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 quant.i.ty. 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 ?iii. of the fol. Digitalis in ?vi. of boiling water, for four hours; then strained it, and added ?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 quant.i.ty 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 quant.i.ty, and in the seventh month of her pregnancy: a woman of very delicate const.i.tution, 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 ?ii. aq. menth. v. simpl. ?iss. m. mane sumend.

R. pulv. scillae ?i. G. ammoniac, sapon. venet. aa ?iss. syr.

q. s. f. pilul. 42 cap. iii. nocte maneque.

On the 7th found her worse, and the swelling increased; the urine about ?x in the twenty-four hours.

R. Fol. siccat. Digital. ?iii. coque in. aq. fontan. ?xii. ad ?vi. cola et adde. aq. juniper. comp. ?ii. sacchar. alb. ?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 quant.i.ty of urine was much increased, and the swelling diminished. Pulse and breathing better.

R. Fol. sicc. Digital. G. a.s.safetid. aa ?i. calomel. pp. gr.

x. sp. lavand. comp. q. s. fiat pilul. x.x.xii. 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 b.r.e.a.s.t.s 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 ?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 appet.i.te nor thirst, spasmodic pains at times across the loins very violent, but not so frequent as on the preceding day.

R. Gum ammoniac, a.s.safetid. aa ?i. camphor. gr. xii. fiat pilul. 24. capt. ii. 3tia quaque hora in cochlear. ii.

mixtur. seq.

R. Balsam. peruv. ?iii. mucilag. G. arab. q. s. flor. zinci g. vi. aq. menth. simp. ?ss. m.

Applic. Emp. vesicat. femorib. internis.

R. Sp. vol. ftid. elixir. paregor. balsam. Traumatic. aa ?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, ?vi. tinct. amar. tinct.

stomachic. aa ?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. a.s.safetid. ?ii. pulv. jacob. ?i. rad. scill. recent.

gr. xii. extract. thebaic. gr. iv. f. pilul. xvi. cap. iv.

omni nocte.

R. Sal. nitr. sal. diuretic. aa ?ii. pulv. e contrayerv.

comp. ?i. sacchar. ?i. emuls. commun. ?i. aq. cinnam. simpl.

?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 quant.i.ty, 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. a.s.safetid. aa ?i. sp. lavand.

comp. q. s. f. pilul. x.x.xii. 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 quant.i.ty 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, appet.i.te 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 quant.i.ty, her strength is recovered, and she has a good appet.i.te. 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.