The Consultation Letters of Dr William Cullen (1710-1790) at the Royal College of Physicians of Edinburgh
[ID:727] From: Dr William Cullen (Professor Cullen) / To: [ADDRESSEE UNKNOWN] / Regarding: Mrs Innes (Patient) / 22 March 1783 / (Outgoing)
Reply 'For Mrs Innes', regarding her case as conveyed to Cullen by writing and by word of mouth from Mr. Anderson.
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- Normalized Text
- Diplomatic Text
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- People
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Facsimile
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Metadata
Field | Data |
---|---|
DOC ID | 727 |
RCPE Catalogue Number | CUL/1/1/15/214 |
Main Language | English |
Document Direction | Outgoing |
Date | 22 March 1783 |
Annotation | None |
Type | Machine copy |
Enclosure(s) | Enclosure(s) present |
Autopsy | No |
Recipe | Yes |
Regimen | No |
Letter of Introduction | No |
Case Note | No |
Summary | Reply 'For Mrs Innes', regarding her case as conveyed to Cullen by writing and by word of mouth from Mr. Anderson. |
Manuscript Incomplete? | No |
Evidence of Commercial Posting | No |
Case
Cases that this document belongs to:
Case ID | Description | Num Docs |
---|---|---|
[Case ID:1639] |
Case of Mrs Innes, who is given very full advice on how to treat her colic. |
1 |
People linked to this document
Person ID | Role in document | Person |
---|---|---|
[PERS ID:1] | Author | Dr William Cullen (Professor Cullen) |
[PERS ID:3018] | Patient | Mrs Innes |
[PERS ID:1] | Patient's Physician / Surgeon / Apothecary | Dr William Cullen (Professor Cullen) |
[PERS ID:2690] | Patient's Relative / Spouse / Friend | Mr Anderson |
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 |
Normalized Text
For Mrs Innes
Having carefully considered the full and exact
information both by Writing and word of mouth from Mr
Anderson with respect to Mrs. Innes consitution and
complaints I am now in a condition to Judge and advise
in them.
The fits of Colic she has been liable to have
been both severe and obstinate and both on that account
and that the repetition of them may hurt her constitution
they are to be prevented with the utmost care and I hope
it may be done by obviating their causes which I think
their causes which I take to be partly a weakness
of her Bowels and partly a neglect of her disposition
to Costiveness.
For obviating and mending the first she
should be more in the fresh air and more in some
Exercise than she has hitherto been.
She should be abroad more or less every day
that the weather allows of it. For exercise she may
[Page 2]
go either on Horseback or in a Carriage but Walking if not
pushed to heat or fatigue her is better than either and let her
mix every kind of Exercise as may be most convenient so as
to have more or less every day.
Further for strengthening her constitution and
Bowels in particular I have ordered on a paper apart a
strengthening powder of which she will please take a
dose twice a day for three weeks after she is well Settled
in the Country. The powder is to be taken in a small
Cupful of water and washed down with the same, one
dose an hour before Breakfast and another as long before
Supper.
Whilst the Bowels are strengthening it must
be Mrs Innes' chief care to guard against Costiveness
which I would wish to be done if possible by the ma¬
nagement of Diet rather than by medicine.
In Diet she should be guided especially by her
own experience and if she has made any observations
to this purpose She should take whatever she knows
to be laxative and carefully avoid what she knows to
[Page 3]
be binding. Without knowing more of her own experience
in this respect I cannot give very particular directions but
I shall give some observations that will generally apply.
Broth and some Animal food at Dinner is better
than much Vegatables but the latter are not to be altogether
avoided but along with her Animal food she may take a
little of Vegetables especially those which she knows to be
of a laxative kind.
For ordinary Drink Small Beer is much
fitter than plain water. If Small beer is not good of its
kind or at any rate is liable to be windy on her stomach
she may take either Strong beer or good Porter mixed with
one or more parts of water.
Every day at Dinner she may take a glass or
two of wine but white is fitter than red.
At Supper or Breakfast if she chuses it she
may take any kind of Milk meat but she must never
take plain Milk to it. On whatever occasion she takes
Milk it should always be previously mixed with an
[Page 4]
equal part of thin Water Gruel or Barley water and the mix¬
ture should be always well sweetened with Honey or coarse
Sugar.
By this management of Diet I hope Costiveness may
be prevented but if even this Diet should not answer it
must be supplied by medicine, so that Costiveness should
never be allowed to go far. I think she should have a
motion of her Belly at least every second day and that
whenever a second day passes without it she should
take a medicine and she may take either one or two of
the Pills ordered on the paper apart, or a table spoonful
of the Laxative Oil also there prescribed.
By all these means I hope any return of Colic shall
be prevented and especially if with these means she shall
be attentive to avoid cold in her feet and legs and in
keeping these always warm and dry.
Although I confidently presume that no Colic is to
occurr I shall not however be so positive in this as not
to give my advise if Colic should happen how it may
[Page 5]
be most certainly and quickly relieved.
If Mrs Innes has formerly observed her Colic
to be ushered in by any particular feelings or symptoms
she should carefully watch the approach of these and
I believe that the taking of a medicine that may move
her belly two or three times and a full dose of Laudanum
in the Evening after will generally prevent the Colic
from coming further.
But if it shall happen that the Colic comes on
without giving warning if it has not yet excited any
Vomiting the same measures may be still proper, only in
this case when the Colic has already set in pretty strongly
the dose of Physic employed should be stronger or in larger
quantity.
The Physic that I judge most fit is to be employed is
either the Laxative Oil I have mentioned above or the
Laxative Powders ordered on the same paper and to be
used in this manner. Take a bit or two of Tea Sugar and
in the bottom of a Tea Cup pour it upon it a little boiling
[Page 6]
water just so much as to make it fall into a Syrup which
is to serve for mixing the powders when they are to be taken
and so as when mixed with the Syrup they may be taken
with a tea spoon.
The management of the Powders is to be in this way
when a Laxative is necessary one of the Laxative Powders
is always to be employed and according no more or less purging
may be required, more or less of the Purging Powders is
to be added. If a moderate dose only is required one of
the Purging Powders marked No 1. is to be joined with
the Laxative but if a stronger dose is required one of
No 2. is to be employed and perhaps on some occasions
both one of No 1 and No 2. are to be employed.
If these doses sit upon the stomach I think they
are likely to go through and put an end to the Colic and it
is only Vomiting that can prevent their taking effect.
In case of Vomiting it will be necessary to quiet this
by a full dose of Laudanum given either by the mouth
or by injections and after such a dose has had an hour
[Page 7]
to operate the purgative may be given with more security.
In all cases of the Colic and especially in those which have
been preceded by any degree of Costiveness the Cure is always
to be attempted and may I hope be frequently obtained by
injections. The first to be employed may be made of warm
water alone but a large quantity if this not under a Choppin
should be employed and for this purpose large bladders
should be provided even such as may contain a Scots pint
for such a quantity is sometimes necessary. Let the
water be thrown in a continued stream with what force
can be easily employed.
If repeated large injections of water alone do not pro¬
cure the necessary discharge other injections in smaller
quantity with the addition of oil or fresh Butter and an
Ounce of common Salts may be tried.
Turpentine Injections properly prepared are com¬
monly very effectual.
Edinburgh 22d March
1783
[Page 8]
✍ For Mrs Innes
Take half a drachm of chamomile flowers and ten grains of Peruvian bark. Mix and make a powder and let there be made of this sixty-two doses. Label: Strengthening Powders, one to be taken twice a day.
22 March
1783
[Page 9]
For Mrs Innes
Take two drachms of aloetic pill Mass and divide into twenty four pills. Label: Laxative Pills, one or two to be taken for a dose at bedtime when occasion requires
Take six ounces of the best Castor Oil and two ounces of Daffy's Elixir. Mix. Label: Laxative Oil, a tablespoonful, more or less, to be taken for a dose in the morning, shaking the vial always very well before pouring it out.
Take two drachms of powdered Crystal Tartar. In this way let there be made six doses. Label: Laxative Powders
Take half a drachm of powdered Jalappa compound. In this way, let there be made a dose of six. Label: Purging Powders No 1.
Take one drachm of powdered Jalappa compound. In this way, let there be made a dose of six. Label: Purging Powders No 2.
Take one and a half ounces of Laudanum liquid. Label: Liquid Laudanum.
22d March
1783.
Diplomatic Text
For Mrs Innes
Having carefully considered the full and exact
information both by Writing and word of mouth from Mr
Anderson with respect to Mrs. Innes consitution and
complaints I am now in a condition to Judge and advise
in them.
The fits of Colic she has been liable to have
been both severe and obstinate and both on that account
and that the repetition of them may hurt her constitution
they are to be prevented with the utmost care and I hope
it may be done by obviating their causes which I think
their causes which I take to be partly a weakness
of her Bowels and partly a neglect of her disposition
to Costiveness.
For obviating and mending the first she
should be more in the fresh air and more in some
Exercise than she has hitherto been.
She should be abroad more or less every day
that the weather allows of it. For exercise she may
[Page 2]
go either on Horseback or in a Carriage but Walking if not
pushed to heat or fatigue her is better than either and let her
mix every kind of Exercise as may be most convenient so as
to have more or less every day.
Further for strengthening her constitution and
Bowels in particular I have ordered on a paper apart a
strengthening powder of which she will please take a
dose twice a day for three weeks after she is well Settled
in the Country. The powder is to be taken in a small
Cupful of water and washed down with the same, one
dose an hour before Breakfast and another as long before
Supper.
Whilst the Bowels are strengthening it must
be Mrs Innes' chief care to guard against Costiveness
which I would wish to be done if possible by the ma¬
nagement of Diet rather than by medicine.
In Diet she should be guided especially by her
own experience and if she has made any observations
to this purpose She should take whatever she knows
to be laxative and carefully avoid what she knows to
[Page 3]
be binding. Without knowing more of her own experience
in this respect I cannot give very particular directions but
I shall give some observations that will generally apply.
Broth and some Animal food at Dinner is better
than much Vegatables but the latter are not to be altogether
avoided but along with her Animal food she may take a
little of Vegetables especially those which she knows to be
of a laxative kind.
For ordinary Drink Small Beer is much
fitter than plain water. If Small beer is not good of its
kind or at any rate is liable to be windy on her stomach
she may take either Strong beer or good Porter mixed with
one or more parts of water.
Every day at Dinner she may take a glass or
two of wine but white is fitter than red.
At Supper or Breakfast if she chuses it she
may take any kind of Milk meat but she must never
take plain Milk to it. On whatever occasion she takes
Milk it should always be previously mixed with an
[Page 4]
equal part of thin Water Gruel or Barley water and the mix¬
ture should be always well sweetened with Honey or coarse
Sugar.
By this management of Diet I hope Costiveness may
be prevented but if even this Diet should not answer it
must be supplied by medicine, so that Costiveness should
never be allowed to go far. I think she should have a
motion of her Belly at least every second day and that
whenever a second day passes without it she should
take a medicine and she may take either one or two of
the Pills ordered on the paper apart, or a table spoonful
of the Laxative Oil also there prescribed.
By all these means I hope any return of Colic shall
be prevented and especially if with these means she shall
be attentive to avoid cold in her feet and legs and in
keeping these always warm and dry.
Although I confidently presume that no Colic is to
occurr I shall not however be so positive in this as not
to give my advise if Colic should happen how it may
[Page 5]
be most certainly and quickly relieved.
If Mrs Innes has formerly observed her Colic
to be ushered in by any particular feelings or symptoms
she should carefully watch the approach of these and
I believe that the taking of a medicine that may move
her belly two or three times and a full dose of Laudanum
in the Evening after will generally prevent the Colic
from coming further.
But if it shall happen that the Colic comes on
without giving warning if it has not yet excited any
Vomiting the same measures may be still proper, only in
this case when the Colic has already set in pretty strongly
the dose of Physic employed should be stronger or in larger
quantity.
The Physic that I judge most fit is to be employed is
either the Laxative Oil I have mentioned above or the
Laxative Powders ordered on the same paper and to be
used in this manner. Take a bit or two of Tea Sugar and
in the bottom of a Tea Cup pour it upon it a little boiling
[Page 6]
water just so much as to make it fall into a Syrup which
is to serve for mixing the powders when they are to be taken
and so as when mixed with the Syrup they may be taken
with a tea spoon.
The management of the Powders is to be in this way
when a Laxative is necessary one of the Laxative Powders
is always to be employed and according no more or less purging
may be required, more or less of the Purging Powders is
to be added. If a moderate dose only is required one of
the Purging Powders marked No 1. is to be joined with
the Laxative but if a stronger dose is required one of
No 2. is to be employed and perhaps on some occasions
both one of No 1 and No 2. are to be employed.
If these doses sit upon the stomach I think they
are likely to go through and put an end to the Colic and it
is only Vomiting that can prevent their taking effect.
In case of Vomiting it will be necessary to quiet this
by a full dose of Laudanum given either by the mouth
or by injections and after such a dose has had an hour
[Page 7]
to operate the purgative may be given with more security.
In all cases of the Colic and especially in those which have
been preceded by any degree of Costiveness the Cure is always
to be attempted and may I hope be frequently obtained by
injections. The first to be employed may be made of warm
water alone but a large quantity if this not under a Choppin
should be employed and for this purpose large bladders
should be provided even such as may contain a Scots pint
for such a quantity is sometimes necessary. Let the
water be thrown in a continued stream with what force
can be easily employed.
If repeated large injections of water alone do not pro¬
cure the necessary discharge other injections in smaller
quantity with the addition of oil or fresh Butter and an
Ounce of common Salts may be tried.
Turpentine Injections properly prepared are com¬
monly very effectual.
Edinr 22d March
1783
[Page 8]
✍ For Mrs Innes
℞ pulv. flor. chamamel. ʒſs
-- cort. Peruviangr. X
ℳ. f. pulvis et fiant [hujus in?]. dos. No XLII
Sig. Strengthening Powders one to be taken twice a day
22 March
1783
[Page 9]
For Mrs Innes
℞ Mass. pil. aloetic. ʒij
Divide in pil. No XXIV
Sig. Laxative Pills one or two to be taken for a dose
at bedtime when occasion requires
℞ Ol. Ricin. opt. ℥vj
Tinct. Senn. comp. ℥ij
ℳ. Sig. Laxative Oil a table Spoonfull more or less
to be taken for a dose in the morning, Shaking the
vial always very well before pouring it out
℞ Crystall. Tartar. pulv. ʒij
Fiant h.m. dos. No vj
Sig. Laxative Powders
℞ pulv.e Jalap. comp. ʒſs
Fiant h.m. dos. No vj
Sig. Purging Powders No 1.
℞ pulv.e Jalap. comp. ʒj
Fiant h.m. dos. No vj
Sig. Purging Powders No 2.
Laudan. liquid. ℥jſs
Sig. Liquid Laudanum
22d March
1783.
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