CASE LXIII.

_March_ 16th. Mrs. P----, aet. 47. Great debility, pale countenance, loss of appet.i.te, legs swelled, urine in small quant.i.ty. 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 appet.i.te, and his skin and eyes turned yellow. By the use of medicines of the deobstruent cla.s.s 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 quant.i.ty 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 quant.i.ty 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 quant.i.ty. 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 appet.i.te gone; his water foul and in small quant.i.ty. 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 appet.i.te 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 appet.i.te 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; appet.i.te 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 pract.i.tioners to be careful how they venture upon even small doses of opium in such const.i.tutions, 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 guiac.u.m 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 Lx.x.x.

_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 a.s.sistance 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 quant.i.ty of effused fluid in the cavity was not more than a pint.