Reference
An eighteenth-century medical glossary
The consultation letters are full of terms that need context: diseases, treatments, and anatomical ideas that meant something different in the 1770s than they do now. This glossary draws on Cullen's own writings to explain the clinical world behind the correspondence.
Coming soon
This page is under development. When complete, it will include:
- Disease definitions from Cullen's First Lines of the Practice of Physic — Cullen's own textbook, first published in 1777 and widely used across the English-speaking world. Definitions drawn from this work show exactly how Cullen understood the conditions his patients described.
- Cullen's nosology — His systematic classification of diseases into classes, orders, genera, and species. Published as Synopsis Nosologiae Methodicae (1769), this was one of the most influential disease taxonomies of the late eighteenth century. Mapping tagged concepts in the letters onto nosological categories reveals the diagnostic framework behind the consultations.
- Treatment glossary — What did "blistering" involve? What was in a "bark" prescription? What did "the cold bath" mean in clinical practice? Entries will explain therapeutic techniques and materia medica in context.
- Clinical lectures comparison — Cullen also taught clinical medicine at the Royal Infirmary of Edinburgh, lecturing on cases drawn from hospital patients. These patients were typically poorer than his consultation correspondents. A future comparison between the consultation letters and the clinical lectures could reveal how social class shaped clinical narrative — the same physician, the same medical framework, different patients.
Sample entries
A preview of what this glossary will contain:
Phthisis
/ˈtaɪsɪs/
Pulmonary consumption — what would now be recognised as tuberculosis of the lungs. One of the most frequently discussed conditions in the correspondence. Cullen classified it under the 'Cachexiae' (wasting diseases) in his nosology. The term comes from the Greek phthisis (wasting away). In the letters, patients and their physicians describe the characteristic decline: cough, emaciation, night sweats, and the slow progression that made prognosis so fraught.
Blistering
The application of a vesicant (blister-raising substance, typically cantharides — Spanish fly) to the skin as a counter-irritant. One of the most common therapeutic interventions in the letters. The logic was revulsive: drawing morbid matter to the surface and away from the affected organ. Blisters were applied to the chest for respiratory complaints, to the head for nervous disorders, and to the affected limb for local pain. The practice was painful and left open wounds that required dressing.
Bark
Cinchona bark (Peruvian bark), the source of quinine. Prescribed widely for intermittent fevers (malaria) and as a general tonic. One of the era's most valued and debated drugs. Cullen discusses its properties at length in his materia medica lectures. In the letters, "bark" appears in prescriptions for fevers, debility, and as a strengthening agent after illness.
Nervous complaints
A broad category in Cullen's nosology encompassing conditions attributed to disordered function of the nervous system. This included what would now be recognised as anxiety, depression, epilepsy, hysteria, and hypochondriasis. Cullen was particularly influential in theorising nervous diseases — his concept of 'neurosis' (literally: disease of the nerves) shaped medical thinking for decades.
Issue / Seton
Deliberately created wounds maintained as a permanent or semi-permanent drain. An 'issue' was a small incision kept open with a foreign body (a pea or bead); a 'seton' was a thread or strip drawn through a fold of skin. Both served as counter-irritants and outlets for 'morbid humours.' Frequently prescribed in chronic conditions where ongoing drainage was thought beneficial.
Cullen's clinical world
The glossary is part of a larger effort to make the clinical context of the letters legible to modern readers. Three related resources are planned:
- Nosological mapping — linking tagged conditions in the letters to their place in Cullen's disease classification, so users can see how a specific complaint fitted into the broader system.
- First Lines cross-references — connecting glossary entries to the relevant passages in Cullen's textbook, letting users read his own account of a disease alongside the letters that discuss it.
- Clinical lectures comparison — Cullen's clinical lectures at the Royal Infirmary of Edinburgh describe hospital cases — patients who were typically poorer, seen in person rather than by letter, and treated in an institutional rather than domestic setting. Comparing how the same physician wrote about similar conditions across these two very different contexts is a natural next step for the Explorer.
If you are interested in contributing to this work — particularly if you have expertise in eighteenth-century medicine, Cullen's publications, or the Edinburgh medical school — please get in touch via the About page.