An Account of the Foxglove and some of its Medical Uses. William Withering
In which the Digitalis was given by the
Direction of the Author.
1775.
It was in the course of this year that I began to use the Digitalis in dropsical cases. The patients were such as applied at my house for advice gratis. I cannot pretend to charge my memory with particular cases, or particular effects, and I had not leisure to make notes. Upon the whole, however, it may be concluded, that the medicine was found useful, or I should not have continued to employ it.
CASE I.
December 8th. A man about fifty years of age, who had formerly been a builder, but was now much reduced in his circumstances, complained to me of an asthma which first attacked him about the latter end of autumn. His breath was very short, his countenance was sunken, his belly large; and, upon examination, a fluctuation in it was very perceptible. His urine for some time past had been small in quantity. I directed a decoction of Fol. Digital. recent. which made him very sick, the sickness recurring at intervals for several days, during which time he made a large quantity of water. His breath gradually drew easier, his belly subsided, and in about ten days he began to eat with a keen appetite. He afterwards took steel and bitters.
1776.
CASE II.
January 14th. A poor man labouring under an ascites and anasarca, was directed to take a decoction of Digitalis every four hours. It purged him smartly, but did not relieve him. An opiate was now ordered with each dose of the medicine, which then acted upon the kidneys very freely, and he soon lost all his complaints.
CASE III.
March 15th. A poor boy, about nine years of age, was brought for my advice. His countenance was pale, his pulse quick and feeble, his body greatly emaciated, except his belly, which was very large, and, upon examination, contained a fluid. The case had been considered as arising from worms. He was directed to take the decoction of Digitalis night and morning. It operated as a diuretic, never made him sick, and he got well without any other medicine.
CASE IV.
July 25th. Mrs. H——, of A——, near N——, between forty and fifty years of age, a few weeks ago, after some previous indisposition, was attacked by a severe cold shivering fit, succeeded by fever; great pain in her left side, shortness of breath, perpetual cough, and, after some days, copious expectoration. On the 4th of June, Dr. Darwin,[4] was called to her. I have not heard what was then done for her, but, between the 15th of June, and 25th of July, the Doctor, at his different visits, gave her various medicines of the deobstruent, tonic, antispasmodic, diuretic, and evacuant kinds.
On the 25th of July I was desired to meet Dr. Darwin at the lady's house. I found her nearly in a state of suffocation; her pulse extremely weak and irregular, her breath very short and laborious, her countenance sunk, her arms of a leaden colour, clammy and cold. She could not lye down in bed, and had neither strength nor appetite, but was extremely thirsty. Her stomach, legs, and thighs were greatly swollen; her urine very small in quantity, not more than a spoonful at a time, and that very seldom. It had been proposed to scarify her legs, but the proposition was not acceded to.
She had experienced no relief from any means that had been used, except from ipecacoanha vomits; the dose of which had been gradually increased from 15 to 40 grains, but such was the insensible state of her stomach for the last few days, that even those very large doses failed to make her sick, and consequently purged her. In this situation of things I knew of nothing likely to avail us, except the Digitalis: but this I hesitated to propose, from an apprehension that little could be expected from any thing; that an unfavourable termination would tend to discredit a medicine which promised to be of great benefit to mankind, and I might be censured for a prescription which could not be countenanced by the experience of any other regular practitioner. But these considerations soon gave way to the desire of preserving the life of this valuable woman, and accordingly I proposed the Digitalis to be tried; adding, that I sometimes had found it to succeed when other, even the most judicious methods, had failed. Dr. Darwin very politely, acceded immediately to my proposition, and, as he had never seen it given, left the preparation and the dose to my direction. We therefore prescribed as follows:
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