An Account Of The Foxglove And Some Of Its Medical Uses Part 16

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 d.a.m.n 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 d.a.m.ned 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 baccha.n.a.lian 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 quant.i.ty 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 quant.i.ty 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 l.a.b.i.a 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 pa.s.sed small quant.i.ties of high-coloured urine; and had an evident fluctuation in the belly. Her legs were dematous.

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 pa.s.sed 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 pa.s.sed 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 pa.s.sed 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 pa.s.sed 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.

CASE XI.

Mrs. Smith, about 50 years of age, after a tedious illness of many weeks, had a jaundice, and became dropsical in the legs. Two spoonfuls of the decoction, with three drams twice a day, increased her urine, and abated the swelling.

CASE XII.

Widow Chatterton, about 60 years of age. Took the decoction in the same way for dropsy of the legs, with little effect.

CASE XIII.

---- Genders, about thirty-four years of age, was delivered of three children, and became dropsical of the abdomen. She pa.s.sed little or no urine, had constant thirst, and no appet.i.te. She took two spoonfuls of an eight ounce decoction, with three drams twice a day. By the time she had finished the bottle, (which must have been on the fourth day,) she had evacuated all her water, and could go about. Her appet.i.te increased with every dose, and she recovered without farther help.

CASE XIV.