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usual, a sense of weight across his loins continuing very troublesome. The usual medicines failing to relieve him, I ordered four grains of pulv. Digital. to be taken every other night for a week, and fifteen grains of mild fixed vegetable alkaly to be swallowed twice a day in barley water. He soon lost all his complaints; but we must not in this case too hastily attribute the cure to the Digitalis, as the alkaly has also been found a very useful medicine in similar disorders. CASE CXLVII.

Nov. 4th. Mr. B—— of N——, Æt. 60. Had been much subject to gout, but his constitution being at length unable to form regular fits, he became dropsical. Pulv. fol. Digital. in doses of two or three grains, at bed-time, gave him some relief, but did not perfectly empty him. About three months afterwards he had occasion to take it again; but it then produced no effect, and he was so debilitated that it was not urged further.

CASE CXLVIII.

Nov. 8th. Mr. G——, Æt. 35. In the last stage of a phthisis pulmonalis, was attacked with a most urgent and painful difficulty of breathing. Suspecting this distress might arise from watery effusion in the chest, I gave him Digitalis, which relieved him considerably; and during the remainder of his life his breath never became so bad again.

CASE CXLIX.

Nov. 13th. Mrs. A—— of W——h——, Æt. 68. One of those rare cases in which no urine is secreted. It proved as refractory as usual to remedies, and not having ever succeeded in the cure of this disease, I determined to try the Digitalis. It was given in infusion, and, after a few doses, the secretion of a small quantity of urine seemed to justify the attempt. The next day, however, the secretion ceased, nor could it be excited again, tho' at last the medicine was pushed so as to occasion sickness, which continued at intervals for three days.

CASE CL.

Nov. 20th. Mrs. B——, Æt. 28. In the last stage of a pulmonary consumption became dropsical. I directed three grains of the pulv. Digital. to be taken daily, one in the morning, and two at night. She took twenty grains without any sensible effect.

CASE CLI.

Nov. 23d. Master W——, Æt. 7. Supposed hydrocephalus internus. A grain of pulv. fol. Digitalis was directed night and morning. After three days, no sensible effects taking place, it was omitted, and the mercurial plan of treatment adopted. The child lived near five months afterwards. Upon dissection near four ounces of water were found in the ventricles of the brain.

CASE CLII.

Nov. 26th. Mrs. W——, Æt. 65. I had attended this lady last winter in a very severe peripneumony, from which she narrowly escaped with her life. When the cold season advanced this winter, she perceived a difficulty in breathing, which gradually became more and more troublesome. I found her much harassed by a cough, which occasioned her to expectorate a little: the least motion increased her dyspnœa; she could not lie down in bed; her legs were considerably swelled, her urine small in quantity. I directed two grains of pulv. Digitalis made into a pill with gum ammoniac, to be taken every night, and to promote expectoration, a squill mixture twice in the day. Her urine in five days became clear and copious, and in a fortnight more she lost all her complaints, except a cough, for which she took the lac ammoniacum.

It is not improbable that the squill might have some share in this cure.

CASE CLIII.

December 7th. Mr. H——, Æt. 42. A large sat man, very subject to gravelly complaints. After an attack in the usual manner, continued to feel numbness in his lower limbs, and a sense of weight across his loins. I directed infusum Digitalis to be given every six hours. Six ounces made him sick, and he took no more. The next day his urine increased, a good deal of sand passed with it, and he lost his disagreeable feels, but the sickness did not entirely cease before the fourth day from its commencement.

CASE CLIV.

December 27th. Mr. B——, of H——, Æt. 55. Symptoms of hydrothorax, at first obscurely, afterwards more distinctly marked. Many things were tried, but the squill alone gave relief. At length this failed. About the third month of the disease, a grain of pulv. Digital. was ordered to be taken night and morning. This produced the happiest effects. In March following he had some slight symptoms of relapse, which were soon removed by the same medicine, and he now enjoys good health. For a more particular narrative see case the first, communicated by Mr. Yonge.

CASE CLV.

December 31st. Mrs. B——, of E——, Æt. 50. An ovarium dropsy of long continuance. She took three grains of pulv. Digital. every night at bed time, for a fortnight, but without any effect.

CASE CLVI.

A poor man in this town, after his kidneys had ceased to secrete urine for several days, was seized with hickup, fits of vomiting, and transient delirium. After examination I was satisfied the disease was the same as that mentioned at CXLIX. A very experienced apothecary having tried various methods to relieve him, I despaired of any success, but determined to try the Digitalis. It was accordingly given in infusion. At first it checked the vomitings, but did not occasion any secretion of urine.

1785.

The cases which have occurred to me in the course of this year, are numerous; but as the events of some of them are not yet sufficiently ascertained, I think it better to with-hold them at present.

FOOTNOTES:

[4] Then resident at Lichfield, now at Derby.

[5] This disease has lately been well described by Mr. White, of Manchester.

HOSPITAL CASES,
Under the Direction of the Author.

The four following cases were drawn out at my request by Mr. Cha. Hinchley, late apothecary to the Birmingham Hospital. They are all the Hospital cases for which the Digitalis was prescribed by me, whilst he continued in that office.

CASE CLVII.

March 15th, 1780. John Butler, Æt. 30. Asthma and swelled legs. He was directed to take myrrh and steel every day, and three spoonfuls of infusum Digitalis every night. On the 8th of April he was discharged, cured of the swellings and something relieved of his asthmatic affections.

CASE CLVIII.

November 18th, 1780. Henry Warren, Æt. 60. This man had a general anasarca and ascites, and was moreover so asthmatic, that, neither being able to sit in a chair nor lie in bed, he was obliged constantly to walk about, or to lean forward against a window or table. You prescribed for him thus.

R. Aq. cinn. spt. ℥iv.

Oxymel. scillit.

Syr. scillit. aa. ℥i. m. cap. cochlear. larg. sexta quaque horâ.

This medicine producing no increased discharge of urine, on the 25th you ordered the infusion of Digitalis, two spoonfuls every four hours. After taking this for thirty six hours, his urine was discharged in very great quantity; his breath became easy, and the swellings disappeared in a few days, though he took no more of the medicine. On the 2d of December he was ordered myrrh and lac ammoniacum, which he continued until the 23d, when he was discharged cured, and is now in good health.

CASE CLIX.

November 3d, 1781. Mary Crockett, Æt. 40. Ascites and universal anasarca. For one week she took sal. diureticus and tincture of cantharides, but without advantage. On the 10th you directed the infusion of Digitalis, a dram and half to half a pint, an ounce to be taken every fourth hour. Before this quantity was quite finished, the urine began to be discharged very copiously. The medicine was then stopped as you had directed. On the 15th, being costive, she took a jallap purge, and on the 24th she was discharged cured.

CASE CLX.

March 16th, 1782. Mary Bird, Æt. 61. Great fullness about the stomach; diseased liver, and anasarcous legs and thighs. For the first week squill was tried in more forms than one, but without advantage. On the 22d she began with the Digitalis, which presently removed all the swelling.

She was then put upon the use of aperient medicines and tonics, and on the first of August was discharged perfectly cured.

The three following Cases were drawn up and communicated to me by Mr. Bayley, who succeeded Mr. Hinchley as apothecary to the Hospital at Birmingham:

Shiffnall, April 26th, 1785.

Dear Sir,

During my residence in the Birmingham General Hospital, I had frequent opportunities of seeing the great effects of the Digitalis in dropsy. As the exhibition of it was in the following instances immediately under your own direction, I have drawn them up for your inspection, previous to your publishing upon that excellent diuretic. Of its efficacy in dropsy I have considerable evidence in my possession, but consider myself not at liberty to send you any other cases except those you had yourself the conduct of. The Digitalis is a very valuable acquisition to medicine; and, I trust, it will cease to be dreaded when it is well understood.

I am, Sir, your obedient,
And very humble servant,
W. BAYLEY.

CASE CLXI.

Mary Hollis, aged 62, was admitted an out patient of the Birmingham General Hospital February 12th, 1784, labouring under all the effects of hydrothorax; her dread of suffocation during sleep was so great, that she always reposed in an elbow chair. She was directed to take two grains of Digitalis in powder every night and morning, and for a few days found great relief; but, on the eighth day, as she had complained of sickness, and had been considerably purged, she was ordered to desist taking any more of her powders. On the 14th day she was ordered an ounce of the following infusion twice in a day: R. Fol. Digital. purp. sicc. ʒiss. aq. bullient. ℔ss. digere per semi-horam, colaturæ adde tinct. aromatic ℥i. This infusion did not purge, but sometimes excited nausea, though not sufficient to prevent her from continuing its use. She grew gradually better, and on the 6th of May was discharged perfectly cured. The diuretic effects of the Digitalis were in this instance immediate.

CASE CLXII.

Edward James, Æt. 21. Admitted March 20th, 1784. Complained of great difficulty of breathing, pain in his head, and tightness about the stomach, with a trifling swelling of his legs. Ordered pil. scillit. ℈i. ter de die. On the third day his legs much more swelled, his breathing more difficult, and in every respect worse; his pulse very small and quick, complained when he turned in bed, of something like water rolling from one side of the thorax to the other. A remarkable blueness about the mouth and eyes, and purged considerably from the pil. scill. Ordered to omit the pills and to take ℥i. of infus. Digitalis every eight hours; the proportion ʒiss. to eight ounces of water and ℥i. of aq. n. m. sp.—7th Day, The infusion had neither purged, nor vomited him: he only complained once or twice of giddiness. His belly was now very hard, rather black on the right side the navel, and his legs amazingly swelled. Ordered a bolus with rhubarb and calomel, to be taken in the morning, and ℥ii. julep salin. cum tinct. canthar. gutt. forty ter die.—12th Day, nearly in the same state, except his breathing which was somewhat more difficult, being now obliged to have his head considerably raised. Persistat—From this day to the 32d day he became hourly worse. His belly which at first was only hard, now evidently contained a large quantity of water, his legs

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