Part 13

May 24th. Joseph B----, Æt. 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----, Æt. 60. A hard drinker; afflicted with asthma, jaundice, and dropsy. His appetite gone; his water foul and in small quantity. 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 appetite totally failed, and he died, but without any return of the ascites.

CASE LXXIV.

June 29th. Mr. A----, Æt. 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 appetite and jaundice continuing, and his debility increasing, he died in about two months.

CASE LXXV.

July 18th. Mrs. B----, Æt. 46. A little woman, and very much deformed. Asthmatical for many years. For several months past had been worse than usual; appetite 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 practitioners to be careful how they venture upon even small doses of opium in such constitutions, 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----, Æt. 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----, Æt. 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----, Æt. 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 guiacum 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----, Æt. 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 LXXX.

September 27th. Mrs. E----, Æt. 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 assistance 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 quantity of effused fluid in the cavity was not more than a pint.

CASE LXXXI.

October 28th. Mr. B----, Æt. 33. Had drank an immense quantity of mild ale, and was now become dropsical. He was a lusty man, of a pale complexion: his belly large, and his legs and thighs swollen to an enormous size. I directed the Infusion of Digitalis, which in ten days completely emptied him. He was then put upon the use of steel and bitters, and directed to live temperately, which I believe he did, for I saw him two years afterwards in perfect health.

CASE LXXXII.

November 14th. Mr. W----, of T----, Æt. 49. A lusty man, with an asthma and anasarca. He had taken several medicines by the direction of a very judicious apothecary, but not getting relief as he had been accustomed to do in former years, he came under my direction. For the space of a month I tried to relieve him by fixed alkaly, seneka, Dover's powder, gum ammoniac, squill, &c. but without effect. I then directed Infusion of Digitalis, which soon increased the flow of urine without exciting nausea, and in a few days removed all his complaints.

1782.

CASE LXXXIII.

January 23d. Mr. Q----, Æt. 74. A stone in his bladder for many years; dropsical for the last three months. Had taken at different times soap with squill and gum ammoniac; soap lees; chrystals of tartar, oil of juniper, seneka, jallap, &c. but the dropsical symptoms still increased, and the dysuria from the stone became very urgent. I now directed a dram of the Fol. Digit. siccat. in a half pint infusion, half an ounce to be given every six hours. This presently relieved the dysuria, and soon removed the dropsy, without any disturbance to his system.

CASE LXXXIV.

January 27th. Mr. D----, Æt. 86. The debility of age and dropsical legs had long oppressed him. A few weeks before his death his breathing became very short, he could not lie down in bed, and his urine was small in quantity. A wine glass of a weak Infusion of Digitalis, warmed with aromatics, was ordered to be taken twice a day. It afforded a temporary relief, but he did not long survive.