CASE LVII.

November 16th. Mrs. F——, AEt. 53. In August last was suddenly seized with epileptic fits, which continued to recur at uncertain intervals. Her belly had long been larger than natural, but without any perceptible fluctuation. Her legs and thighs swelled very considerably the beginning of this month, and now there was evidently water in the abdomen. The medicines hitherto in vain directed against the epileptic attacks, were now suspended, and two grains of the Pulv. fol. Digital. directed to be taken every six hours. The effects were most favourable, and the dropsical symptoms were soon removed by copious urinary discharges.

The attacks of epilepsy ceased soon afterwards. In February, 1781, there was some return of the swellings, which were soon removed, and she now enjoys very good health. Does not the narrative of this case throw light upon the nature of the epilepsy which sometimes attacks women, soon after the cessation of the menstrual flux?

1781.

CASE LVIII.

January 1st. Mrs. G——, of H——, AEt. 62. Ascites and very large hard legs. After trying various medicines, under the direction of a very able physician, I ordered her to take one grain of Pulv. Digital. every six hours, but it produced no effect. Other Medicines were then tried to as little purpose. About the end of February, I directed an infusion of the Fol. Digital. but with no better success. Other methods were thought of, but none proved efficacious, and she died a few weeks afterwards.

CASE LIX.

January 3d. Mrs. B——, AEt. 53. Ascites, anasarca, and jaundice. After a purge of calomel and jallap, was ordered the Infusion of Digitalis: it acted kindly as a diuretic, and greatly reduced her swellings. Other medicines were then administered, with a view to her other complaints, but to no purpose, and she died about a month afterwards.

CASE LX.

January 14th. Mr. B——, of D——. Jaundice and ascites, the consequences of great intemperance. Extremely emaciated; his tongue and fauces covered with apthous crusts, and his appetite gone. He first took tincture of cantharides with infusum amarum, then vitriolic salts, and various other medicines without relief; Infusum Digitalis was given afterwards, but was equally unsuccessful.

CASE LXI.

February 2d. I was desired by the late learned and ingenious Dr. Groome, to visit Miss S——, a young lady in the last state of emaciation from a dropsy. Every probable means to relieve her had been attempted by Dr. Groome, but to no purpose; and she had undergone the operation of the paracentesis repeatedly. The Doctor knew, he said, that I had cured many cases of dropsy, by the Digitalis, after other more usual methods had been attempted without success, and he wished this lady to try that medicine under my direction; after examining the patient, and enquiring into the history of the disease, I was satisfied that the dropsy was encysted, and that no medicine could avail. The Digitalis, however, was directed, and she took it, but without advantage. She had determined not to be tapped again, and neither persuasion, nor distress from the distension, could prevail upon her: I at length proposed to make an opening into the sac, by means of a caustic, which was done under the judicious management of Mr. Wainwright, surgeon, at Dudley. The water was evacuated without any accident, and the patient afterwards let it out herself from time to time as the pressure of it became troublesome, until she died at length perfectly exhausted.

Query. Is there not a probability that this method, assisted by bandage, might be used so as to effect a cure, in the earlier stages of ovarium dropsy?

CASE LXII.

February 27th. Mrs. O——, of T——, AEt. 52, with a constitution worn out by various complicated disorders, at length became dropsical. The Digitalis was given in small doses, in hopes of temporary benefit, and it did not fail to fulfil our expectations.

CASE LXIII.

March 16th. Mrs. P——, AEt. 47. Great debility, pale countenance, loss of appetite, legs swelled, urine in small quantity. A dram of Fol. siccat. Digital. in a half pint infusion was ordered, and an ounce of this infusion directed to be taken every morning. Myrrh and steel were given at intervals. Her urine soon increased, and the symptoms of dropsy disappeared.

CASE LXIV.

March 18th. Mr. W——, in the last stage of a pulmonary consumption became dropsical. The Digitalis was given, but without any good effect.

CASE LXV.

April 6th. Mr. B——, AEt. 63. For some years back had complained of being asthmatical, and was not without suspicion of diseased viscera. The last winter he had been mostly confined to his house; became dropsical, lost his appetite, and his skin and eyes turned yellow. By the use of medicines of the deobstruent class he became less discoloured, and the hardness about his stomach seemed to yield; but the ascites and anasarcous symptoms increased so as to oppress his breathing exceedingly. Alkaline salts, and other diuretics failing of their effects, I ordered him to take an infus. of Digitalis. It operated so powerfully that it became necessary to support him with cordials and blisters, but it freed him from the dropsy, and his breath became quite easy. He then took soap, rhubarb, tartar of vitriol, and steel, and gradually attained a good state of health, which he still continues to enjoy.

CASE LXVI.

April 8th. Mr. B——, AEt. 60. A corpulent man, with a stone in his bladder, from which at times his sufferings are extreme. He had been affected with what was supposed to be an asthma, for several years by fits, but through the last winter his breath had been much worse than usual; universal anasarca came on, and soon afterwards an ascites. Now his urine was small in quantity and much saturated, the dysuria was more dreadful than ever; his breath would not allow him to lie in bed, nor would the dysuria permit him to sleep; in this distressful situation, after having used other medicines to little purpose, I directed an infusion of Digitalis to be given. When the quantity of urine became more plentiful, the pain from his stone grew easier; in a few days the dropsy and asthma disappeared, and he soon regained his usual strength and health. Every year since, there has been a tendency to a return of these complaints, but he has recourse to the infusion, and immediately removes them.

CASE LXVII.

April 24th. Mr. M——, of C——, AEt. 57. Asthma, anasarca, jaundice, and great hardness and straitness across the region of the stomach. After a free exhibition of neutral draughts, alkaline salt, &c. the dropsy and difficult breathing remaining the same, he took Infusum Digitalis, which removed those complaints. He never lost the hardness about his stomach, but enjoyed very tolerable health for three years afterwards, without any return of the dropsy.

CASE LXVIII.

April 25th. Mrs. J——, AEt. 42. Phthisis pulmonalis and anasarcous legs and thighs. She took the Infusum Digitalis without effect. Myrrh and steel, with fixed alkaly, were then ordered, but to no purpose.

CASE LXIX.

May 1st. Master W——, of St——, AEt. 6. I found him with every symptom of hydrocephalus internus. As it was yet early in the disease, in consequence of ideas which will be mentioned hereafter, I directed six ounces of blood to be immediately taken from the arm; the temporal artery to be opened the succeeding day; the head to be shaven, and six pints of cold water to be poured upon it every fourth hour, and two scruples of strong mercurial ointment to be rubbed into the legs every day. Five days afterwards, finding the febrile symptoms very much abated, and judging the remaining disease to be the effect of effusion, I directed a scruple of Fol. Digital. siccat. to be infused in three ounces of water, and a table spoonful of the infusion to be given every third or fourth hour, until its action should be someway sensible. The effect was, an increased secretion of urine; and the patient soon recovered.

CASE LXX.

May 3d. Mrs. B——, AEt. 59. Ascites and anasarca, with strong symptoms of diseased viscera. Infusum Digitalis was at first prescribed, and presently removed the dropsy. She was then put upon saline draughts and calomel. After some time she became feverish: the fever proved intermittent, and was cured by the bark.

CASE LXXI.

May 3d. Mr. S——, AEt. 48. A strong man, who had lived intemperately. For some time past his breath had been very short, his legs swollen towards evening, and his urine small in quantity. Eight ounces of the Infus. Digitalis caused a considerable flow of urine; his complaints gradually vanished, and did not return.

CASE LXXII.

May 24th. Joseph B——, AEt. 50. Ascites, anasarca, and jaundice, from intemperate living. Infusion of Digitalis produced nausea, and lowered the frequency of the pulse; but had no other sensible effects. His disorder continued to increase, and killed him about two months afterwards.

CASE LXXIII.

June 29th. Mr. B——, AEt. 60. A hard drinker; afflicted with asthma, jaundice, and dropsy. His appetite gone; his water foul and in small quantity. Neutral saline mixture, chrystals of tartar, vinum chalybeat. and other medicines had been prescribed to little advantage. Infusion of Fol. Digitalis acted powerfully as a diuretic, and removed the most urgent of his complaints, viz. the dropsical and asthmatical symptoms.

The following winter his breathing grew bad again, his appetite totally failed, and he died, but without any return of the ascites.

CASE LXXIV.

June 29th. Mr. A——, AEt. 58. Kept a public house and drank very hard. He had symptoms of diseased viscera, jaundice, ascites, and anasarca. After taking various deobstruents and diuretics, to no purpose, he was ordered the Infusion of Digitalis: a few doses occasioned a plentiful flow of urine, relieved his breath, and reduced his swellings; but, on account of his great weakness, it was judged imprudent to urge the medicine to the entire evacuation of the water. He was so much relieved as to be able to come down stairs and to walk about, but his want of appetite and jaundice continuing, and his debility increasing, he died in about two months.

CASE LXXV.

July 18th. Mrs. B——, AEt. 46. A little woman, and very much deformed. Asthmatical for many years. For several months past had been worse than usual; appetite totally gone, legs swollen, sense of great fulness about her stomach, countenance fallen, lips livid, could not lie down.

The usual modes of practice failing, the Digitalis was tried, but with no better success, and in about a month she died; not without suspicion 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 small doses of opium in such constitutions, however much they may be urged by the patient to prescribe something that may procure a little rest and ease.

CASE LXXVI.

August 12th. Mr. L——, AEt. 65, the person whose Case is recorded at No. XXIV, had a return of his insanity, after near two years perfect health. He was extremely reduced when I saw him, and the medicine which cured him before was now administered without effect, for his weakness was such that I did not dare to urge it.

CASE LXXVII.

September 10th. Mr. V——, of S——, AEt. 47. A man of strong fibre, and the remains of a florid complexion. His disease an ascites and swelled legs, the consequence of a very free course of life; he had been once tapped, and taken much medicine before I saw him. The Digitalis was now directed: it lowered his pulse, but did not prove diuretic. He returned home, and soon after was tapped again, but survived the operation only a few hours.

CASE LXXVIII.

September 25th. Mr. O——, of M——, AEt. 63. Very painful and general swellings in all his limbs, which had confined him mostly to his bed since the preceding winter; the swellings were uniform, tense, and resisting, but the skin not discoloured. After trying guiacum and Dover's powder without advantage. I directed Infusion of Digitalis. It acted on the kidneys, but did net relieve him. It is not easy to say what the disease was, and the patient living at a distance, I never learnt the future progress or termination of it.

CASE LXXIX.

September 26th. Mr. D——, AEt. 42, a very sensible and judicious surgeon at B——, in Staffordshire, laboured under ascites and very large anasarcous legs, together with indubitable symptoms of diseased viscera. Having tried the usual diuretics to no purpose, I directed a scruple of Fol. Digital siccat. in a four ounce infusion, a table spoonful to be taken twice a day. The second bottle wholly removed his dropsy, which never returned.

CASE LXXX.

September 27th. Mrs. E——, AEt. 42. A fat sedentary woman; after a long illness, very indistinctly marked; had symptoms of enlarged liver and dropsy. In this case I was happy in the assistance of Dr. Ash. Digitalis was once exhibited in small doses, but to no better purpose than many other medicines. She suffered great pain in the abdomen for several weeks, and after her death, the liver, spleen, and kidneys were found of a pale colour, and very greatly enlarged, but the quantity of effused fluid in the cavity was not more than a pint.

CASE LXXXI.

October 28th. Mr. B——, AEt. 33. Had drank an immense quantity of mild ale, and was now become dropsical. He was a lusty man, of a pale complexion: his belly large, and his legs and thighs swollen to an enormous size. I directed the Infusion of Digitalis, which in ten days completely emptied him. He was then put upon the use of steel and bitters, and directed to live temperately, which I believe he did, for I saw him two years afterwards in perfect health.

CASE LXXXII.

November 14th. Mr. W——, of T——, AEt. 49. A lusty man, with an asthma and anasarca. He had taken several medicines by the direction of a very judicious apothecary, but not getting relief as he had been accustomed to do in former years, he came under my direction. For the space of a month I tried to relieve him by fixed alkaly, seneka, Dover's powder, gum ammoniac, squill, &c. but without effect. I then directed Infusion of Digitalis, which soon increased the flow of urine without exciting nausea, and in a few days removed all his complaints.

1782.

CASE LXXXIII.

January 23d. Mr. Q——, AEt. 74. A stone in his bladder for many years; dropsical for the last three months. Had taken at different times soap with squill and gum ammoniac; soap lees; chrystals of tartar, oil of juniper, seneka, jallap, &c. but the dropsical symptoms still increased, and the dysuria from the stone became very urgent. I now directed a dram of the Fol. Digit. siccat. in a half pint infusion, half an ounce to be given every six hours. This presently relieved the dysuria, and soon removed the dropsy, without any disturbance to his system.

CASE LXXXIV.

January 27th. Mr. D——, AEt. 86. The debility of age and dropsical legs had long oppressed him. A few weeks before his death his breathing became very short, he could not lie down in bed, and his urine was small in quantity. A wine glass of a weak Infusion of Digitalis, warmed with aromatics, was ordered to be taken twice a day. It afforded a temporary relief, but he did not long survive.

CASE LXXXV.

January 28th. Mr. D——, AEt. 35. A publican and a hard drinker. Ascites, anasarca, diseased viscera, and slight attacks of haemoptoe. A dram of Fol. Digital. sicc. in a half pint infusion, of which one ounce was given night and morning, proved diuretic and removed his dropsy. He then took medicines calculated to relieve his other complaints. The dropsy did not return during my attendance upon him, which was three or four weeks. A quack then undertook to cure him with blue vitriol vomits, but as I am informed, he presently sunk under that rough treatment.

CASE LXXXVI.

January 29th. Mrs. O——, of D——, AEt. 53. A constant and distressing palpitation of her heart, with great debility. From a degree of anasarca in her legs I was led to suspect effusion in the Pericardium, and therefore directed Digitalis, but it produced no benefit. She then took various other medicines with the same want of success, and about ten months afterwards died suddenly.

CASE LXXXVII.

January 31st. Mr. T——, of A——, AEt. 81. Great difficulty of breathing, so that he had not lain in bed for the last six weeks, and some swelling in his legs. These complaints were subsequent to a very severe cold, and he had still a troublesome cough. He told me that at his age he did not look for a cure, but should be glad of relief, if it could be obtained without taking much medicine. I directed an Infusion of Digitalis, a dram to eight ounces, one spoonful to be taken every morning, and two at night. He only took this quantity; for in four days he could lie down, and soon afterwards quitted his chamber. In a month he had a return of his complaints, and was relieved as before.

CASE LXXXVIII.

January 31st. Mrs. J——, of S——, AEt. 67. A lusty woman, of a florid complexion, large belly, and very thick legs. She had been kept alive for some years by the discharge from ulcers in her legs; but the sores now put on a very disagreeable livid appearance, her belly grew still larger, her breath short, her pulse feeble, and she could not take nourishment. Several medicines having been given in vain, the Digitalis was tried, but with no better effect; and in about a month she died.

CASE LXXXIX.

February 2d. Mr. B——, AEt. 73. An universal dropsy. He took various medicines, and Digitalis in small doses, but without any good effect.

CASE XC.

February 24th. Master M——, of W——, AEt. 10. An epilepsy of some years continuance, which had never been interrupted by any of the various methods tried for his relief. The Digitalis was given for a few days, but as he lived at a distance, so that I could not attend to its effects, he only took one half pint infusion, which made no alteration in his complaint.

CASE XCI.

March 6th. Mr. H——, AEt. 62. A very hard drinker, and had twice had attacks of apoplexy. He had now an ascites, was anasarcous, and had every appearance of a diseased liver. Small doses of calomel, Dover's powder, infusum amarum, and sal sodae palliated his symptoms for a while; these failing; blisters, squills, and cordials were given without effect. A weak Infusion of Digitalis, well aromatised, was then directed to be given in small doses. It rather seemed to check than to increase the secretion of urine, and soon produced sickness. Failing in its usual effect, the medicine was no longer continued; but every thing that was tried proved equally inefficacious, and he did not long survive.

CASE XCII.

May 10th. Mrs. P——, AEt. 40. Spasmodic asthma of many years continuance, which had frequently been relieved by ammoniacum, squills, &c. but these now failing in their wonted effects, an Infus. of Fol. Digitalis was tried, but it seemed rather to increase than relieve her symptoms.

CASE XCIII.

May 22d. Mr. O——, of B——, AEt. 61. A very large man, and a free liver; after an attack of hemiplegia early in the spring, from which he only partially recovered, became dropsical. The dropsy occupied both legs and thighs, and the arm of the affected side. I directed an Infusion of Digitalis in small doses, so as not to affect his stomach. The swellings gradually subsided, and in the course of the summer he recovered perfectly from the palsy.

CASE XCIV.

July 5th. Mr. C——, of W——, AEt. 28. Had drank very freely both of ale and spirits; and in consequence had an ascites, very large legs, and great fulness about the stomach. He was ordered to take the Infusion of Digitalis night and morning for a few days, and then to keep his bowels open with chrystals of tartar. The first half pint of infusion relieved him greatly; after an interval of a fortnight it was repeated, and he got well without any other medicine, only continuing the chrystals of tartar occasionally. I forgot to mention that this gentleman, before I saw him, had been for two months under the care of a very celebrated physician, by whose direction he had taken mercurials, bitters, squills, alkaline salts, and other things, but without much advantage.

CASE XCV.

March 6th. Mrs. W——, AEt. 36. In the last stage of a pulmonary consumption, took the Infus. Digitalis, but without any advantage.

CASE XCVI.

August 20th. Mr. P——, AEt. 43. In the year 1781 he had a severe peripneumony, from which he recovered with difficulty. At the date of this, when he first consulted me, the symptoms of hydrothorax were pretty obvious. I directed a purge, and then the Infusum Digitalis, three drams to half a pint, one ounce to be taken every four hours. It made him sick, and occasioned a copious discharge of urine. His complaints immediately vanished, and he remains in perfect health.

CASE XCVII.

September 24th. Mrs. R——, of B——, AEt. 35, the mother of many children. After her last lying in, three months ago, had that kind of swelling in one of her legs which is mentioned at No. VIII. XXVI, and XXXI. A considerable degree of swelling still remained; the limb was heavy to her feeling, and not devoid of pain. I directed a bolus of five grains of Pulv. Digitalis, and twenty-five of crude quicksilver rubbed down, with conserve of cynosbat. to be taken at bed-time, and afterwards an Infusion of red bark and Fol. Digitalis to be taken twice a day. There was half an ounce of bark and half a dram of the leaves in a pint infusion: the dose two ounces.

The leg soon began to mend, and two pints of the infusion finished the cure.

CASE XCVIII.

September 25th. Mr. R——, AEt. 60. Complained to me of a sickness after eating, and for some weeks past he had thrown up all his food, soon after he had swallowed it. He had taken various medicines, but found benefit from none, and had tried various kinds of diet. He was now very thin and weak; but had a good appetite. As several very probable methods had been prescribed, and as the usual symptoms of organic disease were absent, I determined to give him a spoonful of the Infusion of Digitalis twice a day; made by digesting two drams of the dried leaves in half a pint of cinnamon water. From the time he began to take this medicine he suffered no return of his complaint, and soon recovered his flesh and his strength.

It should be observed, that I had frequently seen the Digitalis remove sickness, though prescribed for very different complaints.

CASE XCIX.

September 30th. Mrs. A——, AEt. 38. Hydrothorax and anasarca. Her chest was very considerably deformed. One half pint of the Digitalis Infusion entirely cured her.

CASE C.

September 30th. Mr. R——, of W——, AEt. 47. Hydrothorax and anasarca. An Infusion of Digitalis was directed, and after the expected effects from that should take place, sixty drops of tincture of cantharides twice a day. As he was costive, pills of aloes and steel were ordered to be taken occasionally.

This plan succeeded perfectly. About a month afterwards he had some rheumatic affections, which were removed by guiacum.

CASE CI.

October 2d. Mrs. R——, AEt. 60. Diseased viscera; ascites and anasarca. Had taken various deobstruent and diuretic medicines to little purpose. The Digitalis brought on a nausea and languor, but had no effect on the kidneys.

CASE CII.

October 12th. Mr. R——, AEt. 41. A publican, and a hard drinker. His legs and belly greatly swollen; appetite gone, countenance yellow, breath very short, and cough troublesome. After a vomit I gave him calomel, saline draughts, steel and bitters, &c. He had taken the more usual diuretics before I saw him. As the dropsical symptoms increased, I changed his medicines for pills made of soap, containing two grains of Pulv. fol. Digital, in each dose, and, as he was costive, two grains of jallap. He took them twice a day, and in a week was free from every appearance of dropsy. The jaundice soon afterwards vanished, and tonics restored him to perfect health.

CASE CIII.

October 12th. Mr. B——, AEt. 39. Kept a public house, drank very freely, and became dropsical; he complained also of rheumatic pains. I directed Infusion of Digitalis, half an ounce twice a day. In eight days the swellings in his legs and the fulness about his stomach disappeared. His rheumatic affections were cured by the usual methods.

CASE CIV.

October 22d. Master B——, AEt. 3. Ascites and universal anasarca. Half a grain of Fol. Digital. siccat. given every six hours, produced no effect; probably the medicine was wasted in giving. An infusion of the dried leaf was then tried, a dram to four ounces, two tea spoonfuls for a dose; this soon increased the flow of urine to a very great degree, and he got perfectly well.

CASE CV.

October 30th. Mr. G——, of W——, AEt. 88. The gentleman mentioned in No. XLVII. His complaints and manner of living the same as there mentioned. I ordered an Infusion of the Digitalis, a dram and half to half a pint; one ounce to be taken twice a day; which cured him in a short time.

On March the 23d, 1784, he sent for me again. His complaints were the same, but he was much more feeble. On this account I directed a dram of the Fol. Digitalis to be infused for a night in four ounces of spirituous cinnamon water, a spoonful to be taken every night. This had not a sufficient effect; therefore, on the 22d of April, I ordered the infusion prescribed two years before, which soon removed his complaints.

He died soon afterwards, fairly worn out, in his ninetieth year.

CASE CVI.

November 2d. Mr. S——, of B——h——, AEt. 61. Hydrothorax and swelled legs. Squills were given for a week in very full doses, and other modes of relief attempted; but his breathing became so bad, his countenance so livid, his pulse so feeble, and his extremities so cold, that I was apprehensive upon my second visit that he had not twenty-four hours to live. In this situation I gave him the Infusum Digitalis stronger than usual, viz. two drams to eight ounces. Finding himself relieved by this, he continued to take it, contrary to the directions given, after the diuretic effects had appeared.

The sickness which followed was truly alarming; it continued at intervals for many days, his pulse sunk down to forty in a minute, every object appeared green to his eyes, and between the exertions of reaching he lay in a state approaching to syncope. The strongest cordials, volatiles, and repeated blisters barely supported him. At length, however, he did begin to emerge out of the extreme danger into which his folly had plunged him; and by generous living and tonics, in about two months he came to enjoy a perfect state of health.

CASE CVII.

November 19th. Master S——, AEt. 8. Ascites and anasarca. A dram of Fol. Digitalis in a six ounce infusion, given in doses of a spoonful, effected a perfect cure, without producing nausea.

1783.

The reader will perhaps remark, that from the middle of January to the first of May, not a single case occurs, and that the amount of cases is likewise less than in the preceding or ensuing years; to prevent erroneous conjectures or conclusions, it may be expedient to mention, that the ill state of my own health obliged me to retire from business for some time in the spring of the year, and that I did not perfectly recover until the following summer.

CASE CVIII.

January 15th. Mrs. G——, AEt. 57. A very fat woman; has been dropsical since November last; with symptoms of diseased viscera. Various remedies having been taken without effect, an Infusion of Digitalis was directed twice a day, with a view to palliate the more urgent symptoms. She took it four days without relief, and as her recovery seemed impossible it was urged no farther.

CASE CIX.

May 1st. Mrs. D——, AEt. 72. A thin woman, with very large anasarcous legs and thighs; no appetite and general debility. After a month's trial of cordials and diuretics of different kinds, the surgeon who had scarified her legs apprehended they would mortify; she had very great pain in them, they were very red and black by places, and extremely tense. It was evident that unless the tension could be removed, gangrene must soon ensue. I therefore gave her Infusum Digitalis, which increased the secretion of urine by the following evening, so that the great tension began to abate, and together with it the pain and inflammation. She was so feeble that I dared not to urge the medicine further, but she occasionally took it at intervals until the time of her death, which happened a few weeks afterwards.

CASE CX.

May 18th. I was desired to prescribe for Mary Bowen, a poor girl at Hagley. Her disease appeared to me to be an ovarium dropsy. In other respects she was in perfect health. I directed the Digitalis to be given, and gradually pushed so as to affect her very considerably. It was done; but the patient still carries her big belly, and is otherwise very well.

CASE CXI.

May 25th. Mr. G——, AEt. 28. In the last stage of a pulmonary consumption of the scrophulous kind, took an Infusion of Digitalis, but without any advantage.

CASE CXII.

May 31st. Mr. H——, AEt 27. In the last stage of a phthisis pulmonalis became dropsical. He took half a pint of the Infusum Digitalis in six days, but without any sensible effect.

CASE CXIII.

June 3d. Master B——, of D——, AEt. 6. With an universal anasarca, had an extremely troublesome cough. An opiate was given to quiet the cough at night, and 2 tea spoonfuls of Infus. Digit. were ordered every six hours. The dropsy was presently removed; but the cough continued, his flesh wasted, his strength failed, and some weeks afterwards he died tabid.

CASE CXIV.

June 19th. Mrs. L——, AEt. 28. A dropsy in the last stage of a phthisis. Infusum Digitalis was tried to no purpose.

CASE CXV.

June 20th. Mrs. H——, AEt. 46. A very fat, short woman; had suffered severely through the last winter and spring from what had been called asthma; but for some time past an universal anasarca prevailed, and she had not lain down for several weeks. After trying vitriolic acid, tincture of cantharides, squills, &c. without advantage, she took half a pint of Infus. Digitalis in three days. In a week afterwards the dropsical symptoms disappeared, her breath became easy, her appetite returned, and she recovered perfect health. The infusion neither occasioned sickness nor purging.

CASE CXVI.

June 24th. Mrs. B——, AEt. 40. A puerperal fever, and swelled legs and thighs. The fever not yielding to the usual practice, I directed an Infusion of Fol. Digitalis. It proved diuretic; the swellings subsided, but the fever continued, and a few days afterwards a diarrhoea coming on, she died.

CASE CXVII.

July 22d. Mr. F——, AEt. 48. A strong man, of a florid complexion, in consequence of intemperance became dropsical, with symptoms of diseased viscera, great dyspnoea, a very troublesome cough, and total loss of appetite. He took mild mercurials, pills of soap, rhubarb, and tartar of vitriol, with soluble tartar and dulcified spirits of nitre in barley water. After a reasonable trial of this plan, he took squill every six hours, and a solution of assafetida and gum ammoniac, to ease his breathing: finding no relief, I gave him chrystals of tartar with ginger; but his remaining health and strength daily declined, and he was not at all benefited by the medicines. I was averse to the use of Digitalis in this case, judging from what I had seen in similar instances of tense fibre, that it would not act as a diuretic. I therefore once more directed squill, with decoction of seneka and sal sodae; but it was inefficacious. His strength being much broken down, I then ordered gum ammoniac, with small doses of opium, and infusum amarum, continuing the squill at intervals. At length I was urged to give the Digitalis, and considering the case as desperate, I agreed to do it. The event was as I expected; no increase in the urine took place; and the medicine being still continued, his pulse became slow, and he apparently sunk under its sedative effects. He was neither purged nor vomited; and had the Digitalis either been omitted altogether, or suspended upon its first effects upon the pulse being observed, he might perhaps have existed a week longer.

CASE CXVIII.

July 26th. Mr. W——, of W——, AEt. 47. Phthisis pulmonalis, jaundice, ascites, and swelled legs. As it was probable that the only relief I could give in a case so circumstanced, would be by carrying off the effused fluids. I tried squill and fixed alkaly; and these failing, I ordered the Infusum Digitalis. This had the desired effect, and, I believe, prolonged his life a few weeks.

CASE CXIX.

August 15th. Mrs. C——, AEt. 60. Ascites, anasarca, diseased viscera, paucity of urine, and total loss of appetite. These complaints had heretofore existed repeatedly, and had been removed by deobstruent and diuretic medicines; but in this attack the symptoms were suffered to exist a longer time and in a greater degree, before assistance was sought for. The remedies that used to relieve her were now exhibited to no purpose. Mild mercurials, soap, rhubarb, and squill were tried; but she grew rapidly worse. Saline draughts with acetum scilliticum seemed for a few days to check the progress of her complaint, but they soon lost their effect, and diarrhoea ensued upon every attempt to increase the frequency of the dose. Draughts with Infus. Digital. were then directed to be taken twice a day. The effect was a powerful action on the kidneys, and a reduction of the swellings, but without sickness. A degree of appetite returned, but still the tendency to diarrhoea existed, and kept her weak. Tonic medicines were then tried, but without advantage, and in a month it was necessary to have recourse to the Digitalis again. It was directed in a half pint mixture; an ounce to be taken thrice in twenty-four hours. On the 2d day, finding her symptoms very much relieved, she took in the absence of her nurse, nearly a double dose of the medicine. The consequence was great sickness, languor continuing for several days, and almost a total stop to the secretion of urine, from the time the sickness commenced.

The case now became totally unmanageable in my hands, and, after a fortnight, I was dismissed, and another physician called in; but she did not long survive.

This was not the first, nor the last instance, in which I have seen too large a dose of the medicine, defeat the very purpose for which it was directed.

CASE CXX.

August 22d. Mrs. S——, AEt. 36. Extreme faintiness; anasarcous legs and thighs; great difficulty of breathing, troublesome cough, frequent chilly fits succeeded by hot ones; night sweats, and a tendency to diarrhoea. Apprehensive that the more urgent symptoms were caused by water in the lungs, I directed an Infusion of Digitalis, with an ounce of diacodium to the half pint to prevent it purging, a wine glass full to be taken every night at bed-time, and a mixture with confect. cardiac. and pulv. ipecac. to be given in small doses after every loose stool.

On the fourth day she was better in all respects; had made a large quantity of water and did not purge. In a few days more she lost all her complaints, except the cough, which gradually left her, without any further assistance.

I was agreeably deceived in the event of this case, for I expected after the water was removed, to have had a phthisis to contend with.

CASE CXXI.

August 25th. T—— W——, Esq; AEt, 50. A free liver, diseased viscera, belly very tense, and much swollen; fluctuation perceptible, but the swelling circumscribed; pulse 132. This gentleman was under the care of my very worthy friend Dr. Ash, who, having tried various modes of cure to no purpose, asked me if I thought the Digitalis would answer in this case. I replied that it would not, for I had never seen it effectual where the swelling appeared very tense and circumscribed. It was tried however, but did not lessen the swelling. I mention this case, to introduce the above remark, and also to point out the great effect the Digitalis has upon the action of the heart; for the pulse came down to 96. He was afterwards tapped, and continued, for some time under our joint attendance, but the pulse never became quicker, nor did the swelling return.

CASE CXXII.

September 7th. Mr. L——, AEt. 43. After several severe attacks of ill formed gout, attended for some time past with jaundice and other symptoms of diseased viscera, the consequences of intemperate living, was sent to Buxton; from whence he returned in three weeks with ascites and anasarca. Under this complicated load of disease, I prescribed repeatedly without advantage, and at length gave him the Digitalis, which carried off the more obvious symptoms of dropsy; but the jaundice, loss of appetite, diseased viscera, &c. rendered his recovery impossible.

1784.

CASE CXXIII.

February 12th. Mrs. C——, AEt. 54. A strong short woman of a florid complexion; complained of great fullness across the region of the stomach; short breath, a troublesome cough, loss of appetite, paucity of urine; and had a brownish yellow tinge on her skin and in her eyes. She dated these complaints from a fall she had through a trap door about the beginning of winter. From the beginning of January to this time, she had been repeatedly let blood, had taken calomel purges with jallap; pills of soap, rhubarb and calomel; saline julep with acet. scillit. nitrous decoction, garlic, mercury rubbed down, infus. amarum purg. &c. After the failure of medicines so powerful, and seemingly so well adapted, and during the use of which all the symptoms continued to increase, it was evident that a favourable event could not be expected. However, I tried the infusum Digitalis, but it did nothing. I then gave her pills of quicksilver, soap and squill, with decoction of dandelion, and after some time, chrystals of tartar with ginger. Nothing succeeded to our wishes, and the increase of orthopnoea compelled me occasionally to relieve her by drastic purges, but these diminished her strength, more in proportion than they relieved her symptoms. Tincture of cantharides, sal diureticus and various other means were occasionally tried, but with very little effect, and she died towards the end of March.

CASE CXXIV.

March 31st. Miss W——, AEt. 60. Had been subject to peripneumonic affections in the winter. She had now total loss of appetite, very great debility, difficult breathing; much cough, a considerable degree of expectoration, and a paucity of urine. She had been blooded, taken soap, assaf. and squill, afterwards assaf. and ammon. with acet. scillit.: but all her complaints increasing, a blister was applied to her back, and the Digitalis infusion directed to be taken every night. The effect was an increased secretion of urine, a considerable relief to her breath, and some return of appetite; but soon afterwards she became hectic, spat purulent matter, and died in a few weeks.

CASE CXXV.

April 12th. Mrs. H——, of L——, AEt. 61. In December last this Lady, then upon a visit in London, was attacked with severe symptoms of peripneumony. She was treated as an asthmatic patient, but finding no relief, she made an effort to return to her home to die. In her way through this place, the latter end of December, I was desired to see her. By repeated bleedings, blisters, and other usual methods, she was so far relieved, that she wished to remain under my care. After a while she began to spit matter and became hectic. With great difficulty she was kept alive during the discharge of the abscess, and about the end of March she had swelled legs, and unequivocal symptoms of dropsy in the chest. Other diuretics failing, on the 12th of April I was induced to give her the Digitalis in small doses. The relief was great and effectual. After an interval of fifteen days, some swellings still remaining in the legs, I repeated the medicine, and with such good effect, that she lost all her complaints, got a keen appetite, recovered her strength, and about the end of May undertook a journey of fifty miles to her own home, where she still remains in perfect health.

CASE CXXVI.

April 17th. Mr. F——, AEt. 59. A very fat man, and a free liver; had long been subject to what was called asthma, particularly in the winter. For some weeks past his legs swelled, he had great sense of fullness across his stomach; a severe cough; total loss of appetite, thirst great, urine sparing, his breath so difficult that he had not lain down in bed for several nights. Calomel, gum ammoniac, tincture of cantharides, &c. having been given in vain, I ordered two grains of pulv. fol. Digitalis made into pills, with aromatic species and syrup, to be given every night. On the third day his urine was less turbid; on the fourth considerably increased in quantity, and in ten days more he was free from all complaints, and has since had no relapse.

CASE CXXVII.

May 7th. Miss K——, AEt. 8. After a long continued ague, became hectic and dropsical. Her belly was very large, and she had a total loss of appetite. Half a grain of fol. Digital, pulv. with 2 gr. of merc. alcalis. were ordered night and morning, and an infusion of bark and rhubarb with steel wine to be given in the day time. Her belly began to subside in a few days, and she was soon restored to health. Two other children in the family, affected nearly in the same way, had died, from the parents being persuaded that an ague in the spring was healthful and should not be stopped.—I know not how far the recovery in this case may be attributed to the Digitalis, but the child was so near dying that I dared not trust to any less efficacious diuretic.

CASE CXXVIII.

June 13th. Mr. C——, AEt. 45. A fat man, had formerly drank hard, but not latterly: last March began to complain of difficult breathing, swelled legs, full belly, but without fluctuation, great thirst, no appetite; urine thick and foul; complection brownish yellow. Mercurial medicines, diuretics of different kinds, and bitters, had been trying for the last three months, but with little advantage. I directed two grains of the fol. Digital. in powder to be taken every night, and infus. amar. with tinct. sacr. twice a day. In three days the quantity of his urine increased, in ten or twelve days all his symptoms disappeared, and he has had no relapse.

CASE CXXIX.

June 17th. Mr. N——, of W——, AEt. 54. A large man, of a pale complexion; had been subject to severe fits of asthma for some years, but now worse than usual. The intermitting pulse, the great disturbance from change of posture, and the swelled legs induced me to conclude that the exacerbation of his old complaint was occasioned by serous effusion. I directed pills with a grain and half of the pulv. Digital. to be taken every night, and as he was costive, jallap made a part of the composition. He was also directed to take mustardseed every morning and a solution of assafetida twice in the day. The effect of this plan was perfectly to our wishes, and in a short time he recovered his usual health. About half a year afterwards he died apoplectic.

CASE CXXX.

Mary B——. A young unmarried woman. Her disease appeared to me a dropsy of the right ovarium. She took an infusion of Digitalis, but, as I expected with no good effect. She is still, I am informed nearly in the same state.

CASE CXXXI.

July 12th. Mrs. A——, of C——, AEt. 56. After a series of indispositions for several years, became dropsical; and had long been confined to her chamber, unable to lie down or to walk. She was so feeble, her legs so much swelled, her breath so short, and the symptoms of diseased viscera so strong, that I dared not to entertain hopes of a cure; but wishing to relieve her more urgent symptoms, directed quicksilver rubbed down and fol. Digital. pulv. to be made into pills: the dose, containing two grains of the latter, to be given night and morning. She was also ordered to take a draught with a dram of aether twice a day, and to have scapulary issues. Her breath was so much relieved, that she was able soon afterwards to come down stairs; but her constitution was too much broken to admit of a recovery.

CASE CXXXII.

July 16th. Mr. B——, of W——, AEt. 31. After a tertian ague of 12 months continuation, suffered great indisposition for 10 months more. He chiefly complained of great straitness and pain in the hypochondriac region, very short breath, swelled legs, want of appetite. He had been under the care of some very sensible practitioners, but his complaints increased, and he determined to come to Birmingham. I found him supported upright in his chair, by pillows, every attempt to lean back or stoop forward giving him the sensation of instantaneous suffocation. He said he had not been in bed for many weeks. His countenance was sunk and pale; his lips livid; his belly, thighs and legs very greatly swollen; hands and feet cold, the nails almost black, pulse 160 tremulous beats in a minute, but the pulsation in the carolid arteries was such as to be visible to the eye, and to shake his head so that he could not hold it still. His thirst was very great, his urine small in quantity, and he was disposed to purge. I immediately ordered a spoonful of the infusum Digitalis every six hours, with a small quantity of laudanum, to prevent its running off by stool, and decoction of leontodon taraxacum to allay his thirst. The next day he began to make water freely, and could allow of being put into bed, but was raised high with pillows. Omit the infusion. That night he parted with six quarts of water, and the next night could lie down and slept comfortably. July 21st. he took a mild mercurial bolus. On the 25th. the diuretic effects of the Digitalis having nearly ceased, he was ordered to take three grains of the pulv. Digital. night and morning, for five days, and a draught with half an ounce of vin. chalyb. twice a day. August 15th. He took a purge of calomel and jallap, and some swelling still remaining in his legs, the Digitalis infusion was repeated. The water having been thus entirely evacuated, he was ordered saline draughts with acetum scilliticum and pills of salt of steel and extract of gentian. About a month after this, he returned home perfectly well.

CASE CXXXIII.

July 28th. Mr. A—— of W——, AEt. 29, became dropsical towards the close of a pulmonary consumption. He was ordered 12 grains of pulv. fol. cicutae and 1 of Digitalis twice a day. No remarkable effect took place.

CASE CXXXIV.

July 31. Mr. M——, AEt 37. Hydrothorax. A single grain of fol. Digital. pulv. taken every night for three weeks cured him. The medicine never made him sick, but increased his urine, which became clear; whereas before it had been high coloured and turbid.

CASE CXXXV.

August 6th. Mr. C—— of B——, AEt. 42. Asthma and anasarca, the consequence of free living. He had been for some time under the care of an eminent physician of this place, but his complaints proving unusually obstinate, he consulted me. I directed an infusion of Digitalis to be taken every night, and a mixture with squill and tincture of cantharides twice every day. In about a week he became better, and continued daily mending. He has since enjoyed perfect health, having quitted a line of business which exposed him to drink too much.

CASE CXXXVI.

August 6th. Mr. M—— of C——, AEt. 44. Ascites and anasarca, preceded by symptoms of the epileptic kind. He was ordered to take two grains of pulv. Digitalis every morning, and three every night; likewise a saline draught with syrup of squills, every day at noon. His complaints soon yielded to this treatment, but in the month of November following he relapsed, and again asked my advice. The Digitalis alone was now prescribed, which proved as efficacious as in the first trial. He then took bitters twice a day, and vitriolic acid night and morning, and now enjoys good health.

Before the Digitalis was prescribed, he had taken jallap purges, soluble tartar, salt of steel, vitriol of copper, &c.

CASE CXXXVII.

August 10th. Mrs. W——, AEt. 55. An anasarcous leg, and sciatica; full habit. After bleeding and a purge, a blister was applied in the manner recommended by Cotunnius; and two grains of fol. Digital. with fifteen of fol. cicutae were directed to be taken night and morning. The medicine acted only as a diuretic; the pain and swelling of the limb gradually abated; and I have not heard of any return.

I must here bear witness to the efficacy of Cotunnius's method of blistering in the sciatica, having used it in a great number of cases, and generally with success.

CASE CXXXVIII.

August 16th. Mrs. A—— of S——, AEt. 78. About the middle of Summer began to complain of short breath, great debility, and loss of appetite. At this time there were evident marks of effusion in the thorax, and some swelling in the legs. The advanced age, the weakness, and other circumstances of this patient, precluded every idea of her recovery; but something was to be attempted. Squills and other remedies had been tried; I therefore directed pills with two or three grains of the pulv. Digitalis to be taken every night for six nights, and a saline draught with forty drops of acetum scillit. twice in the day. She took but few of the draughts, seldom more than half one at a time, for they purged her, and she disliked them. The pills she took regularly, and with the happiest effect, for she could lie down, her breath was very much relieved, and a degree of appetite returned. Sept. 4th, some return of her symptoms demanded the further use of diuretics. I was afraid to push the Digitalis in so hazardous a subject, and therefore directed tinct. amara with tinct. canthar. and pills of squill, seneka, salt of tartar and gum ammoniac. These medicines did not at all check the progress of the disease, and on the 26th it became necessary to give the Digitalis again. The pills were therefore repeated as before, and infus. amarum with fixed alkaly ordered to be taken twice a day. The event was as favorable as before; and from this time she had no considerable return of dropsy, but languished under various nameless symptoms, until the middle or end of November.

CASE CXXXIX.

Aug. 16th. Mrs. P—— of S——, AEt. 50. For a particular account of this patient, see Mr. Yonge's second Case.

CASE CXL.

Sept. 20th. B—— B——, Esq. A true spasmodic asthma of many years continuance. After every method of relief had failed; both under my management, and also under the direction of several of the ablest physicians of this kingdom; I was induced to give him an infusion of the Digitalis. It was continued until nausea came on, but procured no relief.

CASE CXLI.

October 5th. Mr. R——, AEt. 43. (The patient mentioned at No. 102.) He had pursued his former mode of life, and had now a return of his complaints, with evident marks of diseased viscera. His belly not very large, but uncommonly tense. From this circumstance I did not expect the Digitalis to succeed, and therefore tried for some time to relieve him by the saline julep, with acet. scillitic. jallap, mercury, syrup of squill, with aq. cinnam. decoction of Dandelion, &c.; but these being administered without advantage, I was driven to the Digitalis. As he was very weak and much emaciated, I only gave two grains night and morning for five days. As no increase of urine took place, I used alkaline salt with tinct. cantharides:—This proving equally unsuccessful, on the 18th, I directed two ounces of the infusum Digitalis night and morning. This was continued until nausea took place, but the kidney secretion was not increased. Squill with opium, deobstruents of different kinds, sublimate solution, fixed alkaly, tobacco infusion, were now successively tried, but with the same want of success. The fullness of his belly made it necessary to tap him, and by repeating this operation he continued alive to the end of the year.

CASE CXLII.

October 19th. Mrs. R——, of B——, AEt. 47. Supposed Asthma, of eighteen months duration. She had kept her room for four months, and could not lie down without great disturbance; was very thin, and had totally lost all inclination for food. She was directed to take two gr. of pulv. fol. Digital. night and morning for five days, and infusum amarum, at the hours of eleven and five. In the course of a week she was much relieved, and could remain in bed all night. After a few days interval she took the Digitalis for five days more, and was soon after that well enough to come down stairs and conduct her family affairs.

In April 1785, she had a slight return, but not such as to confine her to her chamber. She experienced the same relief from the same medicine, but continuing it for seven days without interruption, it excited nausea.

CASE CXLIII.

October 28th. Mr. A——, subject to nephritis calculosa: After an attack of that kind, had still a troublesome sense of weight about his loins, now and then rising to pain, and a degree of dysuria, together with a want of appetite. These symptoms not readily yielding to the usual methods of treatment, I directed an infusion of Digitalis. The fourth dose caused a copious flow of urine; the sixth made him sick, and he was more or less sick at times for three days; but felt no more of his complaints.

I don't believe it is at all necessary to bring on sickness in these cases, but an unexpected absence from town prevented me from seeing him time enough to stop the exhibition of the medicine.

CASE CXLIV.

October 31st. Mrs. C——, of W——, AEt. 67. Asthma, and very thick hard legs of long continuance. The last month or two her breath worse than usual, her belly swollen, her thighs anasarcous, and her urine in small quantity. After trying garlic, squill, and purgatives without advantage, I directed the Digital. Infus. After taking about five ounces, her urine from thick and turbid, changed to clear and amber coloured, its quantity considerably increased, and her breathing easy. Contrary to my orders, but impelled by the relief she had found, she finished the remaining three ounces of the infusion, which made her very sick, and the free flow of urine immediately ceased. No medicine was administered for a fortnight, during which time her complaints increased. I then directed an infusion of tobacco, which affected her head, but did not increase her urine. She had recourse again to the Digitalis infusion, which once more removed the fulness of the belly, reduced the swellings of her thighs, and relieved her breath, but had no effect upon her legs.

CASE CXLV.

Nov. 2d. Miss B—— of C——, AEt. 22. A very evident fluctuation in the abdomen, which was considerably distended, whilst the rest of her frame was greatly emaciated. The presence of cough, hectic fever, and other circumstances, made it probable that this apparent ascites was caused by a purulent, and not a watery effusion. However it was possible I might be mistaken; the Digitalis was therefore given, but without any advantage.

The further progress of the disease confirmed my first opinion, and she died consumptive.

CASE CXLVI.

Nov. 4th. Mr. P—— of M——, AEt. 40. Subject to troublesome nephritic complaints, and after the last attack did not recover, or void the gravelly concretions as usual, a sense of weight across his loins continuing very troublesome. The usual medicines failing to relieve him, I ordered four grains of pulv. Digital. to be taken every other night for a week, and fifteen grains of mild fixed vegetable alkaly to be swallowed twice a day in barley water. He soon lost all his complaints; but we must not in this case too hastily attribute the cure to the Digitalis, as the alkaly has also been found a very useful medicine in similar disorders.

CASE CXLVII.

Nov. 4th. Mr. B—— of N——, AEt. 60. Had been much subject to gout, but his constitution being at length unable to form regular fits, he became dropsical. Pulv. fol. Digital. in doses of two or three grains, at bed-time, gave him some relief, but did not perfectly empty him. About three months afterwards he had occasion to take it again; but it then produced no effect, and he was so debilitated that it was not urged further.

CASE CXLVIII.

Nov. 8th. Mr. G——, AEt. 35. In the last stage of a phthisis pulmonalis, was attacked with a most urgent and painful difficulty of breathing. Suspecting this distress might arise from watery effusion in the chest, I gave him Digitalis, which relieved him considerably; and during the remainder of his life his breath never became so bad again.

CASE CXLIX.

Nov. 13th. Mrs. A—— of W——h——, AEt. 68. One of those rare cases in which no urine is secreted. It proved as refractory as usual to remedies, and not having ever succeeded in the cure of this disease, I determined to try the Digitalis. It was given in infusion, and, after a few doses, the secretion of a small quantity of urine seemed to justify the attempt. The next day, however, the secretion ceased, nor could it be excited again, tho' at last the medicine was pushed so as to occasion sickness, which continued at intervals for three days.

CASE CL.

Nov. 20th. Mrs. B——, AEt. 28. In the last stage of a pulmonary consumption became dropsical. I directed three grains of the pulv. Digital. to be taken daily, one in the morning, and two at night. She took twenty grains without any sensible effect.

CASE CLI.

Nov. 23d. Master W——, AEt. 7. Supposed hydrocephalus internus. A grain of pulv. fol. Digitalis was directed night and morning. After three days, no sensible effects taking place, it was omitted, and the mercurial plan of treatment adopted. The child lived near five months afterwards. Upon dissection near four ounces of water were found in the ventricles of the brain.

CASE CLII.

Nov. 26th. Mrs. W——, AEt. 65. I had attended this lady last winter in a very severe peripneumony, from which she narrowly escaped with her life. When the cold season advanced this winter, she perceived a difficulty in breathing, which gradually became more and more troublesome. I found her much harassed by a cough, which occasioned her to expectorate a little: the least motion increased her dyspnoea; she could not lie down in bed; her legs were considerably swelled, her urine small in quantity. I directed two grains of pulv. Digitalis made into a pill with gum ammoniac, to be taken every night, and to promote expectoration, a squill mixture twice in the day. Her urine in five days became clear and copious, and in a fortnight more she lost all her complaints, except a cough, for which she took the lac ammoniacum.

It is not improbable that the squill might have some share in this cure.

CASE CLIII.

December 7th. Mr. H——, AEt. 42. A large sat man, very subject to gravelly complaints. After an attack in the usual manner, continued to feel numbness in his lower limbs, and a sense of weight across his loins. I directed infusum Digitalis to be given every six hours. Six ounces made him sick, and he took no more. The next day his urine increased, a good deal of sand passed with it, and he lost his disagreeable feels, but the sickness did not entirely cease before the fourth day from its commencement.

CASE CLIV.

December 27th. Mr. B——, of H——, AEt. 55. Symptoms of hydrothorax, at first obscurely, afterwards more distinctly marked. Many things were tried, but the squill alone gave relief. At length this failed. About the third month of the disease, a grain of pulv. Digital. was ordered to be taken night and morning. This produced the happiest effects. In March following he had some slight symptoms of relapse, which were soon removed by the same medicine, and he now enjoys good health. For a more particular narrative see case the first, communicated by Mr. Yonge.

CASE CLV.

December 31st. Mrs. B——, of E——, AEt. 50. An ovarium dropsy of long continuance. She took three grains of pulv. Digital. every night at bed time, for a fortnight, but without any effect.

CASE CLVI.

A poor man in this town, after his kidneys had ceased to secrete urine for several days, was seized with hickup, fits of vomiting, and transient delirium. After examination I was satisfied the disease was the same as that mentioned at CXLIX. A very experienced apothecary having tried various methods to relieve him, I despaired of any success, but determined to try the Digitalis. It was accordingly given in infusion. At first it checked the vomitings, but did not occasion any secretion of urine.

1785.

The cases which have occurred to me in the course of this year, are numerous; but as the events of some of them are not yet sufficiently ascertained, I think it better to with-hold them at present.



HOSPITAL CASES, Under the Direction of the Author.

The four following cases were drawn out at my request by Mr. Cha. Hinchley, late apothecary to the Birmingham Hospital. They are all the Hospital cases for which the Digitalis was prescribed by me, whilst he continued in that office.

CASE CLVII.

March 15th, 1780. John Butler, AEt. 30. Asthma and swelled legs. He was directed to take myrrh and steel every day, and three spoonfuls of infusum Digitalis every night. On the 8th of April he was discharged, cured of the swellings and something relieved of his asthmatic affections.

CASE CLVIII.

November 18th, 1780. Henry Warren, AEt. 60. This man had a general anasarca and ascites, and was moreover so asthmatic, that, neither being able to sit in a chair nor lie in bed, he was obliged constantly to walk about, or to lean forward against a window or table. You prescribed for him thus.

R. Aq. cinn. spt. [Symbol: ounce]iv. Oxymel. scillit. Syr. scillit. aa. [Symbol: ounce]i. m. cap. cochlear. larg. sexta quaque hora.

This medicine producing no increased discharge of urine, on the 25th you ordered the infusion of Digitalis, two spoonfuls every four hours. After taking this for thirty six hours, his urine was discharged in very great quantity; his breath became easy, and the swellings disappeared in a few days, though he took no more of the medicine. On the 2d of December he was ordered myrrh and lac ammoniacum, which he continued until the 23d, when he was discharged cured, and is now in good health.

CASE CLIX.

November 3d, 1781. Mary Crockett, AEt. 40. Ascites and universal anasarca. For one week she took sal. diureticus and tincture of cantharides, but without advantage. On the 10th you directed the infusion of Digitalis, a dram and half to half a pint, an ounce to be taken every fourth hour. Before this quantity was quite finished, the urine began to be discharged very copiously. The medicine was then stopped as you had directed. On the 15th, being costive, she took a jallap purge, and on the 24th she was discharged cured.

CASE CLX.

March 16th, 1782. Mary Bird, AEt. 61. Great fullness about the stomach; diseased liver, and anasarcous legs and thighs. For the first week squill was tried in more forms than one, but without advantage. On the 22d she began with the Digitalis, which presently removed all the swelling.

She was then put upon the use of aperient medicines and tonics, and on the first of August was discharged perfectly cured.

* * * * *

The three following Cases were drawn up and communicated to me by Mr. Bayley, who succeeded Mr. Hinchley as apothecary to the Hospital at Birmingham:

Shiffnall, April 26th, 1785. DEAR SIR,

During my residence in the Birmingham General Hospital, I had frequent opportunities of seeing the great effects of the Digitalis in dropsy. As the exhibition of it was in the following instances immediately under your own direction, I have drawn them up for your inspection, previous to your publishing upon that excellent diuretic. Of its efficacy in dropsy I have considerable evidence in my possession, but consider myself not at liberty to send you any other cases except those you had yourself the conduct of. The Digitalis is a very valuable acquisition to medicine; and, I trust, it will cease to be dreaded when it is well understood.

I am, Sir, your obedient, And very humble servant, W. BAYLEY.

CASE CLXI.

Mary Hollis, aged 62, was admitted an out patient of the Birmingham General Hospital February 12th, 1784, labouring under all the effects of hydrothorax; her dread of suffocation during sleep was so great, that she always reposed in an elbow chair. She was directed to take two grains of Digitalis in powder every night and morning, and for a few days found great relief; but, on the eighth day, as she had complained of sickness, and had been considerably purged, she was ordered to desist taking any more of her powders. On the 14th day she was ordered an ounce of the following infusion twice in a day: R. Fol. Digital. purp. sicc. [Symbol: dram]iss. aq. bullient. [Symbol: pound]ss. digere per semi-horam, colaturae adde tinct. aromatic [Symbol: ounce]i. This infusion did not purge, but sometimes excited nausea, though not sufficient to prevent her from continuing its use. She grew gradually better, and on the 6th of May was discharged perfectly cured. The diuretic effects of the Digitalis were in this instance immediate.

CASE CLXII.

Edward James, AEt. 21. Admitted March 20th, 1784. Complained of great difficulty of breathing, pain in his head, and tightness about the stomach, with a trifling swelling of his legs. Ordered pil. scillit. [Symbol: scruple]i. ter de die. On the third day his legs much more swelled, his breathing more difficult, and in every respect worse; his pulse very small and quick, complained when he turned in bed, of something like water rolling from one side of the thorax to the other. A remarkable blueness about the mouth and eyes, and purged considerably from the pil. scill. Ordered to omit the pills and to take [Symbol: ounce]i. of infus. Digitalis every eight hours; the proportion [Symbol: dram]iss. to eight ounces of water and [Symbol: ounce]i. of aq. n. m. sp.—7th Day, The infusion had neither purged, nor vomited him: he only complained once or twice of giddiness. His belly was now very hard, rather black on the right side the navel, and his legs amazingly swelled. Ordered a bolus with rhubarb and calomel, to be taken in the morning, and [Symbol: ounce]ii. julep salin. cum tinct. canthar. gutt. forty ter die.—12th Day, nearly in the same state, except his breathing which was somewhat more difficult, being now obliged to have his head considerably raised. Persistat—From this day to the 32d day he became hourly worse. His belly which at first was only hard, now evidently contained a large quantity of water, his legs were more swelled, and a large sphacelated sore appeared upon each outer ancle. Respiration was so much obstructed, that he was obliged to sit quite upright to prevent suffocation. He made very little water, not more than eight ounces in a day and a night, and was much emaciated. Ordered his purging bolus again, and [Symbol: ounce]ii. of a mixture with sal diuretic, [Symbol: ounce]ss. to [Symbol: ounce]xii. three times in a day, and a poultice with ale grounds to his legs.

54th day. To this period there was not the least probability of his existing; his legs and thighs were one continued blubber, his thorax quite flat, and his belly so large that it measured within one inch as much as a woman's in this Hospital the day she was tapped, and from whom twenty seven pounds of coagulable lymph were taken. He made about three ounces of water in twenty-four hours: his penis and scrotum were astonishingly swelled, and no discharge from the sores upon his legs. Ordered to take a pill with two grains of powdered Foxglove night and morning. For a few days no sensible effect, but about the 60th day he complained of being continually giddy, and had some little pain in his stomach. He now made much more water, and dared to sleep. His appetite which through the whole of his illness had been very bad, was also better. 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 legs which were very flabby, to be rolled.

69th day. His belly nearly reduced to its natural size, still made a prodigious quantity of water, his appetite very good, habit of body rather lax, and his complexion ruddy. On the 2d of June, being still rather weak, he was ordered decoct. cort. [Symbol: ounce]ii. ter de die; and on the 12th was discharged from this Hospital perfectly cured.

W. BAYLEY.

Mr. Bayley's respectful compliments to Doctor Withering: he sends the case of Edward James, which he believes is pretty correct. He laments not having it in his power to send the measure of his belly, having unfortunately, mislaid the tape: he heard from James yesterday, and he is perfectly well.

General Hospital, August 5, 1784.

CASE CLXIII.

On the 26th February, 1785, Sarah Ford, aged 42, was admitted an out-patient of the Birmingham General Hospital: she complained of considerable pain in her chest, and great difficulty of breathing, her face was much swelled and her thighs and legs were anasarcous. She had extreme difficulty in making water, and with many painful efforts she did not void more than six ounces in twenty-four hours. She had been in this situation about six weeks, during which time she had taken ammoniacum, olibanum, and large quantities of squills, without any other effect than frequent sickness. Upon her commencing an Hospital patient, the following medicine was exhibited. R. gum ammoniac [Symbol: dram]ii. pulv. fol. Digital. purp. [Symbol: scruple]ii. sp. lavand. comp. ut fiat pil. 40. cap. ii. nocte maneque. She continued the use of these pills for a few days, without any sensible effect. On the eighth day her breathing was much relieved, her legs and thighs were not so much swelled, and in a day and a night she made five pints of water. By the 12th day her legs and thighs were nearly reduced to their natural size. She continued to make water in large quantities, and had lost her pain in the thorax. To the 20th of March, she made rapid advances towards health, when not a symptom of disease remaining, she was discharged.



COMMUNICATIONS FROM CORRESPONDENTS.

London, Norfolk-street, May 31st, 1785.

SIR,

I had the favour of your letter last week; and I shall be very happy if I can give you any intelligence relating to the Foxglove, that can answer the purpose in which you are so laudably engaged.

It is true that my brother, the late Dr. Cawley, was greatly relieved, and his life, perhaps, prolonged for a year, by a decoction of the Foxglove root; but why it had not a more lasting effect, it is necessary I should tell you that he had all the signs of a distempered viscera, long before any watery swellings appeared; it was manifest that his dropsy was merely symptomatic, and he could therefore only from time to time have any relief from medicine. In the year 1776, he returned from London to Oxon. having consulted several physicians at the former place, and Dr. Vivian at the latter, but without any success; and he was then told of a carpenter at Oxon. that had been cured of a Hydrops pectoris by the Foxglove root, and as he was a younger, and in other respects an healthy man, his cure, I believe, remains a perfect one.

I did not attend my brother whilst he took the medicine, and therefore I cannot speak precisely to the operation of it; but I remember, by his letters, that he was dreadfully sick and ill for several days before the secretion of urine came on, but which it did do to a great degree; relieved his breath, and greatly lessened the swelling in his legs and thighs; but the two instances I have lately seen in this part of the world, are much stronger proofs of the efficacy of it than my brother's case.

I am, &c. ROBERT CAWLEY.

N. B. Whenever I have another opportunity of giving the Foxglove, it shall be in small doses:—In which I should hope it might succeed, although it might be more slowly. If you should try it with success, I should be glad to know what mode you made use of.

Dr. Cawley's prescription.

R. Rad. Digital. purpur. siccat. et contus. [Symbol: ounce]ii.

Coque ex aq. font. [Symbol: pound]ii. ad [Symbol: pound]i. colat. liquor. adde aq. junip. comp. [Symbol: ounce]ii.

Mell. anglic [Symbol: ounce]i. m. sumat cochl. iv. omni nocte h. s. et mane.

—I have elsewhere remarked, that when the Digitalis has been properly given, and the diuretic effects produced, that an accidental over-dose bringing on sickness, has stopped the secretion of urine. In the present instance it likewise appears, that violent sickness may be excited, and continue for several days without being accompanied by a flow of urine; and it is probable that the latter circumstance did not take place, until the severity of the former abated. If Dr. Cawley had not had a constitution very retentive of life, I think he must have died from the enormous doses he took; and he probably would have died previous to the augmentation of the urinary discharge. For if the root from which his medicine was prepared, was gathered in its active state, he did not take at each dose less than twelve times the quantity a strong man ought to have taken. Shall we wonder then that patients refuse to repeat such a medicine, and that practitioners tremble to prescribe it? Were any of the active and powerful medicines in daily use to be given in doses twelve times greater than they are, and these doses to be repeated without attention to the effects, would not the patients die, and the medicines be condemned as dangerous and deleterious?—Yet such has been the fate of Foxglove!

A Letter to the Author, from Mr. BODEN, Surgeon, at Broseley, in Shropshire.

Broseley, 25th May, 1785. Dear SIR,

Have inclosed the prescriptions that contained the fol. Digital. which I gave to Thomas Cooke and Thomas Roberts.

Thomas Cooke, AEt. 49, had been ill about two or three weeks. When I saw him he had no appetite, and a constant thirst: a fullness and load in the stomach: the thighs, legs and hands, much swell'd, and the face and throat in a morning; was costive, and made but little water, which was high coloured; the pulse very weak, and his breath exceeding bad. June 17th. R. Argent, viv [Symbol: dram]i. cons. cynosbat. [Symbol: scruple]ii. fol. Digital. pulv. gr. xv. f. pil. xxiv. capt. ii. omni nocte hora decubitus. He was likewise purged by a bolus of argent. viv. jallap, Digit. elaterium and calomel, which was repeated on the fourth day, to the third time. From June 17th to the 29th, the symptoms were mostly removed, making water freely, and having plenty of stools; in a week after he was perfectly well, and remains so ever since. The cure was finished by steel and bitters.

Thomas Roberts, AEt. 40, had a deformed chest, was obliged to be almost in an erect posture when in bed; the other symptoms were nearly the same as Cooke's. August 3d. The pills prescribed June 17th for Cooke.—17th. A purging bolus of jalap and Digitalis, once a week. He continued the medicines till the latter end of August, when he got very well; but the complaint returned in Jan. worse than before. He is now much better, but I have great reason to believe the liver to be diseased.

I am, with the greatest respect,

Your very obliged humble servant,

DANIEL BODEN.

P. S. The second patient, on his relapse, took Digitalis again, combined with other things.



CASE communicated by Mr. CAUSER, Surgeon, at Stourbridge, Worcestershire.

Mr. P—— of H—— M——, in the parish of Kingswinford, aged about 60; had been a strong healthy, robust, corpulent man; worked hard early in life at edge-tool making, and drank freely of strong malt liquor; for many years had been subject to gout in the extremities; for a few years past had been very asthmatic, and the gout in the extremities gradually decreased. When I first saw him, which was Sept. 12, 1779, his legs were anasarcous, his belly much swelled, and an evident fluctuation of water. His breathing very bad, an irregular pulse, and unable to lie down. His easiest posture was standing with his body leaning over a chair, in which situation he would continue many hours together, labouring for breath, with the sweat trickling down his face very profusely; the urine in very small quantity. Diuretics of every kind I could think of were used with very little or no advantage. Blisters applied to the legs relieved very considerably for a time, but by no means could I increase the urinary discharge. Warm stomachic medicines were given, and at the same time sinapisms applied to the feet, in hopes of enticing gout to the extremities, but without any good effect.—November 22d. The swelling considerably increasing, an emetic of acet. scillitic. was given, which acted very violently, and increased the urinary discharge considerably. He continued better and worse, using different kinds of diuretic and expectorating medicines until September 1781, when the disease was so much worse, I did not expect he could live many days. The acet. scillitic. was repeated, a table spoonful every half hour, till it acted briskly upwards and downwards; but without increasing the urinary discharge.—On the 17th of September I infused [Symbol: dram]iii. of the fol. Digitalis in [Symbol: ounce]vi. of boiling water, for four hours; then strained it, and added [Symbol: ounce]i. of tinct. aromatica.—On the 18th he began by taking one spoonful, which he was to repeat every half hour, till it made him very sick, unless giddiness, loss of sight, or any other disagreeable effect took place. I had never given the medicine before, and had prepared him to expect the operation to be very severe. I saw him again on the 21st; he had taken the medicine regularly, till the whole quantity was consumed, without perceiving the least effect of any kind from it, and continued well till the evening of the following day, when a little sickness took place, which increased, but never so as to occasion either vomiting or purging, but a surprising discharge of urine. The saliva increased so as to run out of his mouth, and a watery discharge from his eyes; these discharges continued, with a continual sickness, till the swelling was totally gone, which happened in three or four days. He afterwards took steel and bitters; and continued very comfortably, without any return of his dropsy, until the 7th of April 1782, when he was seized with an epidemic cough, which was very frequent with us at that time. His swellings now returned very rapidly, with the greatest difficulty in breathing, and he died in a few days. Blisters and expectorating medicines were used on this last return.

Extract of a Letter from Mr. CAUSER.

Mrs. S——, the subject of the following Case, was as ill as it is possible for woman to be and recover; from the inefficacy of the medicines used, I am convinced no medicine would have saved her but the Digitalis. I never saw so bad a case recovered; and it shews, that in the most reduced state of body, the medicine in small doses, will prove safe and efficacious.

N. B. The Digitalis, in pills, never occasioned the least sickness. She took two boxes of them.

CASE.

January 2d, 1785. Mrs. S——, of W——, near Kidderminster, aged 38, has been affected with dropsical swellings of her legs and thighs, about six weeks, which have gradually grown worse; has now great difficulty in breathing, which is much increased on moving; a very irregular, intermittent pulse, urine in very small quantity, and in the seventh month of her pregnancy: a woman of very delicate constitution, with tender lungs from her infancy and very subject to long continued coughs.

R. Pulv. scillae gr. iii. Jalap gr. x. syr. rosar. solut. tinct. senn. aa [Symbol: dram]ii. aq. menth. v. simpl. [Symbol: ounce]iss. m. mane sumend.

R. pulv. scillae [Symbol: scruple]i. G. ammoniac, sapon. venet. aa [Symbol: dram]iss. syr. q. s. f. pilul. 42 cap. iii. nocte maneque.

On the 7th found her worse, and the swelling increased; the urine about [Symbol: ounce]x in the twenty-four hours.

R. Fol. siccat. Digital. [Symbol: dram]iii. coque in. aq. fontan. [Symbol: ounce]xii. ad [Symbol: ounce]vi. cola et adde. aq. juniper. comp. [Symbol: ounce]ii. sacchar. alb. [Symbol: ounce]ss. m. cap. cochlear. i. larg. 4tis horis.

She took about three parts of the medicine before any effect took place. The first was sickness, succeeded by a considerable discharge of urine. She continued the medicine till the whole was consumed, which caused a good deal of sickness for three or four days.

I saw her again on the 12th. The quantity of urine was much increased, and the swelling diminished. Pulse and breathing better.

R. Fol. sicc. Digital. G. assafetid. aa [Symbol: dram]i. calomel. pp. gr. x. sp. lavand. comp. q. s. fiat pilul. xxxii. cap. ii. omni nocte hora somni.

A plentiful discharge of urine attended the use of these pills, and she got perfectly free from her dropsical complaints.

March 15th she was delivered: had a good labour, was treated as is usual, except in not having her breasts drawn, not intending see should suckle her child, being in so reduced a state. Continued going on well till the 18th, when she was seized with very violent pains across her loins, at times so violent as to make her cry out as much as labour pains. Enema cathartic. Fot. papav. applied to the part.

R. Pulv. ipecacoan. gr. vi. opii. gr. iv. syr. q. s. fiat pilul. vi. capt. i. 2da quaque hora durante dolore.

R. Julep, e camphor, sp. minder. aa [Symbol: ounce]ii. capt. cochlear, i. larg. post singul. pilul.

19th. Breathing short, unable to lie down, very irregular low pulse scarcely to be felt, fainty, and a universal cold sweat: no appetite nor thirst, spasmodic pains at times across the loins very violent, but not so frequent as on the preceding day.

R. Gum ammoniac, assafetid. aa [Symbol: dram]i. camphor. gr. xii. fiat pilul. 24. capt. ii. 3tia quaque hora in cochlear. ii. mixtur. seq.

R. Balsam. peruv. [Symbol: dram]iii. mucilag. G. arab. q. s. flor. zinci g. vi. aq. menth. simp. [Symbol: pound]ss. m.

Applic. Emp. vesicat. femorib. internis.

R. Sp. vol. foetid. elixir. paregor. balsam. Traumatic. aa [Symbol: dram]iii. capt. cochlear. parv. urgente languore.

20th. Much the same; makes very little water, and the legs begin to swell.—Applic. Emp. e pice burgund. lumbis.

23d. The swelling very much increased.—Capt. gutt. xv. acet. scillitic. ter die in two spoonfuls of the following mixture.

R. Infus. baccar. juniper, [Symbol: ounce]vi. tinct. amar. tinct. stomachic. aa [Symbol: ounce]i. m.

25th. Much the same.

28th. The swelling considerably increased, in other respects very much the same.

30th. Breathing very bad, with cough and pain across the sternum, unable to lie down, legs, thighs, and body very much swelled, urine not more than four or five ounces in the twenty-four hours; hot and feverish, with thirst.

Applic. Emp. vesicat. stomacho et sterno.

R. G. assafetid. [Symbol: scruple]ii. pulv. jacob. [Symbol: scruple]i. rad. scill. recent. gr. xii. extract. thebaic. gr. iv. f. pilul. xvi. cap. iv. omni nocte.

R. Sal. nitr. sal. diuretic. aa [Symbol: dram]ii. pulv. e contrayerv. comp. [Symbol: dram]i. sacchar. [Symbol: ounce]i. emuls. commun. [Symbol: pound]i. aq. cinnam. simpl. [Symbol: ounce]i. m. capt. cochlear. iv. ter die.

April 2d. Much the same, no increase of urine.

3d. Breathing much relieved by the blister, which runs profusely. Repeated the medicines, and continued them till the

12th. The cough very bad, pulse irregular, swelling much increased, urine in very small quantity, not at all increased; great lowness and fainting. She desired to have some of the pills which relieved her so much when with child. I was almost afraid to give them, but the inefficacy of the other medicines gave me no hopes of a cure from continuing them, which made me venture to comply with her request.

R. Fol. siccat. Digital. G. assafetid. aa [Symbol: dram]i. sp. lavand. comp. q. s. f. pilul. xxxii. cap. ii. omni mane; et omni node cap. pilul. e styrace gr. vi.

17th. Considerable increase of urine.

21st. Swelling a good deal diminished; urine near four pints in twenty-four hours, which is more than double the quantity she drinks.

Applic. Emp. vesicat. femoribus internis.

The Digitalis pills and opiate at bed-time continued. Takes a tea cup of cold chamomile tea every morning.

25th. Swelling much diminished, makes plenty of water, appetite much mended, cough and breathing better. She omitted the medicine for three days; the urine began to diminish, the swelling and shortness of breathing worse. On repeating it for two days, the discharge was again augmented, and a diminution of the swelling succeeded. She has continued the pills ever since till the 14th of May; the dropsical symptoms and cough are entirely gone, the water is in sufficient quantity, her strength is recovered, and she has a good appetite. All she now complains of is a weight across her stomach, which is worse at times, and she thinks, unless it can be removed, she shall have a return of her dropsy.

Extract of a Letter from Doctor FOWLER, Physician, at Stafford.

I understand you are going to publish on the Digitalis, which I am glad to hear, for I have long wished to see your ideas in print about it, and I know of no one (from the great attention you have paid to the subject) qualified to treat on it but yourself. There are gentlemen of the faculty who give verbal directions to poor patients, for the preparing and taking of an infusion or decoction of the green plant. Would one suppose that such gentlemen had ever attended to the nature and operation of a sedative power on the functions, particularly the vital? Is not such a vague and unscientific mode of proceeding putting a two edged sword into the the hands of the ignorant, and the most likely method to damn the reputation of any very active and powerful medicine? And is it not more than probable that the neglect of adhereing to a certain and regular preparation of the nicotiana, and the want (of what you emphatically call) a practicable dose, have been the chief causes of the once rising reputation of that noted plant being damned above a century ago? In short, the Digitalis is beginning to be used in dropsies, (although some patients are said to go off suddenly under its administration) somewhat in the style of broom ashes; and, in my humble opinion, the public, at this very instant, stand in great need of your precepts, guards, and cautions towards the safe and successful use of such a powerful sedative diuretic; and I have no doubt of your minute attention to those particulars, from a regard to the good and welfare of mankind, as well as to your own reputation with respect to that medicine.

I remember an officer in the Staffordshire militia, who died here of a dropsy five years ago. The Digitalis relieved him a number of times in a wonderful manner, so that in all probability he might have obtained a radical cure, if he would have refrained from hard drinking. I understood it was first ordered for him by a medical gentleman, and its sedative effects proved so mild, and diuretic operation so powerful, that he used to prepare it afterwards for himself, and would take it with as little ceremony as he would his tea. It is said, that he was so certain of its successful operation, that he would boast to his bacchanalian companions, when much swelled, you shall see me in two days time quite another man.

CASES communicated by Mr. J. FREER, jun. Surgeon, in Birmingham.

CASE I.

Nov. 1780. Mary Terry, aged 60. Had been subject to asthma for several years; after a severe fit of it her legs began to swell, and the quantity of urine to diminish. In six weeks she was much troubled with the swellings in her thighs and abdomen, which decreased very little when she lay down: she made not quite a pint of water in the twenty-four hours. I ordered her to take two spoonfuls of the infusion of Foxglove every three hours. By the time she had taken eight doses her urine had increased to the quantity of two quarts in the day and night, but as she complained of nausea, and had once vomited, I ordered the use of the medicine to be suspended for two days. The nausea being then removed, she again had recourse to it, but at intervals of six hours. The urine continued to discharge freely, and in three weeks she was perfectly cured of her swellings.

CASE II.

December, 1782. A poor woman, who had been afflicted with an ague during the whole of her pregnancy, and for two months with dropsical swellings of the feet, legs, thighs, abdomen, and labia pudenda; was at the expiration of the seventh month taken in labour. On the day after her delivery the ague returned, with so much violence as to endanger her life. As soon as the fit left her, I began to give her the red bark in substance, which had the desired effect of preventing another paroxysm. She continued to recover her health for a fortnight, but did not find any diminution in the swellings; her legs were now so large as to oblige her to keep constantly on the bed, and she made very little water. I ordered her the infusion of Foxglove three times a day, which, on the third day, produced a very copious discharge of urine, without any sickness; she continued the use of it for ten days, and was then able to walk. Having lost all her swellings, and no complaint remaining but weakness, the bark and steel compleated the cure.

Extract of a Letter from Doctor JONES, Physician, in Lichfield.

Anxious to procure authentic accounts from the patients, to whom I gave the Foxglove, I have unavoidably been delayed in answering your last favour. However, I hope the delay will be made up by the efficacy of the plant being confirmed by the enquiry. Long cases are tedious, and seldom read, and as seldom is it necessary to describe every symptom; for every case would be a history of dropsy. I shall therefore content myself with specifying the nature of the disease, and when the dropsy is attended with any other affection shall notice it.

Two years have scarcely elapsed since I first employed the Digitalis; and the success I have had has induced me to use it largely and frequently.

CASE I.

Ann Willott, 50 years of age, became a patient of the Dispensary on the 11th of April 1783. She then complained of an enlargement of the abdomen, difficulty of breathing, particularly when lying, and costiveness. She passed small quantities of high-coloured urine; and had an evident fluctuation in the belly. Her legs were oedematous. Chrystals of tartar, squills, &c. had no effect. The 13th of June she took two spoonfuls of a decoction of Foxglove, containing three drams of the dry leaves, in eight ounces, three times a day. Her urine soon increased, and in a few days she passed it freely, which continued, and her breath returned.

CASE II.

Mr. ——, 45 years of age, had been long subject to dropsical swellings of the legs, and made little water. Two spoonfuls of the same decoction twice a day, soon relieved him.

CASE III.

Mrs. ——, aged 70 years. A lady frequently afflicted with the gout, and an asthmatical cough. After a long continuance of the latter, she had a great diminution of urine, and considerable difficulty of breathing, particularly on motion, or when lying. Her body was much bound. There was, however, no apparent swelling. She took three spoonfuls of an aperient decoction of forty-five grains in six ounces and a half, every other morning. The urine was plentiful those days, and her breathing much relieved. In two or three weeks after the use of it she was perfectly restored. The purgative medicine neither increased the urine, nor relieved the breathing, till the Foxglove was added.

This spring she long laboured with the gout in her stomach, which terminated in a fit in her hand. During the whole of this tedious illness, of nearly three months, she passed little urine, and her breathing was again short.

She took the same preparation of Foxglove without any diuretic effect, and afterwards two and three grains of the powder twice a day with as little. The dulcified spirits of vitriol, however, quickly promoted the urinary secretion.

CASE IV.

Mr. C——, 46 years of age, had dropsical swellings of the legs, and passed little urine. He took the decoction with three drams, and was soon relieved.

CASE V.

Lady——, took three grains of the dried leaves twice a day, for swelled legs, and scantiness of urine, without effect.

CASE VI.

Mrs. Slater, aged 36 years. For dropsy of the belly and legs, and scantiness of urine, of several weeks standing, took three grains of the powder twice a day, and was quite restored in ten days. She took many medicines without effect.

CASE VII.

Mrs. P——, in her 70th year, took three grains of the powder twice a day, for scantiness of urine, and swelled legs, without effect.

CASE VIII.

Ann Winterleg, in her 26th year, had dropsical swellings of the legs, and passed little urine: she was relieved by two drams, in an eight ounce decoction.

CASE IX.

William Brown, aged 76. In the last stage of dropsy of the belly and legs, found a considerable increase of his urine by a decoction of Foxglove, but it was not permanent.

CASE X.

Mr. ——, — years of age, and of very gross habit of body, became highly dropsical, and took various medicines, without effect. One ounce of the decoction, with three drams of the dry leaves in eight ounces, twice or three times a day, increased his urine prodigiously. He was evidently better, but a little attendant nausea overcame his resolution, and in the course of some weeks afterwards he fell a victim to his obstinacy.