tinct Senna Comp. unc j
ℳ. Sig. The Laxative mixture, take one table
spoonfull, (or somewhat more if necessary) [and?]
occasionally at bedtime shaking the glass
℞ Pilul. aloetic
assa fœtid @ dr. j
ℳ. f.t Pilulæ № xxiv
Sig. Laxative Pills, take two or three oc¬
casionally at Bedtime ––––
1782
[Page 5]
℞ assæ fœtida ℥ſs
aq. fontan ℥jv
ℳ. f. solutio ––
Sig. The solution one spoonfull of which
is to be added to the Injection which was given
lately, when there may be occasion to re¬
peat it ––––
℞ Ol. olivar. optimi ℥viij
Injiciatur pro Enemate ––––
This may be used sometimes as an Injection
in place of the above ––––
[Page 6]
℞ Elixir Proprietat vitrioli ℥ij
Signa the antispasmodic drops, take one
Teaspoonfull in a little spirits & water
when the wind is very troublesome
1782
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