Part 7

R. Fol. Digit. purp. siccat. [Symbol: dram]iii. Aq. bull. [Symbol: pound]i. digere per horas duas, et colat. adde aq. junip. comp. [Symbol: ounce]iii.

He was directed to take one ounce of this infusion every two hours until it should make him sick. This was on Wednesday. The fifth dose made him vomit. On Thursday afternoon he vomited again very freely, without having taken any more of the medicine. On Friday and Saturday he made more water than he had done for a week before, and the swellings of his face and body were considerably abated. He was directed to omit all medicine so long as the urine continued to flow freely, and also to keep an account of the quantity he made in twenty-four hours.

These were his reports:

October 31st. Saturday, 5 half pints. November 1st. Sunday, 6 2d. Monday, 8 3d. Tuesday, 8 4th. Wednesday, 7 5th. Thursday, 8

On Wednesday he began to purge, and the purging still continues, but his appetite is better than he has known it for a long time. No swelling remains but about his ancles, extending at night half way up his legs.

Omit all medicines at present.

7th. Saturday, 7½ half pints. 8th. Sunday, 8 9th. Monday, 6¾ 10th. Tuesday, 6½ 11th. Wednesday, 6 12th. Thursday, 6¼

On Tuesday the 17th, some swelling still remained about his ancles, but he was in every other respect perfectly well.

He took a few more doses of the infusion, and no other medicine.

CASE XIX.

December 8th. W---- B----, Æt. 60. A hard drinker. Diseased viscera; ascites and anasarca. An infusion of Digitalis was directed, but it had no other effect than to make him sick.

1779.

In the beginning of this year we had many dropsies in children, who had suffered from the Scarlatina Anginosa; they all yielded very readily to the Digitalis, but in some the medicine purged, and then it did not prove diuretic, nor did it remove the dropsy until opium was joined with it, so as to prevent it purging.--I did not keep notes of these cases, but I do not recollect a single instance in which the Digitalis failed to effect a cure.

CASE XX.

January 1st. Mr. H----. Hydrops Pectoris; legs and thighs prodigiously anasarcous; a very distressing sense of fulness and tightness across his stomach; urine in small quantity; pulse intermitting; breath very short.

He had taken various medicines, and been blistered, but without relief. His complaints continuing to increase, I directed an infusion of Digitalis, which made him very sick; acted powerfully as a diuretic, and removed all his symptoms.

About three months afterwards he was out upon a journey, and, after taking cold, was suddenly seized with difficulty of breathing, and violent palpitation of his heart: he sent for me, and I ordered the infusion as before, which very soon removed his complaints. He is now active and well; but, whenever he takes cold, finds some return of difficult breathing, which he soon removes by a dose or two of the infusion.

CASE XXI.

January 5th. Mrs. M----, Æt. 69. Hydrothorax, (called asthma) ascites and anasarca. I directed an infusion of Fol. Digital. siccat. three drams to a pint; a small wine glass to be taken every third or fourth hour. It made her violently sick, acted powerfully as a diuretic, set her breath perfectly at liberty, and carried off the swelling of her legs; when she was nearly emptied, she became so languid, that I thought it necessary to order cordials, and a large blister to her back. Mr. Ward, who attended as her apothecary, tells me she had some return of her asthma in June and October following, which was each time removed by the same medicine.

CASE XXII.

January 11th. Mr. H----, Æt. 59. Ascites and general anasarca. A large corpulent man, and a hard drinker: he had repeatedly suffered under complaints of this kind, but had been always relieved by the judicious assistance of Dr. Ash. In the present instance, however, not finding relief as usual from the prescriptions of my worthy friend, he sent for me; after examining into his situation, and informing myself what had been done to relieve him, I was satisfied that the Digitalis was the only medicine from which I had any thing to hope. It was therefore directed; but another patient requiring my assistance at a distance from town, I desired he would not begin the medicine before I returned, which would be early on the third day; for I was well aware of the difficulties before me, and that he would inevitably sink under too rapid an evacuation of the water. On my return I was informed, that the preceding evening, as he sat on his chair, his head sunk upon his breast, and he died.

This case, as well as case VI. is mentioned with a view to demonstrate to younger practitioners, how sudden and unexpected the deaths of dropsical patients sometimes happen, and how cautious we should be in assigning causes for effects.

CASE XXIII.

August 31st. Mr. C----, Æt. 57. Diseased viscera, jaundice, ascites and anasarca. After trying calomel, saline draughts, jallap purges, chrystals of tartar, pills of gum ammoniac, squills, and soap, sal succini, eleterium, &c. infusion of Digitalis was directed, which removed all his urgent symptoms, and he recovered a pretty good state of health.

CASE XXIV.

September 11th. I was desired to visit Mr. L----, Æt. 63; a middle sized man; rather thin; not habitually intemperate; found him in bed, where he had been for three days. He was in a state of furious insanity, and had been gradually losing his reason for ten days before, but was not outrageous the first week; his apothecary had given him ten grains of emetic tartar, a dram of ipecacoanha, and an ounce of tincture of jallap, in the space of a few hours, which scarcely made him sick, and only occasioned a stool or two; upon enquiring into the usual state of his health, I was told that he had been troubled with some difficulty of breathing for thirty years past, but for the nine last years this complaint had increased, so that he was often obliged to sit up the greater part of the night; and, for the last year, the sense of suffocation was so great, when he lay down, that he often sat up for a week together. His father died of an asthma before he was fifty. A few years ago, at an election, where he drank more than usual, his head was affected as now, but in a slighter degree, and his asthmatic symptoms vanished; and now, notwithstanding he has been several days in bed, he feels not the least difficulty in breathing.

Apprehending that the insanity might be owing to the same cause which had heretofore occasioned the asthma, and that this cause was water; I ordered a decoction of the Fol. siccat Digital, three drams to half a pint; three spoonfuls to be taken every third hour: the fourth dose made him sick; the medicine was then stopped; the sickness continued at intervals, more or less, for four days, during which time he made a great quantity of water, and gradually became more rational. On the fifth day his appetite began to return, and the sickness ceased, but the flow of urine still continued.

A week afterwards I saw him again, and examined him particularly; his head was then perfectly rational, appetite very good, breath quite easy, permitting him to lie down in bed without inconvenience, makes plenty of water, coughs a little, and expectorates freely. He took no other medicine, except a little rhubarb when costive.