CASE III.
Mrs. M—— G——, Æt. 64. Has had sore legs for these thirty-four years past. Orthopnœa. Sense of oppression at the prœcordia. Pulse intermitting. Legs anasarcous. Urine scanty, high-coloured.
Infus. Digital. c. ʒiss ad aq. bull. ℥viii. cochl. ii. 4tis horis.
Took six doses, when nausea was excited. Urine a quart during the course of the night. The flow of urine continued, and complaints relieved. Sal. Mart. c. extr. gent. and afterwards with the addition of extr. cort. for which last ingredient she had a predilection, confirmed the cure.
On the same day the next year I was called in to her for a similar train of symptoms, excepting that the pulse was but just perceptibly irregular.
Infus. Digital. u. a. præscript.
The directions on the phial not being attended to, two doses of it were given after a nausea had been excited, which, with occasional vomitings, became exceedingly oppressive. A saline draught, given in Dr. Hulme's method, a draught sal. c. c. gr. xii. c. conf. card. gr. x. produced no immediate effect, but the nausea gradually abating, inf. bacc. junip. was ordered; but this appeared to augment it, and a great propensity to sleep coming on, I directed sal. c. c. conf. card, aa gr. viii. 4tis horis, which removed the unpleasant symptoms and myrrh. c. sal. mart. completed the cure. During the use of the above medicines, the urine was augmented, and the pulmonary complaints removed, even before the nausea left her; and the sores of her legs which were much inflamed before she began with the infus. Digital. in a day's time assumed a much healthier appearance, and on her other complaints going off, they shewed a greater tendency to heal than she had ever observed in them for twenty years before. This instance is a very pleasing confirmation of the experience of Hulse and Dr. Baylies, and of the advantage to be derived from a medicine, which, while it helps to heal the ulcers, removes that from the constitution which often renders the healing of them improper.
In one case in which I ordered it, the infusion, instead of digesting three hours as I had directed, was suffered to stand upon the leaves all night. The consequence was that the first dose produced considerable nausea.
The two following cases, with which I have been favoured by a physician very justly eminent, convince me of the necessity there is that every one who discovers a new medicine, or new virtues in an old one, should, in announcing such discoveries, publish to the world the exact manner in which he exhibits such medicines, with all the precautions necessary to obtain the promised success.
In these (says my correspondent) "the infusion was given in small doses, repeated every hour or two, till a nausea was raised, when it was omitted for a day or perhaps two, and then repeated in the same manner.
"An Ascites emptied by it, but filled again very speedily, though its use was never discontinued, and who afterwards found no salutary effects from it. Ended fatally.
"In an Anasarca it sometimes increased the quantity of urine, and abated the swelling, but which as often returned in as great a degree as before, though the medicine was still given, and always increased in quantity so as to excite nausea. Ended fatally.
"I have tried it in many other cases, but found very little difference in the success attending it."
May we not be allowed to conjecture that the inefficacy of its continued use is owing to its narcotic property gradually diminishing the irritability of the muscular fibres of the absorbents, or possibly of the whole vascular system, and thus adding to that weakened action which seems to be the cause of the generality of dropsies, which leads us to caution the medical experimenter against trying it, at least against its continued use, even in small doses, in other diseases of diminished energy, as continued fever, palsy, &c.
I remain with the greatest truth,
Your obliged and affectionate friend,
JONATHAN STOKES.
Stourbridge,
May 17, 1785.