Part 5

_June_ 29th. Mr. A----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 35. A publican and a hard drinker. Ascites, anasarca, diseased viscera, and slight attacks of hæmoptoe. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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 sodæ 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 36. In the last stage of a pulmonary consumption, took the Infus. Digitalis, but without any advantage.

CASE XCVI.

_August_ 20th. Mr. P----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt. 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----, Æt 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----, Æt. 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----, Æt. 28. A dropsy in the last stage of a phthisis. Infusum Digitalis was tried to no purpose.

CASE CXV.

_June_ 20th. Mrs. H----, Æt. 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----, Æt. 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----, Æt. 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 sodæ; 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----, Æt. 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.