PEK may Delle Oot «= 7. Ik OSG OVE, Pie the ern A Se sd tind le Some of its Medical Ufes : eet eRe ltt? : PRACTICAL REMARKS ON DROPSY, AND OTHER DISEASES. a BY WILLIAM WITHERING, M. D. Phyfician to the General Hofpital at Birmingham, nonumque prematur i annum. ies Horace. 3" BIRMINGHAM: PRINTED BY M. SWINNEY: ro Rn: G. G. J. AND J. ROBINSON, EAL ERRONTEE SOM —— ie Fecal ue ONG KO tHRAWAE 5 PORE SPA OH BP FTER being frequently urged to write upon this fubject, and as often declin- ing to do it, from apprehenfion of my own inability, I am at enh eases to ale up the pen, howe aque y Till feel mayfelf For the tale The ufe of the Foxglove is getting abroad, and it is better the world fhould derive fome inftruction, however imperfect, from my experience, than that the lives of men fhould be hazarded_ by its unguarded exhibi- tion, or that a medicine of fo much efficacy | fhould be condemned and re ejected as as “7 : ous and unma ee aS i iP EFA CC: E. It is now about ten years fince I firft be- gan to ufe this medicine. Experience and - Cautious attention gradually taught me how to ufe it. For the laft two years I have not had occafion to alter the modes of manage- ment; but I am ftill far fr om thinking them perfect. _ ? aii ‘Tt would tance beea an eafy tafk to have given felect cafes, whofe fuccefsful treatment would have fpoken ftrongly in favour of the medicine, and perhaps been flattering to my own reputation. But Truth and Science would condemn the procedure. ~I “have therefore mentioned every cafe in which I have preleghed the Fe ake or im- therwife. - Such rn conduct will ae me e open. 45 the Seediicea of — thofe who are difpofed to cenfure, but. it will meet t the approbation of others, who are the beft quilified t to be ie | To the Surgeons and Apbaisebed. © with fe whom Iam connetted in practice, both in aot and at a eae 4. ah leave to - = ~ make ciel PPR E fw CE. vii make this sate acknowledgment, for the affiftance they fo readily afforded me, in per- fetting fome of the cafes, and in commu- nicating the events of others. a: The ages of the patients are not always exaét, nor would the labour of making them fo have been repaid by any ufeful confe- quences. Ina few inftances accuracy in that refpect was neceffary, and there it has been attempted ; but in general, an approxinia- tion towards the truth, was fuppofed to be ps ~ The cafes related from my own experi- ence ie lly written in the fhorteft form I could contrive, in order to fave time and labour. Some of them are given more in detail, when particular circumftances made fuch detail neceflary ; but the cafes communicated by other practitioners, are given in their own words. I muft caution the reader, who is not a practitioner in phyfic, that no general de- ductions, decifive upon the failure or fuccefs. | eee ee” of vill PRERA C'E of the editor: can be ihe from the cafes I now prefent ‘to him: Thefe cafes muft be confidered as the moft hopelefs and deplorable that exift; for phyficians are fel- dom confulted in chronic difeafes, till the ufual:remedies have failed : and, indeed; for fome years, whilft I was lefs expert. in the management of the Digitalis, I feldom pre- fcribed it, but when the failure of every other method compelled me to do it ; fo that upon the whole, the inftances I am going to ad- duce, may truly be confidered as cafes loft to the common run of practice, and only Matched from deftruction, by the efficacy of the Digitalis; and this in fo remarkable a manner, that, if the properties of that plant hadnot been cicorana atk fee the greateft sche af: thefe patients © ; died. 3 =< xe tr are men whowill tabdly sehinie ofany thing which an author advances in fupport of a favorite medicine, and I allow they may have fome caufe for their hefitation: nor do- st —— they will: wave mee ufual modes of PREF 5A..C-E. ix judging upon the prefént occafion. I could with therefore that fuch*readers would pafs over what I have faid, and attend only to the communications from correfpondents, becaufe they cannot be fuppofed to poffefs any unjuft predilection in favour of the me- dicine : but I cannot advife them to this ftep,- for I am certain they would then clofe the book, with much higher notions of the effi- cacy of the plant than what they would haye learnt from me. Not that I want faith in the difcernment or in the veracity of my correfpondents, for they are men of eftab- lifhed reputation; but the cafes they have fent me are, with pone Pees too | much felected. _ They are not upon count lefs valuable i in D heritelves, or they are not the proper premifes from which to draw permanent conclufions. I wifh the reader to keep in view, that it is not my intention merely to introduce a new diuretic to his acquaintance, but one which, though not infallible, I believe to be much 1 more certain than any other in _pre- . fent ufe. . ieee BE ee After &; x P= RES? AS CE, . After all, in fpite of opinion, prejudice, or error, Time will fix the real value upon this difcovery, and determine whether I have impofed upom myfelf and others, or contri- buted to the benefit of fcience and mankind. INTRODUCTION.. “pee Foxglove is a plant ffficiently common in this ifland, and as we have but one fpeéies, and that fo generally known, J dhould -have thought it fuperfluous either to figure or defcribe it ; had I not more-than once feen the leaves of Mul- lein* gathered for thofe of Foxglove. On the con- tinent of Europe too, other fpecies are found, and I have been informed that our fpecies is very rare in fome parts of Germany, exifting. = y means of cultivation, in gardens. It Seidngs to ihe ad rote: of the’ Gea meee or the Dipynamia Ancrospermta. The effential charac- ters of the genus are, Cup with 5 divifions. Bloffom bell-fhaped, bulging. Capfule eggfhaped, 2-celled.— Lrnn. ; * DIGITA'LIS purpu'rea, Little leaves of the empalement egg-fhaped, fharp. Bloffoms blunt the upper lip CASS. Linn. ~ 'Rere- Soest: 1. 2 + The trivial name purpurea is not a very happy one, for the bloffoms though generally purple, re Pe Whee See 2 xii INTRODUCTION. ~ Rererences to Ficures.- Thefe are difpofed in the order of comparative excellence. Rizini monopets > oe: Flora danica, 74, parts of fructi ostion: Tournefort Infittuttones. 73, A, E, L, M, Fuchfit Hift. Piant, 893, copied in Tragi fiirp. hiflor. 889. F. Bauhini uftor.. Vol. it. 812. 3, and Lonicera 74, 1. | Blackwell. aut. 16, — Dodonai pempt. flirp. h if. 169, depeinted'i in ~ Gerard emacul, 7901, and copicdin -- ‘ Parkinfon Theatr. botanic. 6 baa le Gerard, firft edition, GaGiy tosiicie This plant ranks amongft the LURIDA, one of | ‘the Linnean ofders in a natural fyftem. It has for congenera, Nicortana, Atro#a, Hyoscvan f ° Si BA, picked &e. fo that from — te ledge \ . Line = ny ' INTRODUCTION. I intended in this place to. have. traced the hiftory of its effects in difeafes from the time of Fuch- fius, who firft defcribes it, but I have been antici- pated in this intention by my very valuable friend, Dr. Stokes of Stourbridge, who has lately fent me the following ; Historica ‘View of the Properties of ‘Digitalis. pie aii naps ot Fucusts i in == Wf. Airp. 3 ig is the firft author who notices it. From him it receives its name of Drerrauts, in allufion t to the German name of Fin- gerhut, which fignifies @ finger-fiall, from the blof- fomp.selembling, the finger of a glove. pope eee Quatittes. Leaves bitterifh, very nau- ponte Lewis Mat, med. i. 342. : ~ Sensiste Errects. Some perfons, foon after eat- ing? a kind of omalade, into 0 which the ee of mages mene he empl. poi as It isa medicine which is proper only for ne sont inte as it purges very ore and exe cites excellive OED Ray. Hee otis INTRODUCTION, KV . e garded, are medicines of great virtue, and fearce-_ ‘‘ ly inferior to any that the Indies afford.” Lewis. | Mat, med. i. p. 343. Six or feven fpoonfuls of the decoction produce naufea and vomiting, and purge; not without, _ fome marks of a deleterious quality. HALLER hilt, n. 330 from Acrial Infl:. 49, 5. The following is an abridged Ac COUNT of its ErrecTs upon Turkeys. , o* M. Sarerne, a phyfician at Orleans, Seton heard that feveral turkey pouts had been killed. by being fed with Foxglove leaves, inftead of mullein, he gave fome of the fame leaves to a large vigorous — key ae te bird wa, dogmnurh, SHeded, that} he and his ‘excrement S_be came reddifh. Good: nou- rifhment reftored him to health in eight days. ee Being then determined to puth the exbeinieue further, he chopped fome more leaves, mixed them > with bran, and gave them toa vigorous turkey cock which weighed feven pounds. This bird foon ap- ; peared drooping and melancholy ; his feathers ftared, his meck became pale and retracted. The leaves - were given him for four days, during. which | pee ; he took about half a handful. T 3 been. saber about Fai days, and the winter was far advanced. _ pS INTRODUCTION. ally erect arid well itase. became, from the firft, liquid and reddifh, like thofe ofa eeetenc patient, The animal refufing to eat any more of this mix- turé which had done him fo much mifchief, I was obliged to feed him with bran and water only; but notwithftanding this, he continued drooping, and without appetite. At-times he was feized with con- vuld ions, fo {trong as.to.throw him doy down; in the als he walked as if drunk; he did not attempt to peith. “he uttered plaintive cries. Ai length he --refufed all -noutifment. On the fifth or fixth day the excrements became as white as chalk; after- _ terwards yellow, greenifh, and black. On the eigh- teenth day he died, greatly reduced i in fleth, for he ow See oly three e_poia, =O opening him we found the Hen the 2 ine _ the liver, and gall-bladder fhronk and dried: up; gu ® fon ack aan we ages ite “empty if t 7; “but ot der ad ed of * de VAca T cng -“Eprrepsy, =“ “Te bet “af: ineen Ganierisnce ne ‘found ats be effe@ual againft the falling fick- _“ neffé, that divers have been cured thereby; for : * after thet ir ie of the Deco. manipulor, ti, c. poly- _ pod. giiercin, contus, Ziv, in cerevi ifia, they that have _ been troubled with it twenty-fix years; and have _ “fallen ottce ma weeke, or two or three times in a © moneth, have not fallen once in fourteen or BF en society Ss _ is until the writing her > Parkinfon, és G34 ScropHvLa,— INTRODUCTION. xvii _ Seroprivia.—‘* The herb bruifed, or the juice ‘* made up into an ointment, and applied to the “4 place, hath been found by late experience to be ** availeabie for the King’s Evill.” Park. p. 654. = Several hereditary | inftances_ of this difeafe faid to have been cured by it. AEREAL Inriu /BNCES, ‘p. 49, §0, quoted by Hauer, hit. n. £930-" qi A man with fe rophulous ulcers in various parts f the body, and which in the rightleg were {fo viru- lent that its amputation was propofed, -cured by Suce, exprefs. cochl. t. bis intra xiv, dies, in} pinta cereu ipa calida.. ‘The leaves temdining 2 after ath out of the jules were applied every day to the ulcers. Prad. as, p40. quotes: oF i ae apparat. medicam, cz sf fuellin mri upper ly eadibeinfut fookars ofa the joints of ‘the Singers; mach relieved-s but the medicine was left off, on account of its vie> lent effects on the conftitution. Jb. b- 42 a> as sbnevey 525: at het ae man with a ferophulous tumour of the right yes | attended for three years with eres pain was com- XViii INTRODU-G TION, commended to them by Dr. Baylies of Evefham, now of Berlin, as a remedy for this difeafe. Dr, Wail gave it a tryal, as well externally as inter- nally, but their experiments did not lead them to obferve any other properties in it, than thofe of a highly naufeating medicine and draftic purgative. ~“Wovnns. In _ confiderable eftimation. for the as all kinds of biden —— adv. °45- — of little aaa in fuch as are dry. Horse, 1 an R. hift. 768. ocias Bisims, phyfician tohis Pruffion Majefty, saan’ me, when at Berlin, that -he employed it _ with great fuccefs in caries, and obftinate fore legs: ~ Dyspnoea Pituitofa Sauvages i. 657.—** Boiled ** in water, or wine, and drunken doth cut and ‘sconfume the thicke toughneffe of grofie, and Bisse aia ‘and naughtie humours. a = as alfo t a5 abst of the ae omen and ** milt, and of the inwarde Parts." es - Ganaape hift. ae ed. 1 Pp. 647. i : =? Whenfoever there’ is bed GF: rarefying or ‘* extenuating of tough flegme or vifcous humours ’ f\troubling the chet —the decoction or juice here- — “* of made up with fugar or honey is availeable, as ve Ifo. to. clenie, and purge. the body. both up INTRODUCTION. XIX ** and downwards fometimes, of tough flegme, and “4 clammy humours, notwithftanding that thefe ‘* qualities are found to bee in it, there are but few ‘* phyfitions in our times that put it to. thefe- ufes, ‘* but it is in a manner wholly neglected.” . ». Parkinson, p. 654. Previous to the year 1777, you informed meé of the great fuccefs you had met with in curing drop- fies by means of the fol. Digitalis, which you then confidered as a more certain diuretic than any you had ever tried. Some time afterwards, Mr. Ruffel, furgeon, of Worcefter, having heard of the fuc- cefs which had attended fome cafes.in which you had given it, requefted me to obtain for him any information you might be inclined to communicate refpe@ing its ufe. In confequence of this applica- fon. ke wrote to me in the following terms.’ : : dated trate nee 778. you white: as follows: — ‘« T with it was as eafy to write upon the Digitalis ‘* J defpair of pleafing myfelf or inftrudting others, ** in a fubje& fo difficult. It is much eafier to ‘* write upon a difeafe than upon a remedy. ‘The ‘** former is in the hands of nature, ‘and a faith ** obferver, with an eye of tolerable jue “ cannot fail to delineate a likenefs. The latter ** will ever be fubje& to the whims, the i inact ** eies, and the blunders of mankind.”— xx INTRODUCTION, In my notes I find the following memorandam— “* February 20th, 1779, gave an account of Doétor ** Withering’s practice, with the precautions ne- ** ceffary to its fuccefs, to the Medical Society at ** Edinburgh.”—In the courfe of that year, the Di- gitalis was prefcribed in the Edinburgh Infirmary, by Dr. Hope, and in the following year, whilft I was Clerk to Dr. Home, as Clinical Profeffor, I had a favourable opportunity s of oe cable < ee fects. age e: ae wate pt pe eons 5 i one “ate in which i it was given properly at firft, the urine began to flow freely on the fecond day. On the third, the fwellings began to fubfide. The dofe was then increafed more than quadruple in the twenty-four hours. On the fifth day ficknefs came on, and much purging, but the urine ftill increafed though the pulfe funk to 50; On the 7th day, 2 uads uple dofe of the infufion was pseres to be taken every third hour, fo as’to bring. The pulfe fell to forty-four, and’ five ina minute. SiS ) don t t2 v1 = death, for two « or hese days, } her pulfe rofe to near one hundred. —It i is needlefs to obferve to you, how widely, the treatment of this cafe differed from the pelted hich ob ya) have found fo fuccefsfal. OF we, 1 HE 2 eae. : i ‘HE figure of the Foxglove, facing the Title | Page, is copied by the permiffion and under the infpection of Mr. Curtis, from his admirable work, entitled Fora Lonpinensis. ‘The accuracy of the drawings, the beauty of thecolouring, the full defcriptions, the accurate fpecific diftinétions, and the ufes of the different plants, cannot fail to recom- mend that work to the patronage of all who are in- terefted in the encouragement of genius, or the promotion of ufeful knowledge. EXPLANATION. Fig. 1. The Empalement. Fig. 2, 3, 4. Four Curves two long and two ae . Tres at firft large, turgid, oval, touchi bottom, ofa yellowifh colour, and’ Ghent eot- ted ; laftly changing both their form and fitu- ation in a fingular manner. Fig. 5,6, 7. Seep-sup rather conical, of a yellow green colour. Shaft fimple. Summit cloven. _ Fig. 8. Honeycup a gland, furrounding the bottom of the Seed-bud. =, Fig. 9. SeEp-VESSEL, 2 pointed oval Capfule, és two cells and two valves, the lowermoit valve fplit- ting in two, Fig. 10. Seeps numerous, blac, fill, lopped + wt each end. — AN - Ors f we AN a coo 0 we os OF THE INFRODUCTION of FOXGLOVE Into MODERN PRACTICE. a the more obvious and fenfible properties of plants, fuch as colour, tafte, and fmell, have but little connexion with the difeafes they are adapted to cure; fo their peculiar qualities have no certain dependence upon their external configuration. ‘Their chemical examination by fire, after an immenfe wafte of time and labour, having been found ufe- lefs, is now abandoned by general confent. Poffi- bly other modes of analyfis will be found out, which may turn to better account; but we have hi- therto made only a very {mall progrefs in the che- miftry of animal and vegetable fubftances. Their virtues muft therefore be learnt, either from obferv= in. their effects upon infects and quadrupeds; from | , deduced from the already known — of raat of their congenera, or from oes on copies ee ea PR SE OE Ff eed _ -matural fyftem:; but the sah ea ee retin tie | 2 INTRODUCTION within the reach of every.one who is open to infor- mation, regardlefs of the fource from whence it {prings. It was a circumftance of this al which firft fixed my attention on the Foxglove. In the year 1775, my opinion was afked concern- ing a family receipt for the cure of the dropfy. I was told that it had long been kept a fecret by an. old: woman in Shropfhire, who had fometimes made cures after the more regular pra¢titioners had failed. I was informed alfo, that the effects produced were violent vomiting and purging; for the diurétic ef feéts feemed to have been overlooked, This medi- cine was compofed of twenty or more different herbs; but it was not very difficult for one converfant in thefé fubjects, to perceive, that the active herb could — be no other than ~ Rilgieves ae Sebeneerees of fen my ution in a variety of cafes; for the — oor who thus applied for advice, OF FOXGLOVE. 3 large, and urged its continuance too long; for mif- led by reafoning from the effects of the fquill, which generally acts beft upon the kidneys when it excites naufea, I wifhed to produce the fame effe& by the Foxglove. In this mode of prefcribing, when I had fo many patients to attend to in the {pace of one, or at moft of two hours, it will not be expected that I could be very particular, much lefs could I take notes of all the cafes which occurred. Two or three of them only, in which the medicine fucceeded, I find mentioned amongft my papers. It was from this kind of experience that I ventured to affert, in the Botanical Arrangement publifhed in the courfe of the following fpring, that the Digitalis purpurea ** merited more attention than modern a | “ Rowed — it.” ners se a “Thad net,} ° we , yet introduced it i valuable and Teer friend, Dr, Ath, istfoiined me that Dr. Cawley, then principal of Brazen Nofe College, Oxford, had been cured of a Hydrops Pec- toris, by an empirical exhibition of the Toot of the Foxplave, after fome of the firft phyfi ad declared d they could do no ‘ibiee! toxt him, — » determined to purfue my former ideas igoroufly y than before, but was too > well a 4 INTRODUCTION but I expected, if gathered always in one condition ‘of the plant, viz. when it was in its flowering ftate, ‘and carefully dried, that the dofe might ‘be afcer- tained as exadtly as that of any other medicine; nor have I been difappointed in this expectation. The more T faw of the great powers of this plant, the more it feemed neceflary to bring the dofes of ‘it to the greateft poffible accuracy. I fufpected that: this degree of accuracy was not reconcileable with the ule of a-decodion, as it dependec not only upon the cate of ‘thofe who had the preparation of it, but it ‘eafy to conceive from the analogy of another plant of the fame natural order, the tobacco, that its ative properties might be impaired by long boil- ing. The decoétion was therefore difcarded, and the infufion fubftituted in its place. After this I be- gan to ufe the leaves in powder, but I fill very often aia the infifion, © | OF POXGLOVE. 5 fmall dofes of opium, fo as to reftrain its action on — the bowels. us In the fummer of the year 1776, 7 ordered a quantity of the leaves to be dried, and as it then became potlible to afcertain its dofes, it was gradu- ally adopted by the medical hia itoda in the cir- cle of 1 my acquaintance. In the month of Movember 1777, in confequence of an application from that very celebrated furgeon, Mr. Ruffel, of Worcefter, I fent him the following account, which I choofe to introduce here, as fhew- ing the ideas I then entertained of the medicine, and. how much I was miftaken as to its real dofe.— Bes | two ee will Eevee or Ere excite z a naufea. ‘* T have fometimes ufed the green leaves gathered in ‘* winter, but then 1 order three times the weight; ** and in one inftance I ufed three ounces toa pint = joven beiene:§ the defired effect took p: place I 6 INTRODUCTION ** more diftant dofes, fo that the flow of ufine has ‘* taken place without any fenfible affection of the ‘* ftomach; but in general I give it in the manner ** firft mentioned, and order one dofe to be taken “* after the ficknefs commences. I then omit all me- ** dicines, except thofe of the cordial kind are wanted, ‘* during the fpace of three, four, or five days. By ‘* this time the naufea abates, and the appetite be- ‘* comes better than it was before. Sometimes the ** brain is confiderably a affeéted by the medicine, and ‘ indiftin@ vifion enfues; but I have never yet * found any permanent bad effedts from it.”— =< I ufe it in the Afcites, Anafarca, and Hydrops ee Pedoris; and fo far as the removal of the water ** will contribute to cure the patient, fo far may be ‘* expected from this medicine: but I wifh it not to ** be tried in afcites of female patients, believing — * that pens of thefe cafes are dropfies of the ovaria: ee repeatedly in the fame. patient by repeating the — ** de ECC Oct Ot 5 but then eet at tach diftances Mt, dimana sndeed enjoiia aealadls: to drink s teeigeplénitfally of fmall Hiquors through the whole s a of the cure; and fometimes, where the eva- cuations have been very, fudden, I have found a “4 “bandage neceffary as in the ufe of the trochar.”— Early i in. the yeas: 1779). a number of dropfical ffered themfelves to my attention, the confe- quences of the fcarlet fever and fore throat which had raged fo very generally amongft us in the pre- ceding year... Some of thefe had been cured by fquills or other diuretics, and relapfed; in others, the dropfy did not appear for feveral weeks after the original difeafe had ceafed: but I am not able to mention. AwADY. nes having omitted to rahe, This laf circumftance encouraged me » to ufe the medicine more frequently than I had done hereto- fore, and the increafe of practice had eee me a iG improve the Pensioner of it. | exp perience 2 of the aesciet . 8 INTRODUCTION Stokes alfo tells me that Dr. Hamilton — “pat with it in the year 1781. I am informed by my y very see friend Dr. Duncan, that Dr. Hamilton, who learnt its ufe from Dr. Hope, has employed it very frequently in the Hofpital at Edinburgh. Dr. Duncan alfo tells me, that the late very ingenious and accomplifhed Mr. Charles Darwin, informed him of i ze being his father and myfelf, in cafes of Hydrothoray that he has ever fince mentioned ai in his leétures, ; and fometimes employed it in his practice. Cg crit lexivh, in the year 1783, it appeared in the _hew edition of the Edinburgh Pharmacopeeia, into which, I am told, it was received in confequence of : the recommendation of Dr. Hope. But from which, I am fatisfied, it will be again very foon rejected, if it fhould continue to be exhibited in the unre- Srained manner in | which it has heretofore been a | In the following cafes the teader will find other a difeafes befides been ae feveral cafes a ; o with ita 5 th her trial, for i i lowing. maniuferip: note at the article: penis Witten, I believe, by a Mr.. Saunders, who practifed for many years with great reputation as a furgeon and : aire Ropnlireiines in wee terfhire, ae “© Gon: enieniitons are fered infallibly by weak de- ion of Fi ye leaves in water, or wine and. ‘S water, < 5 deck for conftant drink. Or take of ** the juice of the herb and flowers, clar ify it, and ‘* make a fine fyrup with honey, of which take ‘* three fpoonfuls thrice ina day, at phyfical hours. ‘* The ufe of thefe two things of late has done, in - ‘* confumptive cafes, great wonders. But be cautious at ee: saiieorts, meas ot In : Bs * asthe F The precautions annexed to his encomiums of this medicine, lead one to think that he has fpoken from ‘his own pee prperieace. ; _Bhave lately teen het ES in —— 10 ' INTODUCTION, &. | travelling Yorkfhire tradefman. I found him incef- _ fantly vomiting, his vifion indiftiné, his pulfe forty — ina minute. Upon enquiry it came out, that his wife had ftewed a large handful of green Foxglove — leaves in half a pint of water, and given him het liquor, which he drank at one draught, in order to cure him of an afthmatic affection. ‘This good wo- man knew the medicine of her country, but not — the dofe of it, for her hufband narrowly efcaped ie se In which the Digitalis was given by the oe of the Joue 23775- ["™ rin’ in the courfe of this year that I began to ufe the Digitalis in dropfical cafes. The pa- tients were fuch as applied at my houfe for advice gratis. I cannot pretend to charge my memory with particular cafes, or particular etiedis, and I had not leifure to make notes. Upon the whole, however, it may be concluded, that the medicine was found ufefial «« or : thould : not have continued to siesta it a "Ce Ee Diceaker 8th. A man about fifty years Sai age, who had formerly been a builder, but was now much reduced in his circumftances, comsplained to me of an afthma which firft attacked him about the latter end of autumn. His breath was.very fhort, his countenance was funken, his belly large; and, up- on examination, a fluétuation in it was very percep- e — urine for. ened time 8 had Si all 12 Cra oS E98. 4776. about ten days he began to eat with a keen appetite. He afterwards took fteel amd bitters. eae yee 2 OCA 6 oe Es Fanuary 14th. A poor man labouring under an afcites and anafarca, was directed to take a decoction of Digitalis every four hours. It purged him fmart-— ly, but did not relieve him. An opiate was now ordered with each dofe of the medicine, which then ated upon the kidneys — freely, and - foon' - =a div hie complaints * 22 oo 2S So ee eee a CA 5 ee 1) Ses March 15th. A poor boy, about nine yea * : age, was brought for my advice. His countenance — was pale, his pulfe quick and feeble, his body great- ly emaciated, except his belly, which was very large, and, span apts sales contnineis a fluid. ane gob Mai CA S £&. &, 4776. 13 copious expectoration. On the 4th of June, Dr. Darwin,* was called to her. I have not heard what was then done forher, but, between the 15th of June, and 25th of Fuly, the Door, at his different vifits, gave her various medicines of the deobftruent, ‘to- nic, pee seein diuretic, and evacuant kinds. On the osth of July. I was defired to meet Dr, s Darwin at the lady’s honfe. I found her nearly in a flate of fuffocation; her pulfe extremely weak and irregular, her breath very fhort and laborious, her countenance funk, her arms of a leaden colour, clammy and cold. She could not lye down in bed, and had neither ftrength nor appetite, but was ex- tremely thirfty.. Her ftomach, legs, -and thighs were greatly fwollen; her urine: very {mall in quan- tity, mot more than a fpoonful at a time, and that eee ee See. eae to oe ioe “She had sient no o relief f Fonts any if magentlct had been ufed, except from ipecacoanha vomits ; the dofe of which had been gradually increafed fro mi5 to 4o grains, but fuch was the infenfible ftate ofher _ ftomach for the laft few days, that even thofe very large dofes failed to make her fick, and confequ ly purged her. In this fituation of things I kne of nothing likely to avail us, except the Digital but this I hefitated to propofe, from an : little could | abe. sepa from 14 GC-A S E.S 1776: difcredit a medicine which promifed to be of great — benefit to mankind, and I might be cenfured fora prefcription which could not be countenanced by — the experience of any other regular practitioner. — But thefe confiderations foon gave way to the defire — of preferving the life of this valuable woman, and — accordingly I propofed the Digitalis to be tried; — adding, that I fometimes had found it to fucceed — when other, even the moft judicious methods, ‘hae failed. Dr. Darwin very politely, acceded imme-~ diately to ‘my propofition, and, ‘as he had never, feen it given, left the preparation and the dofe ta stdin direttion. ° We therefore ee as follows: R. Fol. Digital. purp. recent. ziv. coque ex” Ag. fontan. pure fbifs ad Bi.” et cola. a ee Decoét. Digital. gifs.- Lae “Aq. Nuc. Mofchat. zi. M. ‘fiat. “haut. odis horis fumend. ) . a | si of Syoes: her to- ings; idagtis ai: -nyrdi addladiedel. and, if coftive, = with calomel and aloes, - =Dessbeke ape gave a ready affent. fe se: goth. This day Dr. Darwin faw: her, and ae rected a continuation: of the apadicins laft_pre- : pears ite a found the aaa canine free fom every appearance of dropfy, her breath quite © eafy, her appetite much improved, but ftill very weak. Having fome fufpicion of a difeafed liver, I directed pills of foap, rhubarb,. tartar of. vitriol, and calomel to be taken twice a — with ante oe Senghtos st i ; athe We ott oa patient eaten, ide re- peated the draughts dire@ed on the tis of Fem: with the addition of tinéture a ae Se | ed pills of aloes, guiacum, ‘and fal martis tobe ta ken if coftive. —— | ae September roth. From this time the management of the cafe fell entirely under my dire@ion, and perceiving fymptoms of effufion going forwards, I fo eee lpi ew | 16 GeA 3S EB S&S. 277: - It is now almoft nine years fince the Digitalis: was firtt prefcribed for this lady, and. notwithRanding I have tried every preventive method I could devife, — the dropfy ftill continues to recur at times; but is never allowed to increafe fo as to caufe much dif trefs, for fhe occafionally takes the infufion and re- lieves herfelf whenever fhe choofes. Since the fir — exhibition of that medicine, very fmall dofes have — been — found se to —— the flow — ; ouhdea Sash cemasaicdes in the neiseatiaeell : shid tafe? partly becaufe Dr. Darwin has related it ra- ther imperfectly in the notes to his fon's pofthumaus ; publication, trufting, I i imagine, to.memory, : partly becaufe it was a cafe whieh gave rife to a Ve- ry general ule of the medicine in that part of Shrop- Mare, oo. oe no het dh BSS he effary to ufe four’ ounces to the = | is she ee free from all tie compl: = ces ES 975: 17 . In O@ober 1777, in confequence of having pur- fued his intemperate mode of living, his dropfy re*» turned, accompanied by evident marks of difeafed ~~ vifcera. A decoction of two drams of Fol. Digital, ficcat. to a pint, once more removed the dropfy. He took ‘a wine glafs full thrice a day. Ls Fanuley 1778, . was dikeed to vifit ecediaia: I found he had gone on in his ufual intemperate life, his countenance jaundiced, and the dropfy coming on apace. After giving fome deobftruent medi- cines, I again directed the Digitalis, which again emptied the water; but he did not furvive mead weeks. HS 1977: ee Sebraagy —. ‘ass: Mo ee aie Siena ai anafarca, but not much otherwife difeafed, and well enough to walk about the houfe, and fee after her family affairs. I thought thisa fair cafe for a trial of the Digitalis, and therefore direded a de- _coétion of the frefh leaves, the ftock of dried ones “being exhaufted. About a week afterwards, —_ stead ot ele to poe Be aed _# = 18 CA 3S. £ SS. “17%, a the medicine been given in a cafe feemingly fo fae ‘vourable as this, and had the patient died under its” ufe, is it not probable that the death would have ra been attributed to it? 44 CAS VIL. Fehtuars Lith. Mr. E —- w- Et 6s § Hydrothorax,. afcites. and anafarca, confequences of 7 - rinki He had been attended for fom : ‘time ae a | phyfician i in his neighbourhood, “who had ; treated his cafe with the ufual remedies, but. with- : out affording him any relief; nor could I expect | to fucceed better by any other medicine than the Digi talis, The dried leaves were not to be had; and the green ones at this feafon being very uncertain in their ftrength, Tl ordered four ounces of the roots in a pint decoétion, and dire@ed three {poonfuls to oe gress fourth hour, ysl it sither a -increafed agai but he had fufered fo fo mk rc -ther willing. to lest nor ts to gives the fame. we me i again. = exhaps Sie. patient es <— om Sool if been well acquainted with the ees Cc mn S$: Ee 1777. 19 real dofes of the medicine, which was certainly in this inftance made very much too ftrong; and not- withftanding the caution to {topthe further exhibition when certain effects fhould take place, it feems the ¢ quantity previoully fwallowed was fufficient to diftrefs him excee y- Co--A SE VU. March 11th. Mrs. H , &t. 32. A few days after a tedious labour, had her legs and thighs fwelled to a very great degree; pale and femi-tranf- parent,* with pain in both groins. After a purge of calomel and rhubarb, ung. merc. was ordered to be rubbed upon the ieee and the sete Gecomion was cnt er | ‘R Fol. Dig purp. recent. B 3 AGE cinn. -f62 ae eer oe egg parv. bis quotidie. The decoétion prefently increafed the fecretion of urine, and abated the diftenfion of the legs: in a fortnight the fwellin#was gone; but fome days — ae her oe her legs fwelled again: about “of the ¢ decoftion on the auf of April. ties 20 GIA SES Se 2977 GAS 2k IX. March 29th. ° Mr. G » Lat. “AF wes 4 much deformed ; afthma of eee years conti ance, but now dropfical to a great degree. oT feveral medicines without Saher and then tried sr Digitalis, but with no better fuccefs. | ooh bs Ba," X- Apt = © Si cane At. 70. Afthmaand etre: ‘Took a ‘decoétion of the frefh leaves the Digitalis, which produced violent ficknefs, Bt no immediate evacuation of water. After the ~ nefs had ceafed altogether, the urine bs to flor ; copioutly, and he was cured. ae c AS iE xt “e a. ede: ae Mr. M= i | . hie OF alt the. dates water. Indee evacuation was fo rapid’ and fo complete, = “came es, to apply a =— guest be CaaS. £ 8.277%. 21 In fomething more than a year and a half, his dropfy returned, but the Digitalis did not then fucceed to our wifhes. In Augu/l, 1779, he was _tapped, and lived afterwards only about five weeks. For more pat iculars, fee the extradt of a letter ~ fom Mr, ibe. 5 : CoA So 2 XE Soe September 12th. -Mifs C of T- , 42t. 48. An ovarium dropfy, and anafarcous legs and thighs. For three months in the beginning of this year fhe _ had been under the care of Dr. Darwin, Who at. _ different times had given her blue vitriol, elat Tium, and calomel; decoétion of pareira brava, and guia- _ cum wood, with tindure.of cantharides ; oxymel of fquills, decoction of parfley roots, &c. Finding no. relief, fhe difcontinued the ufe of medicines, until the urgency of her fymptoms indiced her to afk. my advice about the end of Auguff. She was great- ly emaciated, and had almoft a total lofgof appetite. I firft tried {mall dofes of Merc. fublim. corr. in folution, with decoétion of burdock roots, and blif. ters to the thighs. No advantage attending the ufe of this plan, I dire&ted a deco@ion of F Digit. a dram and half to a pint; one ounce t taken twice aday.. It prefently reduced = ee cous fwellings, but made no alteration in fion of { abdomen. — Re pecs 22 C#£-S EB S82 i. C.. fiz S sk XIII. Oéfober oth. Mrs, B———, At. 40. An ova- — rium dropfy. Took a decoction of Digitalis without effect. Her life was preferved for fome years we repeated tapping. . : 1778. “3G: A-S-8 2 XIV. | : February 8th. Mr. R of Ka, Hale formerly fuffered much from gout, and lived very 4 intemperately. Jaundiced countenance ; . afcitess — legs and thighs greatly fwollen; appetite none; €x- _ tremely weak ; confined to his bed. Had taken — many medicines from his apothecary without advan- _ tage. I ordered him decoction of Digitalis, and @ . cordial; but he furvived only a few days. : fmall face oe coloured ; cough almoft ie O . of feneka was diredted, and {mall dofes Dover's poeeem at night, 3 3 a7. Gum-ammoniac and fquill, ‘with elixit gor. at night—e6th, Squill and decoction of © nek cuts, His complaints ftill increafing, de- — CASES i778 23 coction of Digitalis was then directed, which relieved him in a few days; but his complaints returned | ga and he died in the month of June © CASE XVI. Auguft 18th, Mr. Boney Zt. 33. Pulmonary. confumption and. dropfy. ‘The Digitalis, and that failing, other diuretics were ufed, in hopes of gain- ing fome relief from the diftrefs occafioned by thé ~ dropfical fymptoms; but none of them were effedu- - al. He was then attended by another phyfician, Z and died in about two months. ¢ 2 orien Gade §. Bean BULL. e. September oft. Mrs. M- — W— G— ie: = Zt. 50. An ovarium aroply. She took hala pint : of Infut. Digitalis, whi rer f did relieved: Be tapping. — aes CAS E- Xvi. Odober 28th. R—— W——, At. 33. Sa and univerfal anafarca ; ‘eouhtentmce quite pale and bloated ; appetite none, and the little food he forces at is s generally aaseem . s R. Fol. Dig Pep. ficcat. siti. © November ift. Sunday, 24 CA. 8.5 S&: 1778. He was directed to take one ounce of this infufion — every two hours until it fhould make him fick, This was on Wednefday. The fifth dofe r ade him vomit. On Thurfday afternoon he vomited 3 again very freely, without having taken any more — of tne medicine. OnF tiday and Saturday he made 4 more water than he had done for a week before, and the f{wellings of his face and body were con- — fiderably abated. He was directed to omit all medi- & ~ cine fo long as the t urine continued to flow freely, “and alfo to keep an account of the quantity he made ‘a 2 in twenty-four hours.. eae Thefétwere his reports. Oélober 31Mt.."Saturday, — 2d. Monday, 8 gd. Tuefday, See 4th. Wednefday, sth. Thurfday, Wednefday he wags to pee and ‘the ftill continues, but his appetite is bette hethas known it for a long time. No fwelling remains but about his ancles, extending at | nigh half way 1 up his legs. — Omit all medicines at prefent. 5 3 7th. Saturday, 7% half ints. 8th. Sunday, ~ soe gth. Monday, 62 ~~ toth. Tuefday, 65 ~~: eer A, 11th. Wednelday; “6 == 22 eth. Thurfday, 65 C A S ES. (1979. 25 On Tuefday the 17th, fome {welling ftill remain- ed about his ancles, but he was in every siege re- fpect perfectly — He took a tow more = dota of the infufion, and no ~ other medicine. — GC AS E° XIX. December 8th. W: B , &t. 60. A hard drinker. Difeafed vifcera; afcites and anafarca. An infufion of Digitalis was directed, but it had #9 no other effe@ than to ee him fick. = 1779. oie - In the beginning of hs yarn had many dp fies go childven whoa: fuffered fro cali, but 3 in “fede ie medicine it did not prove diuretic, nor did it remove the - dropfy until opium was joined with it, fo as to pre- vent it purging. I did not keep notes6f thefe _ cafes, but I do not recolle& a fingle inftance: in which the Digitalis failed to — a cure. aS ASR RE: ee tery dit- Z ulnefs ef pe tO 26 = # S..E 3S, 1779s He had taken various inédicenaite and been bli- tered, but without relief. His complaints continu- ing to increafe, I dire&ted an infufion of Digitalis, which made him very fick; acted powerfully as a | diuretic, and removed all his fymptoms. . About three months afterwards he was out upon a journey, and, after taking cold, was fuddenly - feized with difficulty of breathing, and violent pal- pitation of. his. heart: -he fent for me, and I ordered 3 the infufion as before, which very foon removed his complaints. He is now active and well ;. but, ES whenever he takes cold, finds fome return of difficult. ee breathing, which he foon removes by a dofe or two of the oS G A S -E. — XXT, 4 "January 5th. Mrs. M——, ‘Et. 69. “Hiyditho- Tax, (called atime) afcites. and anafarca. I di = ft it néceflary to order cordial, ee es and. a large blifter to her back. Mr. Ward, who . attended as her apothecary, tells me fhe had fome return of her afthma in June and Odober following, which was each time removed by the re ak eos GA, SeeB. 8. 1p79, 27 CA S 2-2] January 11th. Mr, H , Et. 59. Afcites and general anafarca. A large corpulent man, and. a hard drinker: he had repeatedly fuffered. under complaints of this kind, but had been always re- lieved by the judicious affiftance of Dr. Afh. In the prefent inftance, however, not finding relief as ufual from the prefcriptions of my worthy friend, he fent for me ; after examining into his fituation, and informing myfelf what had been doneto relieve him, I was fatisfied that the Digitalis was the only medi- cine from which I had any thing to hope. It was therefore dire&ted; but another patient requiring my affiftance at a diftance from town, I defiredhe _ would not begin the medicine before I returned, which would be early on the third day; for I was well aware of the difficulties before me, and that _ he would inevitably | fink und % - ation of the water. On my return I aeetiod, that the preceding evening, as he fat on his chair, his head funk upon his breaft, and he died. This cafe, as well as cafe VI. is mentioned with a view to demonitrate to younger practitioners, how fudden and t baa d the deaths of dropfical aa 28 — WER SE CS, 17795 ing calomel, faline draughts, jallap purges, chryftals * of tartar, pills of gum ammoniac, {quills, and foap, fal fuccini, eleterium, &c. infufion of Digi- talis was direéted, which removed all his urgent: fymptoms, and he recovered a pretty good ftate of health. ei CANSS Ris ERI; September 11th. I was defired to vifit Mr. L——, #t. 63; a middle fized man; rather thin; not ha- bitually intemperate ; found him in bed, where he had been for three days. He was in a ftate of furi- _ ous infanity, and had been gradually lofing his rea- fon for ten days before, but was not outrageous the firft week: his apothecary had given him ten grains of emetic tartar, a dram of ipecacoanha, and an’ ounce of tincture of jallap, in the fpace of a few hours, which fearcely made him fick, and only oc- afioned a ftool or uiring i be was often obliged to fit up cand, for the laft year eat, when he lay — _ the greater part the fenfe of fuffocation was | down, that he often fat up for a eek together. His father died of an afthma before he was fifty. A few ; years ago, ake an eleQion, where ; he drank more o _ than ufual, his head was affe@ed as now, but in Ae now, notwithftanding he has been feveral gu days on Es £1779- 29 days in bed, he feels mot the leaf difficulty in breathing. Apprehending that the infanity nigh teaiuing to the fame caufe which had heretofore occafioned the afthma, and that this caufe was water; I ordered a decottion of the Fol. ficcat Digital. three drams to half a pint; three fpoonfuls to be taken every third hour: the fourth dofe made him fick; the medicine was then ftopped; the ficknefs continued at inter- vals, more or lefs, for four days, during which time he made a great quantity of water, and gradually became more rational. On the fifth day his appe- tite began to return, and the ficknefs megs but ue dioye = urine dete ee mitting him to ie dowit i in bad without 3 inconveni- ence, makes plenty of water, coughs a little, and expectorates freely. He took no other medicine, except a little rhubarb when coftive. September 15th. Mr. J. R——~, Et. 50. Su to: an -afthmatical —— for more —— 30 CuA SS E-S& a7 with vin. chalyb. and at bed-time pil. ftyr. and _ {quill. His complaints increafing, the {quill was pufhed as far as could be borne, but without any good effect. September 15th, an infufion of Digitalis hd was direéted, but he died the next morning. : GC TASS ok - Sa y ._ September 18th. Mrs. R——, Et. 30. Aftera — fevere child-bearing, found both her legs and thighs 4 {welled to the utmoft ftretch of the fkin. They _ looked pale, and almoft tranfparent. The cafe be- 2 ing fimilar to that related at No. VIII. I determined _ upon a fimilar method of treatment ; but as this 1 pes tient had an inflammatory fore throat alfo, I wifhed — to get that removed firft, and in three or four days _it-was done, _ I then-dire@ed. an infufion of Digi- talis, which foon increafed the urinary fecretion, and reduced the fwellings, without any difturbance iat bet gflomach, eee Bog of, fwelling in her legs re ned, which was Gare: By calomel, an opeaig : “0 aeber es niet See a Eutie: doin, ee “fpine-and thorax greatly. eT “a year — _— ‘complain CHA SF Fs 1779. 31 -and a flu@uation in it became perceptible. He had no anafarca, no appearanice of difeafed vifcera, arid no great paucity of urine. Purges and diuretics of different kinds affording him no relief, my affiftance was defired. After trying fquill medicines without effect, he was ordered to take Pulv. fol. Digital. in fmall dofes. ‘Thefe producing no fenfible effect, the dofes were gradually increafed until naufea was excited; but there was no alteration in the quantity of urine, and confequently no relief to his com- plaints. I then advifed tapping, but he would not hear of it; however, the diftrefs occafionéd by the increafing fulnefs of his belly at length compelled him to ea to the PY aah on abe a of mM - March the oth. During the intervals, no method T could think of eer omitted to prevent the return of the difeafe, but nothing feemed to avail, In the gage of February 234, his ftrength was fo much reduced, ~ that the water was not entirely removed ; ; and 0 ‘the th of. — a his pace ialf empti 32 CA SOE 2S. 2.1970, enfued, and violent vomiting; thefe vomitings con tinued through the night, and in the intervals he lay in a ftate nearly approaching to fyncope. The next day I found him with nearly the fame fymp- toms, but remarked that the quantity of fluid he had thrown up was very much more than what he had taken, and that his abdomen was confiderably fallen; in the courfe of two or three days more, he difcharged the whole of the effufed fluid; his ftrengtl and appetite gradually returned, and he was in _reff ec ; much better than he had been before Taft operation. Some time afterwards, his belly saint to again, and he again applied to me; upon ana rate examination, I judged the quantity of might then be about four or five quarts. Na had pointed out the true method of cure in cafe; I therefore ordered him to bed, and dir meena x vomits to ne ‘given night and x morni g CH SE 2 1580, 33 (1780. G 423.2 XXvual see Fanuary 11th. Captain V-——, At. 42. Had | fuffered much from refiding in hot climates, and» drinking very freely, particularly rum in large quan- tity. He had tried many phyficians before I faw him, but nothing relieved him. I found him greatly emaciated, his countenance of a brownifh yellow; no appetite, extremely low, diftreffing falnefs acrofs his ftemach; legs and thighs greatly pratiens pulfe quick, and very: feeble; urine in A few Toh occafioned a copious ‘flow of urine, without ficknefs or any other difturbance. The me- dicitie was difcontinued ; and the next day the urine continuing to be fecreted very plentifully, he loft _ his moft diftreffing complaints, was in great fpirits, and ate a pretty good dinner. In the evening, as he was converfing chearfully with fome friends, he ftooped forwards, fell from his chair, and died in- ftantly. Had he been in bed, I think — fon to believe this fatal fyncope, _if if fuch it ° would not have ee: fetoe es | 34° Gi S.2E. Su: wgSis CG A SE . > XXIX. ere ee Gt ; Mr. H > et. 63. fee sls tat yea or two had formed very iinperfedlly He saee now piagees a water in 2 his: chef, | or moved by the fame medicine. Bitters and tor were. all occali nee bashes but his: deb ers sth “Ts was def red oe GA SE S 178s. | 35 gree; pale and femi-tranfparent. I found her ex- tremely faint, her pulfe very {mall and flow; vomit- ing violently, and frequently purging. She was at- tended by a gentleman who had feen me give the Digitalis in a fimilar cafe of fwelled legs after a lying- in (fee Cafe XXVI.) about fix months before. He had not confidered that this patient was delicate, the other robuft; nor had he attended to ftop the exhibition of the medicine when its effe@s began to take place. ‘The great diftrefs of her fituation was evidently owing to the imprudent and unlimited ufe of the Digitalis. I was very apprehenfive for her fafety ; ordered her cordials and volatiles; a free fupply of wine, chamomile tea with brandy for common drink, and blifters. The next day the fitu- ation of things was much the fame, but with all this difturba: ce no increafed fecretion of urine. The fame methods were continued ; an piabeordiee at night, and liniment. volatile upon flam »plied to groins, as fhe now complained of ¢ great pain in thofe parts. The third day the naufea was lefs urgent, the yomitings lefs frequent, the pulfe not fo flow. Camphorated fpirit, with cauftic volatile alkaly, was applied to the ftomach, emulfion given for common drink, and the fame medicines repeated. From this time, the intervals became gradually longer ie tween the fits of vomiting, the flow of arin 36 ok ee S. 1780. C8 A282 5B Seen: March 16th. Mr. D——, &t. 70. A paralytic ftroke had for fome weeks paft cane the ufe of his left fide, and he complained much of his biceiie and of a ftraitnefs acrofs his ftomach; at length, an anafarca and afcites appearing, I had no doubt as to the caufe of the former fymptoms; but, upon ac- count of his advanced age, and the paralytic affec- _ tion, I hefitated to give the Digitalis, and there- | _ fore tried the other ufual modes of practice, until — at length his breath would not permit him to lie _ down in bed, and his other fymptoms increafed fo — rapidly as to threaten a fpeedy diffolution. In this a dilemma I ventured to prefcribe an infufion of the — Fol. ficcat. Digital. which prefently excited a copious | : flow of eine: and made him very fick; a ftrong — infufion of chamomile flowers, with brandy, relieved _ the ficknefs, but the diuretic effects of the Digitalis SeSauting.t his Healy Mass removed, and hi : te bine luc He web th = wy, return of the ar a XXXII. Nae 18th. “Mit Sea Rt. $: Aydin fis internus. As the cafe did not yield to calomel, when matters were nearly advanced. to extremities, it occurred to me to try the Infufum Digitalis; 2 tes few ficfes of which were given, but had no fenfible 2 C A S E S 1780. 37 CASE XXXIV. - March 19th. A young lady, foon sites the birth of an illegitimate child, became infane. After be- ing near a month under my care, fwellings of her legs, which at firft had been attributed to weaknels, extended to her thighs and belly; her urine became foul, and {mall in quantity, and the infanity re- mained nearly the fame. As it had been very dif- ficult to procure evacuations by any means, I or- dered half an ounce of Fol. Digital. ficcat. in a pint infufion, and directed two fpoonfuls to be giv- en every two hours: this had the defired effect; the dropfy and the infanity difappeared together, and the had afterwards no o other oetiene pre feaoe April 10th. Mr. R——, Et. 32. For the laft three or four years had had more or lefs of what — was confidered as afthma;—it appeared to me Hy- - drothorax. I dire@ed an infufion of Digitalis, which prefently removed his complaints. In June following he had a relapfe, and took two grains of the Pulv. fol. Digit. three times a day, which cured — him after taking forty praitis,, and he has ne 38 Goa Se Ke te span GC AL SE XXXVI. May 15th. Mrs. Ho——, At. 40. A fpafino- dic afthma, attended with fymptoms of effufion. An infufion of Digitalis relieved her very confide _ ably, and fhe lived four years afterwards without — any relapfe. ts A Ss ee ‘May 86. 2 = Tous, confumptive, aS at aah asctres “Fook Infuf. Digital. without advantage. Died the Fuly — following. : c A S$ E XXXVUL June 4th. Mrs. S——, of W Ke oy Afcites and anafarca. Had taken many are 3 : firft from her speerany afterwards by the direc: : ne be 5 gate ae the Infaf. ee which | = ina . few days nearly removed the dropfy. I then ‘Zz __ left her to the care of her phyfician; but her con- = fiitution was too much impaired to admit of reftor- ee Cx S* Ee Sz = | 39 C26 OE XXXMK. sais Fune 13th. Mr. P———, 't. hy hard drinker, was attacked with a fear hewopiee: which was followed by afcites and anafarca. He had every appearance of difeafed vifcera, and his urine was fmall in quantity. The powder and ihe infufion of Digitalis were given at different times, but without the defired effet. Other medicines were tried, but in vain. Tapping prolonged his exiftence a few weeks, and he died early in the following autumn, remedies, "e took ike infufion ot three dofes made him very fick; but ie oigh his breathing relieved. After one week he took it ‘ again, and was fo much better ; as to want no other medicine. se we | In the ee the lowing winter he e ae 40 GcA S&S: Es & 2788: lie down. After a trial of fquill, fixed alkaly, and 4 dulcified fpirit of nitre, I directed Puiv. Digital. — gr. 2, thrice a day. In four days he was able to ~ come down ftairs; in three days more no appearance _ of difeafe remained ; and under the ufe of aromatics and {mall dofes of opium, he foon recovered his ftrength. eo oC Soe Fuly 7th. Milfs H— of T— the laft fi of a phthifis Glegerttis became dropfi- cal. She took the Digitalis without being relieved. Goa 8-8. &Lirr. “uly gth. Mrs. F , Et. 70. A chear- ful, ftrong, healthy woman; but for a few years — - back had experienced a degree of difficult breathing _ when in exercife. In the courfe of the laft year her ee & {welled, and fhe felt sate fulnefs saat her - a very | sts Spoons to solve her. The — more regular p er failing to a quack, who I believe nied. her very powerfully — with Daphne laurec kind. I found her greatly reduced in ftrength, her _ belly and lower extremities fwollen to an amazing — ~ fize, her urine fmall in quantity, and her appetite. | y impaired. For the firit fortnight of my 2t- e blifters were applied, folution of fixed scodtion of feneka with vitriolic se i , fhe had recourfe — 1, or fome draftic purge of that chryftals of tartar, {quill and cordial ‘medicines were fucceflively exhibited, but with no advantage. ae | then directed Pulv. Fol. Digital. two grains’ every four hours. After taking eighteen grains, the urine began to increafe. The medicine was then Rtopped.. The difcharge of urine continued to incréafe, and in five or fix days the whole of the dropfical water paffed off, without any difturbance to the ftomach or bowels. Ass the diftenfion of the belly had been very great, a fwathe was applied, and drawn gradu- ally tighter as the water was evacuated. As no pains were fpared to prevent the return of the dropfy, and as the beft means I could devife proved unequal to my wifhes, both in this and in fome other cafes, I fhall take the liberty to point out the methods I tried at different times in as concife a manner as pofible, for the knowledge of what will not do, eee fometimes affift us to SINGERS what wil. FOO oo are Fuly 18th. Infufum amarum, fteel, ie water. September 22d. Neutral faline byt ae with tind. -canthar. 26th. Pills of foap, garlic and mill goth. The fame pills, with infufum amarum. Oéober 11th. Pills of aloes, affafetida, and fal mar-_ tis, in the day-time, and mony rubbed. pac: : at night. te December aif. The accumulation of water aig uired a repetition of the Di zs = reéted in ir infufion, a dram andhalfto 2 and an ounce and cot given e 42 OA Sx EX Sh 2298, until its effects began to appear. The water was — foon carried off, ‘ goth. Sal diuretic. twice a day. To eat prefered garlic frequently. a 1 Bs moniac. 3d. Infufion of Digitalis repeated, and after the — | water Was carried off, Dover's owder | was s tried Hae itera? eae = 4 “March 18th. Tufut. Digital. Sneed as ‘26th. Pills of fal martis and aromatic aad with — ~ infufum amarum. : “May 5th. Being feverith; James's powder 2nd i ~~ faline draughts. ~ a oth. Laudanum every night, and an “opening : tin@ure to obviate coftivenels. ; 24th. Infuf. Digitalis, one ounce only every fourth : _ hour, which foon pesos a perfect evacuation 2 ofthe water, at . a ; ug 5 ith. © aafat Digits Digi rital her 23d. An emetic—Pills of — sn gum a aad in ev ery bers at ait yrup cae A blifter to the back. qth. ‘Tindure CH SPESSS igios 43 4th. Tinéture of cantharides and paregoric elixir. 28th. Infuf. Digitalis, half an ounce every morn- ing, and one ounce every night, was Ben: cient to empty her. March 26th. Infuf. Digitalis ; and when emptied; vitriol of copper twice a day. — | April 1. A cordial mixtute for occafional ufe. .; Two months afterwards a purging came on, which every now and then returned, inducing great weaknefs—her appetite failed, and fhe died in in July. INTERVALS. From Fuly oth, 1780, to Deceinber aif, 171 days. From December 21ft to February 3d, 1781, 34 ene From February 3d to March 18th, 44 days. From March 18th to May 24th, 66 days. ee Oe From May 24th to Auguft 1 Tith; . 79 da ee See i From Auguft 11th to November 16th, 98 days. — From November 16th to January 28th, 1789, 74 days. From January 28th to March 26th, 57 days. None of the ee te of water were at all equal to that which exifted when 1 firft faw her, for finding fo eafy a mode of relief, fhe became impa- tient Bader: a fall sai of age and 44 C2A- 5S cE 38> 1520. CA Se XLIV. July 12th. Mr. Ht , of A , 4Et. 60. In the laft ftage of a life hurried to a eS by free living, dropfical fymptoms became the moft — diftrefling. He withed to take the Digitalis. It was given, but afforded no meties: i eee XLV. July 13th. Mr. S——, t- 49. Afthma, or rather hydrothorax, ahalarci. and fymptoms of a difeafed liver. He was directed to take two grains of Puly. fol. Digital. every two hours, until it pro- duced fome effe&. It foon removed the dropfical — and afthmatic affections, and fteel, with Seltzer wa- _ ter, reftored him to health. “C: A S.B... M1 Vee Auguft 6th. Mr. L——, Ait. 35. Afcites and : anafarca. = eae grains —_ a ees every eects direed't to ke folution of merc. fublimat. and foon recovered his health and ftrength. 7 “CAS EB. XLVI. Auguft 16th. Mr. ae of W——., At 86. e _ Afthma of many years duration, and lately. an in- cipient anafarca, with a paucity of urine.. He had — __ ever lived intemperately, was of a chearful difpo- 3 | ae 3 and very fenfible: for fome years back sp eS alls ae ee GA BS ES Be 1780: 45 loft all relifh for animal food, and his only fupport had been an ounce or two of bread and cheefe, or a {mall flice of feed-cake, with three or Soue-gints of mild ale, in the twenty-four hours. After: i ing chryflals of tartar, fixed alkaly, fquills, &e, I direéed three grains of Pulv. fol. Digital. made into pills, with G. ammoniac, to be given every fix hours; this prefently occafioned copious difcharges of urine, removed his fwellings, and reftored him to his ufual ftandard of health, oe Se Sa See XLVIIL. Auguft 17th. T B , Efg. of K- ft. 46. Jaundice, dropfy, and great hardnefs in the region of the liver. Infufion of Digitalis carri- ed off all the effufion, and afterwards a courfe of | deobftruent and tonic medicines noses — other | complaints. — : et ua CFs Ee ae Auguft 23d. Mr. C——, Et. 58. (The perfon mentioned at Cafe XXIII.) He had continued free from dropfy until within the laft fix weeks; his ap- petite was now totally gone, his firength extremely _ reduced, and the yellow of his jaundice changed a blackifh hue. The Digitalis was now tried in and he died Rey, afterwards. 46 CA Ss. Ec Sic 3980. to atertian ague. Three grains of Puly. Digitalis, given every fourth hour, occafioned a very copious flow of urine, and fhe gat well without any other — medicine, : axe | SAS fa ? ~ Auguft 28th. Mr. J H—, At. 27. In confequence of very free living, had an afcites and fwelled legs. I ordered him to take two grains of Fol. Digital. pulv. every two hours, until it pro- duced. fome. effec ; a few dofes caufed a plentiful fecretion of urine, but no ficknefs, or purging: in- fix days the fweilings difappeared, and he has fince remained in good health. - CASE LI. September 27th. Mr. S , Et. 45. Had been long in an ill ftate of health, trons what had been — fuppofed an HL) Sid Boat, was 8 greatly emaciated, ee Li rt! feurity: hae I fafpeBed - the poifon of lead, and was ffrengthened in this — fufpicion, ‘upon finding his wife had likewife ill health, and, at times, fevere attacks of colic; but — the anfwers to my ‘enquiries feemed to prove my re esis ieee ‘and, oe other eS a at gic to Se lungs stake: ei alo ; : ig ee of pale fwelling in his legs. '?p : le CA Ss E Se 498q,. 47 fol. Digital. made into_ pills, with gum ammoniac and aromatic fpecies, foon relieved his. breathing. : Attempts were then made to affift him i in other re- {pects, but with litile good effect, and fome months afterwards he died, with every appearance of a worn cut conta union. About t two ion after this gentleman's death, I was talking toa pump-maker, who, in the courfe of con- verfation, mentioned the corrofion of leaden pumps, by fome of the water in this town, and inftanced that at the houfe of Mr. S——, which he had re- placed with a wooden one about three years before. ‘The lead, he faid, was eaten away, fo as to be very thin in fome places, and full of holes in others ;— this accidental Jalesmation Reems the pees. a for in fome oti by sae : fhall fuffer from it, whilft the reft receive it with impunity. In the fpring of the year 1776, I was defired to vifit Mrs. H. ; of §—— Park, who Z had repeatedly been attacked with painful colics, and had fuffered much from infuperable coftiver 1 I fufpected lead to be the caufe of her complai but was unable to trace by what means it was tak She was relieved by the ufual methods; bu iths afterwards, I was defired to fe h her fuf fferin tes were the fame as s be fore | uefs, | the was n never in erfe 48 CA S bee. efcaped fevere attacks twice or thrice ina year; fhe — had alfo frequent pains in her joints. I could not — find any traces of fimilar complaints either in Mr.. — H ; the children, or the fervants Mrs. H——_ was a water drinker, and feldom tafted any fer- mented liquor. The pump was of wood, as I had ier been informed upon my firft vifit. Her health con - tinued nearly in the fame ftate for two or three years more, but fhe always found herfelf better if the left’ her own houfe for any length of time. At length it — occurred to me, that though the pump was a wooden — one, the pifton might work in lead. I therefore — - ordered the pump rods to be drawn up, and upon — examination with a magnifying glafs, found the leather of the pifton covered with an infinite num-_ ber of very minute fhining particles of lead. Per- — haps in this inftance the metal was fo minutely — divided by abrafion, as to be mechanically fufpend-~ ed in the water. The lady was directed to drink — the water ‘of a {pring, and never to fwallow that — from n the pump. The- ‘event bos naaemap ro og : ) this i: had aya attack sacs pole. SOAS. E “LI. September 98th. Mrs. J— 7a - Afeites : and very thick siaistesin legs an Paid total lof of ftrength and appetite: Infufion of Digitalis was | maven, but, as had been a Bet no (AS ES arf gi CASS Ee September 30th. Mr. A » et. 57- A ftrong man; hydrothorax and fwelled or ; in other ref- pects not unhealthful. He was direéted to take two grains of the Pulv, fol. Digit. made into a pill with gum ammoniac. Forty grains thus taken at intervals, effected a cure by increafing the quantity of urine, and he has had no rela apfe. EDS wep & LV. November 2d. Mr. P—— of T——, £t. 42. -A very ftrong man, drank a great quantity of ftrong ale, and was much expofed to alterations of heat and cold. About the end of fummer found himfelf~ fhort winded, and loft his appetite. The dyfpnea gradually increafed, he. got a moft diftreffing fenfe of tightnefs acrofs his tomach; his urine was little, and high coloured; and iis. legs b egan to fwell; his pulfe flender and feeble. From the goth of Sep- tember I frequently faw him, and obferved_a gradual and regular increafe of all his complaints, notwith- flanding the ufe of the moft powerful medicines rT could prefcribe. He took chryftals of tartar, feneka, gum ammoniac, faline draughts, emetics, tin cantharides, fpirits of nitre dulcified, fquills forms, volatile alkaly, calomel, Dover's ke. lifters and drattic purgatives eT erpe of ftee 59 Cukse S: Eb S$22.3fn. At length I was compelled to it, and dire&ed one grain to be given every two hours until it {hould — excite naufea. This it did; but, as I expected, it did no more. The reafon of this belief will be — mentioned hereafter. Five days after this laft trial I gave himaffafetida in large quantity, flattered bya ’ - hope > that his extreme fufferings from the ftate of his refpiration, might perhaps arife in part from fpafm, but my hopes were in vain. I now thought of ufing — an infufion of tobacco, and sd se the follow- & Fol. ous indif. zi. _ Ag. bull. Ibis, = 8p. Vini reaif. az digere per horam. _ A directed a fpoonful | of this to be given every two. hours until it fhould vomit. This medicine hadi no talis in pills, with gum ammon- ium being added, that effeé nied to to be Sage Spee them as purged him, , _ ceafed, and he long as he iver — GU A> S° ES... 1582 51 CA. S-E. -Eay November 16th. Mrs. F , At. 53. = Auguft \aft was fuddenly feized with epileptic fits, which continued torecur at uncertain intervals. fier: belly had long been larger than natural, but without any perceptible flu@tuation. Her legs and thighs {welled very confiderably the beginning of this month, and now there was evidently water in the abdomen. ‘The medicines hitherto in vain dire@ed againit the epileptic attacks, were now fufpended, and two grains of the Pulv. fol. Digital. dire@ed to be taken every fix hours. ‘The effe&s were moft favourable, and the dropfica! fymptoms were foon removed by a urinary difcharges, The attacks of epilepfy ceafed foon afterwards. In February, 1781, there was fome return of ie ” fwellings, which were foon removed, and fhe : . enjoys very good health. Does not the narrz of this cafe throw light upon the nature of the epi- lepfy which fometimes attacks women, foon after the ceffation of the menftrual flux ? 1781. -G A SE LVI. semen, 1. Mis. C——, of H—, ‘ Pym rE: ordered her to take one on of Pulv. ee CU. cA 5 sk 2S, 1781. Digital. every fix hours, but it produced no effect Other Medicines were then“ttied to as little p pofe. About the end of February, I directed infufion of the Fol. Digital. but with no better fue cefs. Other methods were thought of, but none proved efficacious, and fhe died a few weeks afte jallap, was ¢ ‘detest ae 2 of Digital: acted Kindly? us a diuretic, and greatly reduced he fwellings. « Other mc-licines were then adminifle ed, with a view to her other complaints, but to 1 . pos. — fhe died about a month afterwards. eS s E. LK. oe S Jonuary. 14th. Mr. B- —~ 0 D im ee Sriicc falts, Souk a | without reliefs, Tnfutum Dig LF aon: od. Ts was defzed by the Ie aig CAS ES 121 53 young lady in the laft ftate of € maciati dropfy. Every probable means to reliey been attempted by Dr. Groome, but to n pofe; and fhe had undergone the operation of t =. paracentefis repeatedly. The Doétor knew, he faid, : that I had cured many cafes of dropfy, by the Di- gitalis, after other more ‘ufual methods ‘had been attempted without fuccefs, and he wifhed this lady to try that medicine under my direction ; ‘after exa- mining the patient, and enquiring into the hiftory of the difeafe, I-was fatisfied that the drapfy was encyfted, and that no’ medicine could avail. The Digitalis, however, was directed, and fhe took it, | but without gvaniage She had determined 1 not to the patient afterwards let it out Hertel? from time to time as the prefliire of it became froublefome, un- =, eet at seas ead exlraufied. ea BAS: there not a ptobability thet this tm se patie oa Be ufed, foa eS ow ger 54 CoA S&S -& 8 ep. diforders, at length became dropfical. The Digita~ — lis was given in fimall dofes, in hopes of temporary benefit, and it did not fail to fulfil our expectations. oe kh S LXIII. March 16th. Mrs. P , it. 47. Great de- bility, pale countenance, lofs of appetite, legs fwelled, urine in {mall quantity. A dram of Fol. ficcat. Di- gital. in a half pint infufion was ordered, and an ounce of this infufion directed to be. taken every morning. Myrrh and fteel were given at intervals. ‘Her urine foon increafed, and the ‘yap. of _ dropfy difappeared. 3 C#-S° ELE: March 18th. Mr. W. , in the laft ftage ofa pulmonary confumption became dropfical. Brice : = ate was given, but it ax BY good eee a 2 “April 6 6th. Be —— Ft. 63, For i years back had complained of being afthmatical, — and was_ not without fufpicion of difeafed vifce- S . ra. The Taft. winter he had been moftly ¢ col ifine = to his houfes became dropfical, loft his appetite, and his fkin and eyes turned yellow. By the ufe __ of medicines of the deobftruent clafs he became lef _ Adifcoloured, and the hardnefs about his ftomach : emed to yield; but the afcites and anafarcous: Anereafed fo as to —_ his breathing oie i GiA S$ 2BeSse 2278. 55 exceedingly. Alkaline. falts, ed other. diuretics failing of their effeéts, I ordered himto take ; an infuf. of Digitalis. It operated fo powerfully. that i _be- came neceflary to fupport him with cordials an blifters, but it freed him from the dropfy, and his breath became quite eafy. He then took foap, thu- barb, tartar of vitriol, and fteel, and gradually at- tained a good ftate of —_ which he full conti- nues to enjoy. GC ££ SS LXVI. April 8th. Mr. B pe Aite Oa oe corpulent man, with a {tone inhis badder. from which at times his petite are extreme. | He had been affected was fmall in pre Ssh: 3 _.furia was more dreadful than ever; his breath veut not allow him to lie in bed, nor would the dyfuria* permit him to fleep ; in this diftrefsful fituation, after | having ufed other medicines to little purpofe, Idi- tected an infufion of Digitalis to be given. When the quantity of urine became more Pleat the 56 C2.A- $2 825.2 350u CG A S23 ed. April 24th. Mr. M——, of C ; fet. Bae Afthma, anafarca, jaundice, and great hardnefs and © ftraitnefs acrofs the region of the ftomach. After a : free -exhibition of neutral draughts, alkaline falt, — &c. the dropfy and difficult breathing remaining the _ fame, he took Infufum Digitalis, which removed — thofe complaints. He never loft the hardnefs about — his ftomach, but enjoyed very tolerable health for three years afterwards, without any return “ the dropfy. 3 oF gOc Ae 3: Eh EVO. April 25th. Mrs. J te 42. Phthifis pul- monalis and anafarcous levs and thighs. the Infufum Digitalis without effet. Myrrh and fteel, with fixed alkaly, were then ences _ to Bie ade | May 1ft. : , oF Sis A 6. I found him with every aps of hydrocephalus internus. Asi it was yet ae in the difeafe, in cc fequence of ideas whi n will be mentioned herez ter, I direéted fix ounces of blood to be imm __ ately taken from the arm; the temporal artery _ be opened the fucceeding day; the head to be fha- ‘ven, and fix pints of cold water to be poured | upon gfouzth hour, and two feruples of ftrong meé CoA S=E28a 8h. 5? curial ointment to be ribbed: into the legs every day. Five days afterwards, finding the febrile {ymp- toms very much abated, and judging the remaining difeafe to be the efle& of effufion, I direéteda fcru- ple of Fol. Digital. ficcat. to be infufed in three ounces of water, and a table fpoonful of the infu- fion to be given every third or fourth hour, until its adtion fhould be fomeway fenfible. The effea was, an increafed fecretion of urine; and the pa- tient foon recovered. Oe eae o LXX. May 3d. Mrs. B-—, At. 59. Afcites sii ana- a ftrone 5 fymptoms of difeafed viteera. In- ~ CAS E LXXL May 3d. Mr. S——, At. 48. A ftrong mae 5 had lived intemperately. For fome time paft. his — aa CLA S2ESSe ete C Ae i Been, May 24th. Jofeph B——, At. 50. Afcites, ama- farca, and jaundice, from intemperate living. Infu-- fion of Digitalis produced naufea, and lowered the frequency of the pulfe; but had no other fenfible e& — fects. His diforder continued to increafe, and killed a him about. two _mnidaths- afterwards. 7 GAS EB Lxxm = 2 agth. Mr. BS, Et. 60. A see drinkers afflicted with afthma, jaundice, and dropfy. ‘His appetite gone; his water foul and in fmall quantity, E Neutral faline mixture, chryftals of tartar, vinum chalybeat. and other medicines had been prea J to ne abvantage. Infufi ion of Fol. ae Fe a d | houfe e drar C &£ Ss -b s Se 59 a few dofes occafioned a plentiful flow of urine, re- lieved his breath, and reduced his fwellings; but, on account of his great weaknefs, it was judged i im- prudent to urge the medicine to the entire evacua- tion of the water. He was fo much relieved as to be able to come down ftairs and to walk about, but his want of appetite and jaundice ia 2 “oe his debility increafing, he died in about months. mn Min . Cie eM LXXY, Fuly 18th. Mrs. B——, Zt. 46. A little wo- man, and very much deformed. Afthmatical for many years. For feveral months paft had been worfe al; appetite totally gone, legs fwollen, © of sig falnefs about her ftomach, ‘counte- ~The ufual inde of prac ng, the Dig was tried, but with no better fuccefs, and in about a month fhe died; not without fufpicion of her death having been accelerated a few days, by her taking half a grain of opium. ‘This may be a caution to young practitioners to be careful how they venture — upon even n {mall goles of Jee in fach ¢ co: > Cua S SERS.S Wer. CAS: B-: LEKVI. — Auguft voth. Mr. L , At. 65, the perfon whole: Caf s recorded at No. XXIV, had a Te an 1 ie Be aicae which cured him before was note: f adminiftered without effect, for his weaknefs was fuch that I did not dai ex set ite os Zo aos FE “Lxxvil. ~ September 1oth. Mr. = 7 : of S— cétiiplexion. His difeafe an afcites and fwelled le the e confequence_ of a very free courfe of life 5 had been once ‘tapped, and taken much med: before I faw see The Digitalis was now C28 SES. 61 eafy to fay what the difeafe was, and the patient living at a diftance, I never learnt. the: future — grefs or termination of it. san CASE LXXIX. ; | September 26th. Mr: aan: Et. 42 a very _ fenfible and judicious furgeon at B cay fordfhire, laboured wader afcites and erp nie anafarcous legs, together with indubitable fymptoms of difeafed vifcera. Having tried the ufual diure- tics to no purpofe, I divesiad a {cruple of Fol. Digi- tal, ficcat. in a four ounce infufion, a table {poon- ful to be taken twice a day. The fecond bottle eins tis his arog which never returned. | ‘September agth, N ee ee A _fedentary woman; afte: 5 ilinefs, very” dir: _ tinély marked; had fymptoms of enlarged liver and _ dropfy. In this cafe I was happy in the affiftance of Dr. Ath. Digitalis was once exhibited in fmall _ dofes, but to no better purpofe than many other medicines. She fuffered great pain in the abc Pe teoral weeks, and a = T he © 62 GA 8. EB. $18 G A. 5.44 bee Odober 28th. Mr. B——, Et. 33. Had drank an immenfe quantity of mild ale, and was now be- _ come dropfical. He was a lufty man, of a pale complexion : his belly large, and his legs and thighs © fwollen to an enormous fize. I dire@ed the Infu- fion of Digitalis, which in ten days completely emptied him. He 1 was then put upon the ufe of — fteel and bitters, and « directed to live temperately, which I believe he did, for I faw him two ‘years - afterwards i in perfec health, See: = 93 GC ASS 5 -- Cam Odober 1gth. Mrs. R ,of B , Et. ‘47: Suppofed Afthma, of eighteen months duranee She had kept her room for four months, and could not lie down without great difturbance; was very thin, and had totally loft all inclination for food. She was directed to take two gr. of pulv. fol. Digital. night and morning for five days, and infufum ama- rum, at the hours of eleven and five. In the courfe of a week fhe was much relieved, and could remain in bed all night. After a few days interval fhe took the Digitalis for five days more, and was foon after that well enough to come down fairs and condud her family aftaiey, In April 1785, fhe had a flight + return, but not fuch as to confine her to her chamber. — She « expe- rienced the fame relief from the fame medicine, but ‘continuing it for feven days without gee it excited naufea. — CoA] S e a p Odober 28th. Mr. A——, fubje& to ney calculofa : After an attack of ‘that kind, troublefome fenfe of weight about his loi then rifing to pain, and a degree oO 04° GA $ & 3. 1784. caufed a copious flow of urine ; the fixth made him fick, and he was more or lefs fick at times for three days ; but felt no more of his complaints. I don’t believe it is at all neceffary to bring on ficknefs in thefe cafes, but an unexpected abfence from town prevented me from feeing him time enough to = the exhibition of the medicine. ance. The lat tenth’ or two her Goer wor fe than ‘ufual, her belly fwollen, her thighs anafarcous, and ther urine in fmall‘ quantity. After trying garlic, f{quill, and purgatives without advantage, I directed the Digital. Infuf. After taking about five ounces, her urine from: thick afid turbid, chariged to clear and amber coloured, its quantity confiderably in- creafed, and her breathing eafy.. Contrary to my — ‘orders, but impelled by the relief the had found, fhe finifhed the remaining three ounces of the in- fufi ion, which made her very fick, and the free flow of urine imviniediately ceafed. Noi medicine was adminiftered for: a fortnight, during Whack #3 ime e her er complaints increafed. I then direéted an’ infufion ~ ‘of tobacco,” ‘which. affeQed her head. es aiid . her urine. She hail réeourfe did Digitalis infufion, which once —_ , removed the @ again ‘to the = SAS BSt 250m 95 Gv Rus..% “CXLV. | Nov. 2d. Mifs B+ of C » Et. 22. Asvery evident fluctuation in the ge tacams which was confiderably diftended, whilft the reft of her frame was greatly emaciated. The prefence of cough, hee- tic fever, and other circumftances, made it probable that this apparent afcites was caufed by ‘a purulent, and not a watery effufion. However it was poflible I might be miftaken; the Digitalis was therefore given, but without any advantage. The further progrefs of the difeafe confirmed my firft opines and. pbs died aconacaative. ee ie ea ee atgaceelad peat or ia ie a epetientrsons asufual, a fenfeof weight acrofs his loins continuing very troublefome. The ufual medicines failing te relieve him, I-ordered four grains of pulv. Digital. to be taken every other night for a week, and fif- teen grains of mild fixed vegetable alkaly to be fwal- seteiies twice a -— in barley water. He foon loft all aplaints ; but we muft not in this but e the cure to + che: aa 96 C.:A $2 Ee @ 21 hi CG A'S E. CXLVIL. Nov. 4th. Mr. B—— of N——, At. 60. Had been much fubje& to gout, but his conftitution be- _ ing at length unable to form regular fits, he became dropfical.’ Pulv. fol. Digital. in dofes of two or three grains, at bed-time, gave him fome relief, but did not perfe&tly empty him. About three months af terwards he had occafion to takesit again ; but it fect, and he 1 was fo debilitated 23 poe Be tae — Nov. 8th. Mr.G , Et. 35. In the lak flage of a phthifis satiate was attacked with a moft urgent and painful difficulty of breathing. Sufpect- ing this diftrefs might arife from watery effufion in the cheft, I gave him Digitalis, which relieved him ‘confiderably ; ; and during the remainder of his life his pee never naan fo bad again, Nov. a3th. “Mrs. _ of W—h , Ft 68. . One of thofe rare cafes in which no ise iS fecreted. It proved as refractory as ufual to reme- dies, and not having ever fucceeded in the cure, of this difeafe, I determined to try the Di igitalis. It Was, given in infufion, and, after. a pag dofes, the fecretion of a {mall quantity of urine feemed to ju eattempt. The next day, however, the fe- Zn cretion — CA SES “1784, 97 cretion ceafed, nor could it be excited again, tho’ at laft the medicine was pufhed fo as to occafion ficknefs, which comierisen at intervals for three days. Roe CL. Nov. 20th. Mrs. B he. 28. In the laft ftage of a pulmonary confumption became dropfi- — cal. I dire&ted three grains of the pulv. Digital. to be taken daily, one in the morning, and two at night. She took twenty grains without any fenfi- ble effect. ees ee rr. Nov. ott ‘Mafter W——, Zt. 7. Suppofed hydrocephalus internus. A grain of pulv. fol. Di- gitalis was dire&ed night and morning. — ‘After three days, no fenfible effects taking place, it was omitted, and the mercurial plan of treatment adopted. ‘The child lived near five months after- . wards. Upon diffection near four ounces of water were found in the ventricles of the brain. CA 8 8 GLH. = Ne o6th. Mrs W——, Et. 65. I tended this lady laft winter in a very fever neumony, from which fhe narrowly her life. ss When the aes (odloy: adv 98 i~ C, AC S gh 1984. her much harraffed by a cough, which occafioned her to expectorate a little: the leaft motion increafed her _ dyfpneea; the could not lie down inbed; her legs were confiderably fwelled, her urine fall in quan- tity. I diredted two grains of pulv. Digitalis made into a pill with gum ammoniac, to be taken every — night, and to promote expectoration, a {quill mix- ture twice in the day. Her urine in five days be- ~ came clear and sopions, and i in a fortnight more fhe 7 , except a: n, for which = It is Sica es AS the fault r aig nt 1 fome fhare in this ¢ cure. c. A S E CLIT. ‘December ath. Mr. H. » it. 42. A large fat man, very fubject to paeeliy complaints. Af — ter an attack in the ufual manner, continued to feel numbnefs i in his lower limbs, and a fenfe of weight acrofs his loins. I dire@ed infufum Digitalis to ‘be given every fix hours. Six ounces made him fick, | and he took no more. ‘The next day his urine in- creafed, a good deal of fand paffed with it, and he — loft his difagreeable feels, but the ficknefs did not entirely ceafe-before the fourth, ay Epp. its com = 2 mencement, =e tile GAS R= Sea tes December 27th. Mr. B ,of H ; Zt. 5 4 3 Symptoms of hydrothorax, at firft obfcurely, after- wards more diftinély marked. Many things were tried, but the fquiil alone gave relief. At length this failed.. About the third month of the difeafe, a grain. of pulv. Digital. was. ordered to be taken night and morning. This produced the happieft effects. In March following he had fome flight fymptoms of relapfe, which were foon removed by the fame medicine, and he now enjoys good health. For a more particular narrative fee cafe the firft, communicated by Mr. Yonge, ~ CAS Ee CLV. 2 December 31%. Mrs. B ; of E—, At. O. An ovarium dropfy of long continuance. “She took three grains of pulv. Digital. every night at ~— time, for a fortnight, but without any effect. GA -S = CEVE : ~ A poor man in this town, after his kidneys had __ ceafed to fecrete urine for feveral days, was feized with hickup, fits of vomiting, and tranfient de After examination I was fatisfied the di thefameasthat mentioned at CXLIX. A’ rienced apothecary having tried 1 ¥ ‘ic | relieve hi im, I defpaired of any fuccefs ae any | 10n. yt it checked the vomitings did not occafion any fecreti a St ck ake = wry: HOSPITAL CASES, Under the Direction of the Author. O four following cafes were drawn out at my requeft by Mr. Cha. Hinchley, late apothecary to the Birmingham Hofpital. They are all the Hofpital cafes for which the Digitalis was prefcribed by me, whilft he continued in that office. CAS E- ‘cLvu. | March 1 5th,” 9 780. “John Batler Et. 30. Afthma and {welled legs. He was dire@ed to take myrrh and fteel every day, and three fpoonfuls of © infufum Digitalis every night. On the 8th of A pril he was difcharged, cured of the fwellings and lamin thing relieved of his afthmatic affetions. t CAS E CLVIII. November 18th, 1780. Henry Warren, Zt. 60. ~ This man had a general anafarca and afcites, and Was moreover fo afthmatic, that, neither ein to fit in a chair nor lie in bed, he was obliged con- ftantly to walk about, or to lean forward ag rinft a wenden crea Joye : fc ik d a for hin h “Z (102 HOSPITAL CASES. 1789. R. Ag. cinn. fpt. Ziv. Oxymel. fcillit. Syr. {cillit. aa. i,m cap. cochlear. larg. fexcta quaque hora. This ‘medicine producing no increafed difcharge of urine, on the 25th you ordered the infufion of Digitalis, two {fpoonfuls every four hours. After taking this for thirty: fix hours, his urine was dif charged. in mee : : antity, ae breath became hex was Soe - cured, and i is now in Prot health, cA Ss CLEX. November 3d, 1781, Mary Crockett, Ait. ro Afcites and univerfal anafarca. For one. week. the. igo, fal. diueticus and tinéture of cantharides, but ithout, advantage. On the 10th you. dire@ed the | infuf igite alis,.a dram and half to half a pi nty. an ounce “to ‘be taken every fourth hour. Before this quantity was quite finifhed, the urine began to be difcharged. very “€opioufly. othe: medicine was — _ then fi d_as-you had diregted. . On the. 15th, < being coltive, ‘the took.a ES RE rege; and. -on the, 3 S =2 {he was siltnrasg See ES, ee oe a. 2 bth, bas Mace oe Ae Gi cee a ae about the ftomach ; Skate liver, and ana-— eG 2 —— farcous HOSPITAL CASES. 1782. 13% farcous legs and thighs. For the firft week {quill was tried in more forms than ‘one;-- but without ad- vantage. On the 22d fhe began with theD Digitali which prefently removed all the fwelling. ~~ _ She was then put upon the ufe of aperient medi- cines and tonics, and on the firft of Augu/t was dif- charged cg A cured. The three following Cafes were drawn up and com- municated to me by Mr. Bayley, who fucceeded Mr. Hinchley as apothecary to the Hofpital at pags Dear Str, - Shiffal, Aptl ath, 1785. | Birmingham’ Ceneril Hofpital, ge had —- op: portunities of feeing the creat effects of the | Digitalis in dropfy. As the exhibition of it was’ ol- owing inftances inimediately under yo ‘re@ion, I have drawn'them up for yaibinifpetion, previous to your publifhing upon that excellent diuretic. Of its efficacy in dropfy I have confide- rable evidenicein my pofféffion, but confider my- fel not at liberty to fend you any other cafes ex- | cept Ul thofe you had’ yourfelf the’ coridué of. The ~ 104 HOSPITAL CASES. 1784. G. A. oe CLXI. Mary Hollis, aged 62, was admitted an out pa- tient of the Birmingham General Hofpital February 12th, 1784, labouring under all the effets of hy- drothorax; her dread of fuffocation during fleep was fo great, that fhe always repofed in an elbow chair. She was directed to take two grains of Di- gitalis in powder every night and morning, and for a few days found great relief; but, on the eighth i as ie —_ complained of ficknefs, and’ had . , ably purged, fhe was ordered to defift taking 3 any more of her powders. On the 14 - fhe was ordered an ounce of the following infiafion twice in a day: R. Fol. Digital. purp. ficc. 3ifs. aq. bullient. i6fs. digere per femi-horam, colature adde tiné. aromatic 3i. This infufion did not purge, but fometimes excited naufea, though not fufficient to prevent her from continuing its ufe. She grew gradually better, and on the 6th of May was dif- — charged perfectly cured. The diuretic effets of the ve Di eee were in this inftance immediate. i G A 8 EF .--GLXIE __ Edward James, Et. 21. Admitted March goth, a 1784. Complained of great difficulty of breath- ing, pain in his head, and tightnefs about the fto- mach, with a trifling {welling of his legs. Ordered pil. fcillit. 5i. ter de die, On the third day his legs — much more fwelled, his breathing more difficult, — and i gs refpea& worfe; his pulfe very fmall ieee HOSPITAL CASES. 1784. 105 and quick, complained when he turned i in bed, of fomething like water rolling from one fide of the _ thorax to the other. A remarkable pluenefs about the mouth and eyes, and purged confiderably from. the pil. fcill. Ordered to omit the pills and to — take Zi. of infuf. Digitalis every eight hours; the proportion 3ifs. to eight ounces of water and i. of aq. n. m. fp.—7th Day, The infufion had neither purged, nor vomited him: he only complained once or twice of giddinefs. His belly was now very hard, _ rather black on the right fide the navel, and his legs amazingly fwelled. Ordered a bolus with rhubarb and calomel, to be taken in the morning, and Zii. julep falin. cum tinct. canthar. gutt. forty: ter die. —12th Day, nearly in the fame flate, except his breathing which was. fomewhat more difficult, being now obliged to have his head confiderably raifed,. Perfiftat—From this day to the 32d day he eee oe 2 hourly worfe. His belly which at fir - was © hard, now evidently contained a large qua ae water, his legs were more {welled, and a large ipl celated fore appeared upon each outer ancle. Re- = fpiration was fo much obfiructed, that he was obliged =~ to fit quite upright to prevent fuffocation. He made _ very little water, not more than eight ounces in a day and a night, and wasmuch emaciated. Ordered his purging bolus again, and 3ii. of a mixture wi fal diuretic. 3fs. to Zxii. three times in a day, a Poulet. with ale grounds to his legs. _ path po : To this period there se the | aft probability of his eee his legs and nighs were "one 106) HOSPITAL CASES. 1784. one continued blubbery his ‘thorax quite flat, and his belly fo large that it meafured within one inch as much as a woman's in this Hofpital the-day fhe was tapped, and from whom twenty feven pounds of coagulable lymph were taken. He made about three’ounces of water in twenty-four hours: his penis and fcrotum were aftonifhingly fwelled, and no difcharge from the fores. upon his legs. -Ordered: to take.a pill with two if mes powdered Fox-glove nee: and norming. For a few'days no fenfible but’ about. the: Goth: day he’ complained of Hs giddy, Seeicnetora little pain in his fomach, He now made much more.wetcr, and: daved to fears His appetite whieh: through 1 the’ whole ofthis ilinefs had been ‘very bad, wasalfo bet: ter. 66th day. Breathing very much relieved, the quantity of water he made was three chamber’ pots full'in'a-day and a night, each pot containing two _ quarts and four ounces, moderately full, Ordered _. to continue his pills, and his which were Eee : orci to be rotted: es : “65the any: His belly nearly rédweed to its ee 3 fizey’ fil: made’ a prodigious quantity of water, his appetite: very ‘good; habit: of body rathér Jax, and his ‘completion ruddy. On the ad of Fun 25 being” : Rill rather weak, he was ordered” deco®@? cort! gee ter de*dieS and on: ee eam ce a mis Hofpital SS Ww. BAYLEY. Z HOSPITAL CASES. eet 107 which ra Helicats is. siento cairetiaes i. . ments not having it in his power to. fendethe meafure of his belly, having unfortunately miflaid the tape: he heard from James —_ day, and he is perfectly welbe.---- General Bape, ‘Auguft 5, 1784. G A S E CLXITIT. On the 26th February, 1785, Sarah Ford, aged 42, was admitted an out-patient of the Birming- ham General Hofpital: the complained of esnGde: é rable pain in her cheft, and great difficulty of breathing, her face was much fiwelled and her © thighs and legs were anafarcous. She had extreme difficulty in making water, and with many — ainful “ efforts fhe did not void more than ee ar twenty-four hours. She had been int ua | about fix weeks, during which time the | had taken ammoniacum, olibanum, and large quantities of {quills, without any other effed ele frequent fitke<.-5 nefs. Upon her commencing an Hofpital patient, _ the following medicine was exhibited. R. gum am- — moniac sii. pulv. fol. Digital. purp. 91. fp. lavand, : comp. ut fiat pil. 40. cap. ii. note maneque. She : oe the ufe of thefe = for a few day 108 HOSPITAL CASES, 1785. a night fhe made five pints of water. By the 12th day her legs and thighs were nearly reduced to their natural fize. She continued to make water in large quantities, and had loft her pain in the thorax. To the 2oth of March, fhe made rapid advances towards health, when not a fymptom of difeafe remaining, fhe was difcharged. COMMU- “© 109, ez COMMUNICATIONS FROM CORRESPONDENTS. ‘London, Norfolk-ftreet, May 31ft, 1785. : Sir, I HAD the favour of your letter laft week; and I thall be very happy if I can give you any intelligence relating to the Foxglove, that can an- fwer the pens in which oe fo fandably en- gaged. = ‘ : * It is true that my eS the i Drs. Cawley, was greatly relieved, and his life, perhaps, pro- longed for a year, by a decoction of the Foxglove root; but why it had not a more lafting effect, it is neceffary I fhould tell you that he had all the figns * | of a diftempered vifcera, long before any watery fwellings appeared; it was manifeft that his dropfy’ was merely fymptomatic, and he could therefore on- ly from time to time have any relief from miedi- cine. In the year 1776, he returned from. Lon- os don to Oxon. having confulted feveral phyf at the former place, and Dr. Vivian at 1 _ but without any fuccefs; and he was = 2 carpenter at Oxon. that had been red A pectoris = the rosgores root; _ and 110 COMMUNICATIONS was ayounger, and in other refpedts an healthy man, his-cure, 1 beli€ve, remains-a perfect-one. I did not attend my brother whilft he took the medicine, and therefore I cannot fpeak precifely to ‘the operation of it; but I remember, by his let- ters, that he was dreadfully fick ard ill for feveral days before the fecretion of urine came on, but which: it see do to a great-degree; relieved his great y jeGened the fwelling i in his legs part = ne es are much fesse te efficacy of it than my brother's eafe. [ee see ~ ROBERT CAWLEY. ; eA eee ae -~ N, B. Whenever I have another opportunity of giving the Foxglove, it fhall be in fmall dofes:—_ In which I fhould hope it might fuceed, although it Te might be more flowly. if you fhould try it a fame: Tthould be as | to know 5 ae . mode: Br. Lawley’ 8 ae r R. Rad. 1 Digital purpur. ficcat. et contuf. Zi. | Coque « ex aq. font. fii. ad fbi. colat. liquor. = _ adde aq. junip. comp. 3ii. es Ses _ Mell. anglic 3i- ma. famat cochl. iv, omni fi _ from CORR ESPONDENT s, 112 —I have elfewhere remarked, that when the Di- gitalis has been properly given, and the diuretic ef- effects produced, that.an accidental over-dofe bring ing on ficknefs, has topped the fecretion of urine. in the prefent inftance it likewife appears, that vi- olent ficknefs may be excited, and continue for fe- veral days without being accompanied by a flow of urine; and it is probable that the latter circum-- ftance did not take place, until the feverity of the former abated. If Dr. Cawley had not had a con- ftitution very retentive of life, I think he muft have died from the enormous dofes he took; and he probably would have died previous to the aug- mentation of the urinary difcharge. For if the Toct from which his medicine was prepared, was gathered in its active ftate, he did not take at each dofe-lefs than ¢welve times the quantity a ftrong man» ought to have taken. Shall we wonder then that patients refufe to repeat fuch a medicine, | anc that a “ae pra@itioners tremble to prefcribe it? Were any o | the active and powerful medicines in daily ufe to be given in dofes éwelve times greater than they are, and thefe dofes to be repeated without atttention to the effe&s, would not the patients die, and the nee be condemned as dangerous and deleteri- #-Yet fuch has been the fate of Foxglove! 112 |. COMMUNICATIONS. A Letter to the Author, from Mr. Bonen, _ Surgeon, at Brofeley, in Shropfhire. Dear Str, Brofeley, 25th May, 1785. HAVE inclofed the preferiptiotis that contained the fol. Digital. which I gave to Thomas Cooke and Thomas Roberts, Thomas Cooke, Ait. 49, had been ill about two or three weeks. When I faw him he had no appe- tite, and a. conftant thirft: a fullnefs and load ae the ftomach: the thighs, legs ‘and hands, much fwell'd, and the face and throat ina morning ; was _ coftive, and.made but little water, which was high coloured ; the pulfe very weak, and his breath ex- ceeding bad. Fune 17th. R. Argent. viv 3i. conf. cynofbat. Dii. fol. Digital. pulv. gr. xv. f. pil. xxiv. — capt. ii. omni noéte hora decubitus: He was likees wife purged by a bolus of argent. viv. jallap, Digit. ; elaterium and.calomel, which was repeated on the fourth day, to the third time. - From Fune 17th to the 29th, the fymptoms were moftly removed, making water freely, and having plenty of ftools ; in a week after he was perfectly well, and remains _ fo ever fince. The cure was finifhed by fteel and bitters, Saxe : Thomas Roberts, Ait. 40, had a deformed cheft, zs was obliged to be almoft in an ere@ potture when i: in bed; the other fymptoms were nearly the fame 88 Cooke's. Augufi 3d. The pills preferibed Fume from CORRESPONDENTS, 113 17th for Cooke. 17th. A purging bine of jalap and Digitalis, once a week. He continued the me- dicines. till the latter end of Augufi, when he got very well; but the complaint returned in Fan. worfe than before. He is now much better, but I have great reafon to believe. the liver to be difeafed. = am, with the preatelt repeat es «. Yoni very obliged humble fervant, ‘DANIEL BODEN, ‘P.S:: The ne patient, on his relapfe, took Digits see soorianed with ae ae C A 5 E onamsied . Mr. C, AU s ER, : Surgeon: at : Stourbridge, Worc efterfhire. = es Mr. P of H+. M , in Se pactth of” A Paints aged about 60; had been a ftrong : healthy, robuft, corpulent man; worked hard early in life at edge-tool making, and drank freely of : - trong malt liquor 5 for many years had been fub- _ _ je& to gout in the extremities ; for a few years paft had been very afthmatic, and the gout in the ex- in sm A decreafed. When I fir “114 COMMUNICATIONS pofture was ftanding with'his body leaning over 2 chair, in which fituation he would continue many hours together, Jabouring for breath, with the fweat trickling down his face very profufely ; the urine in very fmall quantity. Diuretics of every kind I could think of were ufed with very little or no ad- vantage. Blifters applied to the legs relieved very confiderably for atime, but ‘by‘no means could I anereale J the urinary: difcharge. Warm ftomachic s were given, and at the fame time fina lied.to 1 the feet, in hopes of enticing gout es a Fae 22d. The {welling confiderab y increafing, = €8,°: but: without any good effett.— van iémetic of iin March 1 5th the was : delivered? had a “good i bour, was treated as is ufual, except in not hav- ing her breafts drawn, not intending fhe fhould - fuckle her child, being in fo reduced a ftate. Conti- hued going on well till the 18th, when fhe was feized with 1 very violent pains acrofs her. loins, at times fo _ 118 COMMUNICATIONS R. Julep. e camphor. fp. minder. aa Zii. capt. cochiear, i. larg. poft fingul. pilul. igth. Breathing fhort, unable to lie down, very irregular low pulfe fcarcely to be felt, fainty, and a univerfal cold fweat: no appetite nor thirft, fpaf- modic pains at times acrofs the loins very violent, but not fo frequent as on the preceding day. ye Gum ammoniac.. affafetid. aa gi. camphor.. gr. xii. fiat pilul. 24. capt. ii. 3tia quaque hora in cochlear. ii. mixtur. eo aR, “Balfam. peruv. sili, mnie G eee q. fe flor. zinci g. vi. aq. menth, fimp. lbfs.m. Applic. Emp. veficat. femorib. internis. R. Sp. vol. foetid. elixir. paregor. balfam. Traumatic. : aa Sul. capt. cochlear. | ~pary. ul a one = — ae cle wile and the oe = to —— moet e ee aga. 1 The Sa increafed.—Capt. ~~ gutt. xv. acet. {eillitic, ter die i in two fpoaigs of _ the following mix eS cise eee R. Infof. baiieart® juniper. ‘Bvis tina. sme Z = Bomachic. aa Zi, m. eet from C. ORRESPON DENTS. 119 a5th. Much the fame. 98th. The fwelling confiderably increafed, in other refpects very much. the fame. 3oth. Breathing very bad, with cough and pain acrofs the fternum, unable to lie down, legs, thighs, and body very much fwelled, urine not more than four or five ounces in the twenty-four hours ; hot and feverith, with thirft. Applic. Emp. veficat. ftomacho et fterno. R. G. affafetid, Sii. pulv. jacob. 93, rad, {cill. re- cent. gr. Xil- extract. thebais: gr. iv. f pilal. Xvi. cap. iv. omni modi, R. Sal. nitr. fal. anne. aa 3ii. t peliae. cont comp. 3i. facchar. i: emulf: comm L _ aq. cinnam. firmpl. a m. — hlear. at : pee otitis Moe ie Fee Te ees Agee April 2d. Much the fame, no increafe oe urines: 3d. Breathing much relieved by the blifter, which Tuns profufely, Repeated t the medicines, and Gad - Mgned shem till the ee pete 3 a The sees ity ia ane ula 120 COMMUNICATIONS her fo much when with child. I was almoft afraid to give them, but the inefficacy of the other me- dicines gave me no hopes of a cure from. continu- ing them, which made me venture to sg: with her rr, R. Fol. ficcat. Digital. G. affafetid. aa 3i. fp. la- vand. comp. q. f. f. pilul. xxxii. cap. ii. om- ni mane; et omni nose ge: pilul. e bios ro Confiderable increafe of urine. 7 : ait. Swelling a ae deal Giminifhed: ‘urine near four pints in twenty-four hours, which is more — than double the quantity fhe drinks, _ Applic. Eup. veficat. femoribus internis, Phe Digitalis pills and opiate at bed-time conti- nue: ae a iia 3 of cold d chs eivrnite' ten “2. 5th. ‘Swelling much diminifhed, makes plenty. of water, appetite much mended, cough and breath- ing better, She omitted the medicine for three ae days; the urine began to diminith, the {welling 2 = and fhortnefs of breathing worfe. On repeating it for | two days, the difcharge was again augmented, 1 diminution of the fwelling fucceeded. She inued the pills ever fince till the tet of 78 = Ze = wn ‘ | give ‘iaghaik divedtions t to poor ae ENTS. mar. May; the dropfical fymptoms and cough z are che tirely gone, the water is in fufficient quantity, her ftrength is recovered, and fhe has a good appetite. All fhe now complains of is a weight acrofs her fto- from CORRESPONDED ‘mach, which is worfe at times, and fhe thinks; un- lefs it can be removed, the thal have a return of her eee . he é 2 Extrad éf a Teter from Doctor Fow t ER, Phyfician, at Stafford. I UNDERSTAND youare going to publifh on the Digitalis, which I am glad to hear, for I have. long wifhed to fee yoiters in p: I know of no one eee the grea paring ‘and taking of an infufion or decoétion _ green plant. Would one fuppofe t fe that fuch gentle- men had ever attended to the nature and operation of a fedative power on the functions, particularly — the vital?’ Is noi fuch’a vague and unfcientific mode ~ of proceeding putting a two edged fword into the the hands of the ignorant, and the moft likely me- _thod to damn the reputation of any very acti S - powerful medicine? And is it not more than] Z _ that the negled of adhereing to a certain and regular — _- Preparation of the nicotiana, and the 1 -- You emphatically calt) j pradticable dofe, have’ ie heise caufes of the once. rifing reputation of Bee 122 ~ COMMUNICATIONS that sioted plant being damned: above a century ago? In thort, the Digitalis is beginning to be ufed in dropfies, (although fome patients are faid to go off fuddenly under its adminiftration) fomewhat in the ftyle of broom afhes; and, in my humble opinion, the public, at this very inftant, ftand in great need of your precepts, guards, and cautions to- wards the fafe and fuccefsful ufe of fuch a power- ful fedative diuretic; and I have no doubt of your minute attention: to thofe particulars, from a regard =a mankind, as well as to nee = oui ae magi eat “% Teaemters an eH’ n the Stafordfhire militi who died here of a dropfy five years ago. The Di- gitalis relieved him a number of times in a wonder- ful manner, fo that in all probability he might have obtained a radical cure, if he would have refrained from hard drinking. TI underftood it was firft or- dered for him by a medical gentleman, and its fe- dative effeds proved fo mild, and. diuretic -opera- tion fo: powerful, that he ufed to prepare it after- wards for himfelf, and would cake? it with as little — ceremony as he would his tea. It is faid, that he was fo certain of its fuccefsful operation, that he would boat to his bacchanalian companions, when much fwelled, you fhall fee me in two days time 3 = gate snother man, kee. from CORRESPONDENTS. i . CASES cciitaguneted fig Mr. Ie Frere, jun. Surgeon, in Birmingham, GC-A-S £ F Nov. 1780. Mary Terry, aged Go. Hadbeen fubje& to afthma for feveral years ; after a fevere fit of .t her legs began to fwell, and the quantity of urine to diminifh. In fix weeks fhe was much troubled with the fwellings in her thighs and abdomen, which decreafed very little when the lay down: fhe made not quite a pint of water in the twenty-four hours. ¥ ordered her to take tw@{poonfuls of the infufion of Foxglove every three hours, By the time fhe had taken eight dofes her urine had. increafed to the quantity of two quarts in the day and night, but as fhe complained of naufea, and had once vo- mited, I ordered the ufe of the medicir {pended for two days. The naufea bein then re-_ moved, fhe again had recourfe to it, but at inter- vals of fix hours. ‘Fhe urine continued to difcharge ; freely, and in three weeks the was tego! mes of her fwellings. CK. Se II. Decenlir 1782. Ac poor: woman, is affi@ed with an ague during the whole o _ naney, and for two months with dropfi fwellings of the feet, legs, thighs, abdomen, vasidebis ae fe - seas ee | 14 $COMMUNICATIONS taken in labour. On the day after her deliv ery the ague returned, with fo much violence as to en? danger her life... As foon-as the fit-left her, I be- gan to give her the red bark in fubftance, which had the defired effe& of preventing another pa- roxyfm. She continued to recover her health for a fortnight, but did not find any diminution iti the fwellings; her legs were now fo large as to oblige her to keep conftantly on the bed, and fhe made very little water. =. “ordered her the infufion of three times a day, “which,~on the third ay, producec avery copious difcharge of urine, t = any ficknefs; fhe continued the -ufe of it. for ten days, and was them able’ to walk.” Having loft all her fwellings,- and no complaint remaining but weaknefs, the bark and fteel rk ee ee Cure. . Extract of a Letter from Dostor Foxes Bes -Phyfican,, in Lichfield. | ~ ANXIOUS. to procure anfhentic accounts from _ the patients, to whom I gave the Foxglove, I have © unavoidably been delayed in anfwering your laft favour. Se attest I rae the <— will be made ym tom; . Mom it ne cafe wai be a io of rs oe perthre content myfelf ae {pe =< ge from CORRESPONDED 125 fying the nature of the difeate, a = whist the drop- fy is attended with any other affeion ie notice “at | - Two years have’ analy elapfed fince TF firft Oe ployed the Digitalis; and the fuccefs I have had has induced me to ufe it largely and frequently. i = eo os Oe Ann Willott, 50 years of age, became.a patient of the Difpenfary on the 11th of April 1783. She then complained of an enlargement of the abdo- men, difficulty of breathing, particularly. when ly- ing, and coftivenefs. - paffed fmall quantities of high-coloured urine 5 and had an evident fludtu- : ation in the belly. Her legs. were cedematous. Chryftals of tartar, fquills, &c. had no effet The - -igth of Fune fhe took two fpoonfuls = of Foxglove, | containing ‘three dra ay ‘leaves, in eight ounces, three times a » day. Ties. urine. foon inéreafed, and in a few days the paffed it freely, which. continued, and her breath te-- turned. : Mein Gok s > SS eee Mr. , 45 years Sor ar age, had been fubje& to dropfical fetings of the legs, , little water. Two fpoonfuls of the fa x _ twice a day, foon relieved cr EASE: 126 COMMUNICATIONS Gc As Bie Mrs. saged 7o years. A lady frequently afflided with the gout, and an afthmatical cough. Aftera long continuance of the latter, - fhe had a great di- minution of urine, and confiderable difficulty of breathing, particularly on motion, or when lying. Her body was much bound. There was, however,: no septs {welling eae took eee espe of thofe days, an ther breathing auch - Gelieved.. ry ‘eno oF “thr e€ weeks after the ufe of it the was perfectly ony The purgative medicine . neither imcreafed the urine, nor relieved the breath- ing, till sed Foxglove was a added. This fpring fhe jong laboured. with the pce. in her ftomach, which terminated in a fit in her hand. Spies the whole of this tedious seer of pont _ She took the fame preparation of Foxglove with- _ out any diuretic effect, and afterwards two and three grains of the powder twice a day with as little. The _ -dulcified fpirits of vitriol, however, cay hess : “noted the urinary | ecretion. i we B Best IV. = AE Mr. ‘C , 46 years of age, had dropfical fwel- lings of the legs, and paffed little urine. He took the decoction with three drams, and was foon re- lieved. 2 ee ee Lady , took three grains of the dried leaves twice a day, for {welled legs, and fcantinefs of urine, without effect. belly and leg and et twice a dae ands was ciate: ¥ tt u She took many medicines without effet. OG. A SE: eee: = ~ Mrs. P. , im her goth year took three 3 grains of the powder twice a day, for feantinefs of a a8 welled legs, without effec. = SQ Se E. Ve 2:8 COMMUNICATIONS Gr Ase 2 a WV; =e ee aged 76. In. the laft flage of droply of the belly. and legs, found a confiderable increafe of his urine by a decoction of Foxglove, A but it was not permanent, : Somalia ¢ A$ Bg & in eight ounces, twice or three times a dy. increaf ed his urine prodigioufly. He was evidently better, buta little attendant naufea overcame his refolution, : and in the courfe of fome weeks pi Bilge he fell . a vidim to his piney. vs about aes aa 36, 1 ottion i in the fame my for dro fy of the le from CORRESPONDENTS. 129 CA Ss E> Sale Genders, about thirty-four years of age, was delivered of three children, and became drop- _ fical of the abdomen. She paffed little or no urine, had conftant thirft, and no appetite: She took two fpoonfuls of an eight ounce deco@ion, with three drams twice a day. By the time fhe had finifhed _ the bottle, (which muft have been on the fourth day,) fhe had evacuated all her water, and could go about. Her appetite increafed with every dofe, and ihe recovered without farther help. GAs E XIV. Mifs M— mies “% in ‘+5 goth + year. Had been infirm from her cradle, and, after various fut : - ferings, had an aftonifhing cedematous {welling of one leg and thigh, of many weeks ftanding. She paffed little or no urine, and had all her other com- plaints. She took 2 fpoonfuls of an eight oz. decoc- tion of two-drams, twice a day. Her urine.imme-' diately increafed ; and, « on n the third day, the fwel- Hing had entirely fubfic . te. RS ap” CASE XV. Mr. P— , 65 years of age, and of a full habit of body. Had lived freely in his youth, and for ‘Many years led rather am inactive life. His health — was, much impaired feveral months, and he had a = confi epee —_ and evident flu@uation in = I _ : 130 COMMUNICATIONS the abdomen, and a very great cedema of the legs and thighs. His breathing was very fhort, and ra- ther laborious, appetite bad, and thirft confidera- ble. His belly was bound, and he paffed very {mall quantities of high-coloured urine, that depofited a reddifh matter. He had taken medicines fome time, and, I = the Digitalis; and had been better. A blifter was applied to the upper and infide of each thigh; he took two fpoonfuls of the decoction, with three drams of the dry leaves, two or three times a day; and fome opening phyfic occafion- ally. He lived at a confiderable diftance, and I did not vifit him a fecond time; but I was well informed, about ten days or a fortnight afterwards, that his - urine increafed amazingly upon taking the decotti- on, and that the water was ey evacuated. Mrs. G— : “pei 50 years. After Seine tele ailing, | had a large collection of water in the abdo- men and lower extremities. Her urine was high- coloured, inifmall quantities, and had a reddifh fediment. She took the decoction of Digitalis, {quills, &e. without any-effe&. The chryftals % | pe, Sete. cured her fpeedily. CAS E xXvIL Mr. , about 50 years of age, com aine q of great tenfion and pain acrofs the abdomen, and of lofs of appetite; his urine, he thought, was lefs than ufual, but the difference was fo trifling he could fpeak with no certainty: his belly feemed to fluétuate. Among other things he tried the Fox- glove leaves dried, twice a day; and, although it appeared to afford him relief, yet the effect was not permanent. GC A S E XxXvViull. Mr. W- =, aged between 60 and 79 Yeates and rather capa was confider bly < ‘opfical, both of the belly and legs, ‘Gnade urine. in fi all quantities. Three grains of the dry leaves, t a day, evacuated the water in Tefs. than a CA S E- Se Sarah Taylor, 40 years of age, was admitted in- to the Difpenfary for dropfy of the abdomen and — legs ; and was relieved Be the Decoétum ae: num. eatine XX. _ Lydia Smith, aged 60. Difpenfary. Laboured any years under an afthma, and became dropfi- _ She took the. decottion without effec. eS Ia CASE. 132 COMMUNICATIONS GyA-S=E= XXL John Leadbeater, aged 15 years. Had a quoti- dian intermittent, which was removed by the hu- mane affiftance of an amiable young lady. His intermittent was foon attended bya very confidera- ° ble afcites; for which he became a patient of the Difpenfary. He took a decoction of Foxglove night and morning. His urine increafed immediately, and: he = all his complaints i in four Pe ¢ A S B= | XXII. William Millar, aged 50 years. Admitted into the Difpenfary for a tertian ague, and general drop- fy. he dropfy continuing after the ague was re- moved, and his urine beng fill pauted in fmall quantities; he took the powdered leaves, and ee ss eced his health in five days. : ~. Ann Ani 16 years of age. Had for feve- ral weeks dropfy of the belly after an ague. She took a n of Foxglove, which removed all : = —— ay the foutth ae GC AS i XXIV. Ann. Meachime; : a Difpentary patient. Had an and fcantinefs of urine She took the pow det frm CORRESPONDENTS. — 133 der of Foxglove, and evacuated all her’ Water in three days. ‘It may not be improper to obferve, 1ft. That various diuretics had long been given in many of thefe cafes before I was confulted. And, 2dly. That the exhibition of the Foxglove was but feldom attended with ficknefs. wee iw A NORD, Thefe Cafes, thus liberally communicated by my friend, Dr. Jones, are more acceptable, as they feem to contain a faithful abftra& from his notes, both of the peiiteisel. as well as the fuccefsful Cafes. is li RSE STOEL POS ee ar "Rag The ote Tabular View of them will give. us ~ fome Idea of the ebony of the Medicine 3 Bnaitce oe ee 7] Cafes - Cured 3 Relieved -1 Failed - - 3 5 Cafes - Cured - - 4 Relieved =e f. QGidematous leg = - 1 Cafe - Cured -- 2 © Afcites and anafarca - 7 Cafes - Cured - - 4 é : : Relieved - 2 = ee Failed - - 1 Afthma and dropfy -- 1 Cafe - ‘Failed -_ -- pe = ge ee 2 = ae | a Sas. Lage 2 Afcites - - - 134 COMMUNICATIONS A CASE of Anafarca communicated by Mr. Jones, Surgeon, in Birmingham. ~ Dear Sr, HAVING lately experienced the diuretic powers of the Foxglove, in a cafe of anafarca; I do myfelf the pleafure of communicat- SS you. Iam, — Birmingham, W. JONES. May 17th, 1785. ~My patient, Mrs. C , who is in her 5 itt year, had the following. fymptoms, viz. alternate {welling of the legs and abdomen, a little cough, _ fhortnefs of breath in a morning, thirft; weak pulfe, and her urine, which was fo fmall in quantity 3s ~ feldom- to amount to 0 half a pint in twenty-four a Jepofit a A oe = bullient. Zviii. f infuf, et cola. — - Samat each. Targa i iii, o.m. et mane, On the 17th fhe had: sea twice of the + infafom, se thor et ak two i sor gS a about an hour before it came up again, and that the the difcharge of urine not fo copiox Ss =e days, ther ee a ee Ct ee ge EF et ge ie coe ee ee ee se frm CORRESPONDENTS. 135, ‘dofe, yet the quantity of urine ‘was increafed to about a pint in the twenty-four hours. She was then dire@ed to take two table fpoonfuls night and morning. And, On the 18th, a degree of naufea was produced. A pint and half of urine was made in the laft twen- ty-four hours. During the time above fpecified fhe had two or three ftools every day. ‘The infufion was now omitted. On the 19th the fwelling of the legs was remov- ed. A degree of naufea took place in the morning, ~ and increafed fo much during the day, that fhe vo- mitted up all her food and medicine. As fhe was very low, and complained of” want of appetite, a a cordial julep was directed to be taken occafionally as well as red port and water, mint tea, Se She informed me that whatever fhe took gi id mint tea ftaid longeft on the ftomach. The vomit- ing decreafed gradually, and ceafed on the 29d. The difcharge of urine remained confiderable dur- ing the three following ea 2 its ——— was : not meafured, sod A dofe of neutral faline ne julep was di to ~ taken every | fourth hour. : x hs the a3d fhe sea af thirft, nd th ag at the pre- efore the faline jul p was continu- . . ed. 136 COMMUNICATIONS ed every fourth hour, with the addition of thirty drops of the following medicine: R. Aceti fcillitic. zvi. Tina. aromat. 3ii. = thebaic. gutt. Xx. m. _ The bowels have ai kept open from the 19th, by the occafional ufe of emollient injections. : On the ogth the fens: were much fwelled again ; fhe complained of languor and a degree of naufea. The difcharge of urine increafed a little fince the 23d. Her pulfe was low and her tongue white. The urine, which had been rendered clear by the infufion of Foxglove, now depofited a whitifh fedi- ment. . On the 25th her appetite began to return, the fwelling of the legs diminifhed, and fhe thought’ herfelf much relieved. ‘The urine ‘was confiderable : wantity, and clear, ae = ~ On the 26th the. was —s an a wget: | fwelling was removed: the quantity of urine dif- charged in the laft twenty-four hours was about a~ _ 3 pint. She continued t to Se ren from this time, and is now in good healt m imes, was shire? to follow the ufe of the tere e and i it lafted ning or ten Sa , from CORRESPONDENTS. —137_ This is the fecond time that I have relieved this _ patient by the infufion of F oxglove. - - I ufed the fame proportion of the frefh leaves the firfttime as I did of the dried ones the laft. The violent vo- miting which followed the ufe of the infufion made with the dried leaves, did not take place with the frefh, though fhe took near a pint made with the fame proportion of the herb frefh gathered. © Rm EM -A-R KS. THE above is a very inftrudive cafe, as it teaches us how fmall a quantity of the infufion was neceffary to effect every defirable purpofe. At firft fight it may appear from the Pe aed paragraph, that the green leaves ough . 0 th ’ dried ones, as being fo much wilder iH in their opera- as will appear hereafter, the ae ion with the dried leaves was five times the ftrength of that before prepared from the green ones. We need not won- © der, therefore, that the effeéts of the former were fo difagreeable, when the dofe was five times em than it ought to have been. But what makes this matter ftill more obvious, is the miftake menti at firft, of two tea fpoonfuls only being gi e ~ dofe. Now a tea fpoonful, contai ing a foutth or a fifth part of the contents. fpoon, the dofe then given, was very 3 a that which tion 5 but let it be noticed, ae the fame tity 138 COMMUNICATIONS infufion of the green leaves, and it produced pre- cifely the fame effects for it increafed the urinary difcharge, without exciting the violent vomiting. Lesion ee Doctor Jobers Phyfician, in Birmingham. Dear a ee _ THE following cafes are felected from many ees in which I have given the Digi- lis purpurea; and from repeated experience | of its aifieacy after other diuretics have failed, I can re- commend it as an etiectual, and when properly managed, a fafe medicine. Iam, &c. Birmiagham, May 26, — Jef 7 N 5 i ONE. —; ae aE a cola: nite sacha led -esular and. temperate- life, At. 68. He was affected with great difficulty of refpiration, and cough particularly troublefome on attempting to lie down, cedematous | fwellings of the legs and thighs, abdo- _ men tenfe. and fore on being. preffed, pain ftriking from the pit of the ftomach to the back and fhoul- — = ders; almoft conftant naufea, efpecially after taking food, which he frequently threw up; water. tbisk from CORRESPONDENTS. 139 {mall quantity ; body coftive; pulfe natural; face much emaciated, eyes yellow and depreffed. He had been fubje& to cough and difficulty of breathing in the winter for feveral years; and about four years before this time, after being expofed to cold, was fuddenly deprived of his fpeech and the ufe of the right fide, which he recovered as the warm wea- ther came on; but fince that time had been remark- ably coftive, and was in every refpe& much debili- tated. He firft perceived his legs fwell about a year ago; by the ufe of medicines and exercife, the fwellings fubfided during the fummer, but returned on the approach of winter, and gradually increafed to the ftate in which I found them, notwithftand- ing he had ufed different preparations of {quills and a great variety of other diuretic | medicines. I ordered the following mixture. Ne eee R. Foliorum Digitalis purpur. re ecent que ex aq. fontan. 3xii ad svi co) Tinétur. aromatic. Syr. zinzib. aa 3i. m. capt. cochl. duo larga fe- canda quaque hora ad quartam vicem nifi prius naufea. fuperseree March gth. He took iar dofes of the mixture - without being in the leaft fick, and made, during - the night badge of two abi ohn : Water. ees 5 seth. 140 COMMUNICATIONS 1oth. Took the remainder of the mixture yefter- day afternoon and evening, and was-fick for a fhort time, but made nearly the fame quantity of water as before, the f{wellings are confiderably diminifhed, his appetiie increafed, but he is {till coftive. R. Argent. viv. balfam peruv. aa xfs tere ad ex- tinctionem merc. et adde gum. ammon. Sil aloes focotorin. 3fs rad. {cil. recent. 3fs. fyr. fimpl. rae Seas mais. in ae xxxii divid. ae iii. = die. = ae : — Goithack to nakie sae: — >The fwellings of his legs have gradually decreafed ; fore- nefs and tenfion of the abdomen confiderably lefs. Oat. pil. cap. miftur. c. decoct. Digitalis. &e. 3tia quaque hora ad 3tiam vicem. 15th. Made a pint and a half of water laft night, : without | being in the leaft fick, and is in every © refpec tony. better. ee Pillul. aut or. Mike water as ufaal ae in n health, til 2 the a are Pisin. given | Seok, fal. bbe = ae . '. car oduced no imm ‘= sar ey naufea gra wally abating, inf. was ordered; ‘but this cece to an ? 3 ' and a great propenfity to fleep. coming on, I di- rected fal. c.c. conf. card, aa gr. vili. 4tis horis, which- removed the unpleafant fymptoms and mprrf. ¢ . fal. mart, completed the cure. During the ufe of the above medicines, the urine was augmented, and the pulmonary complaints removed, even before the nau- fea left her; and the fores of herlegs which were much inflamed before fhe began with the infuf. Digital: in a day's time afflumed a much healthier appear- ance, and on her other complaints going off, they fhewed a greater tendency to heal than the had ever obferved in them for tw enty years before. This inftance i is a very pleafing confirmation of the ex- periensgy of eee and Dr. ie and of the ad- the confitutiok which often ese Jers the them i se lie Ee fh one cate 4 in which I Cfdeiee it, the; : _ inftead of digefting three hours as I bad diredted, was fuffered to ftand upon the leaves all night. The confequence was that the firft dofe es confi- desable naufea. a ti: 3 ‘The tio. following ‘floss ee swith: I | favoured by a phyfician very juftly. emin ¥ of the neceffi ity thereisthat € ae ae 150 COMMUNICATIONS bits fuch medicines, with all the precautions necef- fary to obtain the promifed fuccefs. - In thefe (fays my correfpondent) ‘* the infufion “* was given in {mall dofes, repeated every hour or “two, till a naufea was raifed, when it was omit- “ted for a day or perhaps two, and then sepeated *t in the fame manner.” t 2d d by ity _but filled again its ufe was never difconti- found nao Suey ef- BB cam toda & felis from it. to ster : “a, In an “Awasarca it fometimes increafed the ** quantity of urine, and abated the fwelling, but ** which as often returned in as great a degree as 6 hehe: though the medicine was flill given, and al- * ways increafed i in EER: ee as to excite naufea, reases Saially,* ben ets ) Scere itin = = t found Bas difference i in. she fuccels saiending it.” ’ = Geiubiliy a of ‘the ; bents, or poffibly of the 1916 ly and thus adaing ed adion which feems to be the e cau uity of. dropfies, which leads | us to lical experimenter again trying i i : from C ORRESPONDENTS, 151 againft its continued ufe, even in {mali dofes, i in other difeafes of diminifhed energy, as continued fever, palfy, &c. ; I remain with the greateft truth, — __. Your obliged and affedtionste friend, Stourbiidse:, JONATHAN STOKES. May 17, 1785. , THE three following Hofpital Cafes, which Stoxes had an Speeremty of ohfery- Ether k——, Zt 55. Ge ec pa dyfpneea, of feven mont a med The firit dole ie took to-< - eee: zs 152 COMMUNICATIONS 3d Dav. Minuatur dofis ad 3 fs. This ftayed upon her ftomach, but produced an almoft conftant fick- nefs. Stools more frequent, water fcarce fenfibly increafed; and her fwellings not at all reduced. 4th Dav. Cap. Calomel. ambos. feill. Gc. Oss. Sufficient athe was eit allowed to Sees its effects, neither was the patient enjoined the free ufe of diluents, —_ ane sete e terminated geealy. ee William T—, At. 42.- Afcites, with cough and dyfpneea. Abdomen very much diftended. The reft of his body highly emaciated. Urine thick, high coloured, and in nie fmall geantity, aes ) 4tis horis. Be 7 PE Fer - Decodt =: ® in nm Efe Ke Poa of taking it. “The ath dole > pr dun fcknefs. oe gp a * cat ; after the a amie isth. A fmart purging « came on, aac the = of urine Spe cera oo - aoe 93d. Belly inch bound. Took a cathart. pow- der, which was followed by a diminution of the abdomen, _. 29th. To take a cathart. powder every ath morn- ing, continuing the decod. oie _ Oss. = the medicine w was vaginas till it 5 iat 3 zo to produce diuretic effects; and thefe effects were Dot | aided = any sees! tae Cute ee Bu: ee ‘Atcites, re and dylpnon. dis legs fo oe 154 COMMUNICATIONS Infuf. Digital. ziiifs. ad. aq. tbfs. cap, Zi. altern. horis donec naufeam excttavertt. Rep. 31its die- bus. tempore intermedio cap, fol, guaic, Zi. ter in die ex inf. finap. ift Day of taking it. Became fickifh towards night. | | : ~ 9d Dar. Madea had 8 flowed i into the bowels, farce appeersatcs® being then removed, t ie Digi. talis was omitted, and fills: competed of. wesc cinereus, aloes, and fal tartari ¢ aie Sted t we = Si. es vin. chal seat , Her a in are refpeds sae flowly, but regularly, from that time until the gth — of Oober; when the ftate of plethora again recur- _ ring, with its ufual attendant fymptoms, Ziv. of : blood were taken from the arm; and this was upon the fame occafion, repeated in the following mo -with manifeft good confequences; though i inftanees the oes = the blood, =< : ae = ak in. its colon as. pet 3 ome 3 “The = prey improved, in 1 commen ae: A soaks = 132 COMMUNICATIONS. the fyftem; but no intromiffion of bile had yet happened: the hardnefs about the hypogaftric regi- on, though lefs, continued in a confiderable de- gree, and you ordered pills of mercury rubbed down, and ruft of iron, to be taken twice a day, — a decoction of dandelion and fal fode. A cataplafm of on was applied every eed over the ftomach and right fide; and, with little deviation from this plan, fhe continued to the end » improving in her general health, but | affeétion yet remiainiig: Te was then deterninea” to try the effe&s of electricity; gentle fhocks were paffed throught the 2 Baty daily, and as nearly as could be through the liver, in va- rious directions, On the fifth day there was reafon to think that. fome gall had been fecreted and poured out, and -this became every day more evident; but it flowed © only in fmall pooees and a into” the though ebiaitoene yet fo ate as to pro- - -mife us the fatii sfa@ion of feeing her betes ref rune 29. The bile i is Row fecretdd in pretty es a atity, her appetite i is perfeétly good, her ftre r ee to aut Sed ees of exercife, and her health 2 fiom CORRESPONDENTS, 173 health in general better than it ae been, for fome years. eit ea ae ce GA § he - | Mr. W. , aged —. In Fune, 1782, was affected with flight difficulty in re{piration, upon tak- -ing exercife or lying down in bed. Thefe fymp- toms increafed gradually until the end of July, _ when he complained of fenfe of weight and uneafi- nefs about the prcecordia; lofs of appetite; and coftivenefs. The urine was {mall in quantity, and high coloured ; his pulfe feeble, and intermittings he breathed with difficulty - when in bed, and flept little. ‘After the exhibition of an emetic, and an me) pening medicine of rhubarb, ee he was directed to take half a dram —— {quill pi ae pharm. Edinburg. night and morning, with 3fs fa fode in Zifs. infuf. amar. fimpl. twice ad 2 thefe medicines were continued during ten days, without any fenfible effe&. A blifter was then ap- plied to the fternum, and fix grains of calomel giv- en in the evening. The fymptoms were now in- creafed very confiderably, in every particular; and the following infufion was fubftituted for the formme®. medicines. 2 Fol. Digital =e sii. oe — sii. infund.— i734 COMMUNICATIONS Sometime in the night confiderable naufea ac- curred, and the following day he began to make wa- ter in great quantity, which he continued to do for three or four days. The pulfe in a few hours be- came regular, flower, and ftronger, and, in the courfe of a week, all the fymptoms entirely vanith- ed, and an ele&uary of cort. peruvian, fal martis, and fpec, aromatic. confirmed his cure. ‘ ; is Sten hd ‘getitenia Sends relapfe his difeafe, from which he again foon he by the fame means, and is now perfectly Jn Febru, Ste G A——, a hufbandman, aged 57. Was in the year 1782 affeéted with a flight, but conftant pain in his breaft, with difficult refpiration. His. countenance was yellow; the abdomen fwelled, and e hard his urine high coloured, and in fmall quan- _ ity; app ~ ite > and fleep little.” be of fre- : Kaeee — exhibition of an emetic, fix grains of calomel were pa Be a ” a of va in the Z sie Fhe Nin tan became clearer and from CORRESPONDENTS, 175 the pain in his breaft confiderably diminifhed. But every other circumftance remaining the fame, and a fluctuation in the belly being now more evident, - the infufion of Digitalis as prefcribed in cafe third, - was given in the dofe of one ounce twice a day. On the 5th = the effets Were apparent, and)he continued his medicine fora fortnight without mn. ae fea, making four or five pints of water every night, but little in the day, and gradually lofing the fymp- toms of his difeafe. In 1784, this perfon had a pale and was again, eured pi Depileninaaee nie te R Hi sae ae ae ‘Tepsidathe sok Se year 1783, became affected with flight cough and ex- pectoration of purplent matter. In December his {kin became univerfally of a pale yellow colour. The abdomen was {welled and hard; his appetite little, and he complained of a violent and conftant — palpitation of the heart, which prevented him from fleeping, The urine pale, and in fmall quantity. The pulfé exceedingly ftrong, and reboundi beating 1 Tq) to 120 aes every minute. He 176 COMMUNICATIONS pofe. Repeated bleeding had no effet in diminifh- ing the violent aétion of the heart. He died in January following, under complicated fymptoms of phthifis and tees a 6 Sg 3a man aged 57, who had lived freely in the fum- wt of 1784, became affe@ed with oedematous fwelling of his. legs, for which he was advifed to irink Fox Glove Tea took a four ounce bafon of m with the green leaves, Oa the 5th he was faddenly feized with faintnefs and cold fweatings. I found him with a pale coun- tenance, complaining of weaknefs, and of pain, with a fenfe of great heat in his ftomach and bowels. The fwelling of the legs was entirely gone, he having evacuated urine in very large quantities for the t two Shoes days. He was s affeded with m eve ry h bli: nifters- were applied to the ancles, = sehsich his ‘pti became gra- dually alleviated, aa he recovered perfeétly in the — fpace of three wee eks farca, for which the Digitalis was afterwards fuccefs- ally employed, in {mall dofes, without pee dif ble eo. pig Ge eee ; except a relapfe of the ana- | fron CORRESPONDENTS. 177 Case Wi ——— oD , a middle aged fingle woman, was affected in the year eighty-one, with a painful rigidity and flight inflammation of the integuments on the left fide, extending from the ear to the fhoul- der. In eyery other particular fhe was healthy. The ufe of warm fomentations, and opium, with two or three dofes of mercurial phyfic, afforded her eafe and theinflammation difappeared, but was fuc- ceeded by an oedematous {welling of the part, which very gradually extended along the arm, and down- ward to the breaft, back, and belly. Friction, electricity and mercurial ointment were amongtt the number of applications unfuccefsfully employed to relieve her for the fpace of three months, during _ which time fhe continued in good general health. In November fhe became afcitic, paffing fmall quantities of urine, and foon afterwards a fudden _ dyfpnoea gave occafion to fuppofean effufion of water in the thorax. The Digitalis, fquills, and cantha~ tides were given in very confiderable dofes without effe&. She died the latter end of December fol- lowing. CASE VII. : Wie Ceniee;..a collier aged 58, was at- _ tacked in the fpring of 1783 with 2 tertian ague, which he attributed to cold, by fleeping in a coal oe : M pit, ss 178 COMMUNICATIONS, &c. pit, and from which he recovered in a few days, except a {welling of the lower extremities, which had appeared about that time, and gradually in- creafed for two or three months. The legs and thighs were greatly enlarged and cedematous. _ His belly was fwelled, but no flu@uation perceptible. He made fmall quantities of high coloured water. The appetite bad, and pulfe feeble. He had taken many medicines without relief, and was now fo reduced _ in ftrength, as to fit up with difficulty. An infufion . of the Digitalis was directed for him, in the proportion of one ounce of the frefh leaves to a pint of water ‘two ounces to be taken three times a day, until the ftomach or bowels became affected. Upon the exhibition of the fixth dofe, naufea fupervened, and continued to opprefs him at intervals for two or three days, during which he paffed large quantities of pale urine. The fwelling, affifted by moderate | bandage rapidly diminifhed, and without any repe- Btior pete: ees at the expiration of fixigen a labour reds OF OF THE PREPARATIONS and DOSES, ee OF ERLE FOXGLOVE E" VERY part of the plant has more onlefs of the. eae inion’ Vv “a ae SS ger as ROOT. —This varies a thie ag of “the Plant. When the ftem has fhot up for flower- ing, “which it does the fecond year of its yom, the root becomes dry, nearly taftelefs, and inert. ‘Some praitioners, who have ufed the root, and — ~ been fo happy as to cure their patients without exe citing ficknefs, have been pleafed to communicate the circumftance to me as an improvement in the ufe of the plant. I have no doubt of the tra their remarks, and I thank Pipe 2 But ‘ 180 PREPARATIONS if neceffary, bring other proof to fhew that the root is juft as capable as the leaves, of exciting naufea. S T EM.—tThe ftem has more tafte than the root has, in the feafon the ftem fhoots out, and lefs tafte than the leaves. I do not know that it- has been ' particularly felected for ufe. LEAVES. —Thefe vary greatly in their eff- _ cacy at different icaions of the Phe a perhaps, Some who have been habituated to the af of the recent leaves, tell me, that they anfwer their purpofe at every feafon of the year; and I believe them, notwithftanding I myfelf have found very. great variations in this refpe&. The folution of this difficulty is obvious. They have ufed the leaves — fuch large proportion, that the dofes have been a acious fiate. The ftehs ec hag in =< FES een. — te Bisse: and the ‘pointal have nearly the, tafte of the leaves, and 5 Se 3. be to me, by a very fenfible and judicious friend, that it might be well to fix on the flower for internal ufe. I fee no objection to” the - prope Bon: but I have not tried it. 5; SEEDS. or more than fufficient, even in their — and DOSES. 181 SEED S.—Thefe I believe sae untried, From this view of the different parts of the plant, it is fufficiently obvious why I ftill continue to <= fer the leaves. Thefe fhould be gathered after the Coe ftem has fhot up, and about the time that the —— are coming forth. The leaf-ftalk and mid-rib of the leaves fhould - be rejected, and the remaining part fhould be dried, either in the fun-{hine, or on a tin ek or pewter pa before a ie sabeet dried, they ali ritdonnty « bois ful green powder, which weighs fomething lefs than one-fifth of the original weight of the leaves. — muft be taken that the leaves be not fcorche drying, and they fhould not be dried more than what is requifite to allow of their being — re-" ~ agg to — = alone Coenetienes unite it ok aron ym ometimes form it into pills with a_ 182° PREPARATIONS. - Ifa liquid medicine be preferred, I ordera dram of thefe dried leaves to be infufed for four hours in half a pint of boiling water, adding to the ftrained liqu ior an ounce ‘of any fpirituous water. One ounce of this infufion given twice a day, is a medium dofe for an adult patient. If the patient be ftronger than ufual, or the fymptoms very urgent, this dofe may be given once in eight hours ; and on the contrary in many inftances half an ounce at a time will be quite fuilicient. About ne! grains of the AD ae i: The ingenuity of man has ever been fond of eR erting itfelf to vary the forms and combinations of medicines. Hence we have {pirituous, vinous, and acetous tin@ures; extrads hard and foft, fyrups with fugar or heney, &c.. but the “more we multi- ply the forms of any medicine, the longer we fhall be. in afcertaining its real dofe. I have no lafting bjection however to any of thefe formule secret | Teas appears “i ae igitalis is difpofed ee opium may be join : ith it advantageoully and when the bowels are ? may be given at the fame time, without ee er, without haters with its dinsetic effeas ; but I have not found benefit from any other adjund _ ae this view of the dofes in whe the: Dig- talis really ought to be exhibited, and from the evi- dence of many of the cafes, in which it appears to have been given in quantities fix, eight, ten or even twelve times more than neceffary, we muft admit as an inference either that this medicine is perfectly fafe when given as I advife, or that the medicines in daily ufe are highly dangerous. ( 184 .: EFFECTS, RULES, and CAUTIONS. Tiers Foxglove when given in very iste and quick- ly-repeated dofes, occafions ficknefs, vomiting, purging, giddinefs, confufed vifion, objeéts appear- ing green-or yellow ; increafed fecretion of urine, with frequent motions to part with it, and fometimes inability to retain it 5 flow pulfe, even as flow as 35 a min 0 = fweats, convulfions, aay When given in a lefs violent manner, it pro- duces moft of thefe effects in a lower degree ; and it is curious to obferve, .that the ficknefs, with a cer-. tain dofe of the medicine, does not take place for ma- — ny hours after its exhibition has been difcontinued ; that the flow of urine will often precede, fometimes accompany, frequently follow the ficknefs at the diftance of fome day:, and not unfrequently be checked by it. The ficknefs thus excited, is ex- tremely different from that occafioned by any other medicine; it is peculiarly diftreffing to the patient ; it ceafes, it recurs again as violent as before; and thus it will continue to recur for three or four days, . at diftant and more diftant intervals. ae *® RULES and CAUTIONS; 185 Thefe fufferings of the patient are genera y re- warded by a return of appetite, much greater than what exifted before the taking of the medicine. But thefe fufferings are not at all neceffary ; they are the effects of our inexperience, and would in fimilar circumftances, more or lefs attend the ex- hibition of almoft every active and powerful medi- ciné we ufe. Bettas the reader will better underftand how it ought to be given, from the following detail of my own improvement, than from precepts pesemnpors, ly delivered, and: their —_— verled * in obfcurity. AGE tI oes it tl a , tiie in ala continue the ficknefs, in order to enfure the di = : effects. T foon learnt that the naufea being once excited, it was unneceflary to repeat the medicine, as it was certain to recur frequently, at intervals more or lefs diftant. a ~ Therefore my patients were ordered to perfift — until the naufea came on, and then to flop. But foon appeared that the diuretic effects would tale place firft, and fometimes be checked wl licknef{s or a purging Le edigii 186 SE EE ECSE S The direction was therefore enlarged thus—Con- tinue the medicine until the urine flows, or ficknefs or purging take place. . I found myfelf fafe under this regulation for two or three years ; but at length cafes occurred in which the pulfe would be retarded to. an alarming degree, without any other preceding effect. _ The direétions therefore required an eileen | attention ‘to the fate of the pulfe, and it was more- over of confequence not to repeat the saee too matckiy. but to aHow- tulhiciene