CASE CXXXII.
July 16th. Mr. B——, of W——, Æt. 31. After a tertian ague of 12 months continuation, suffered great indisposition for 10 months more. He chiefly complained of great straitness and pain in the hypochondriac region, very short breath, swelled legs, want of appetite. He had been under the care of some very sensible practitioners, but his complaints increased, and he determined to come to Birmingham. I found him supported upright in his chair, by pillows, every attempt to lean back or stoop forward giving him the sensation of instantaneous suffocation. He said he had not been in bed for many weeks. His countenance was sunk and pale; his lips livid; his belly, thighs and legs very greatly swollen; hands and feet cold, the nails almost black, pulse 160 tremulous beats in a minute, but the pulsation in the carolid arteries was such as to be visible to the eye, and to shake his head so that he could not hold it still. His thirst was very great, his urine small in quantity, and he was disposed to purge. I immediately ordered a spoonful of the infusum Digitalis every six hours, with a small quantity of laudanum, to prevent its running off by stool, and decoction of leontodon taraxacum to allay his thirst. The next day he began to make water freely, and could allow of being put into bed, but was raised high with pillows. Omit the infusion. That night he parted with six quarts of water, and the next night could lie down and slept comfortably. July 21st. he took a mild mercurial bolus. On the 25th. the diuretic effects of the Digitalis having nearly ceased, he was ordered to take three grains of the pulv. Digital. night and morning, for five days, and a draught with half an ounce of vin. chalyb. twice a day. August 15th. He took a purge of calomel and jallap, and some swelling still remaining in his legs, the Digitalis infusion was repeated. The water having been thus entirely evacuated, he was ordered saline draughts with acetum scilliticum and pills of salt of steel and extract of gentian. About a month after this, he returned home perfectly well.