CASE LV.
November 2d. Mr. P—— of T——, Æt. 42. A very strong man, drank a great quantity of strong ale, and was much exposed to alterations of heat and cold. About the end of summer found himself short winded, and lost his appetite. The dyspnœa gradually increased, he got a most distressing sense of tightness across his stomach, his urine was little, and high coloured, and his legs began to swell; his pulse slender and feeble. From the 20th of September I frequently saw him, and observed a gradual and regular increase of all his complaints, notwithstanding the use of the most powerful medicines I could prescribe. He took chrystals of tartar, seneka, gum ammoniac, saline draughts, emetics, tinct. of cantharides, spirits of nitre dulcified, squills in all forms, volatile alkaly, calomel, Dover's powder, &c. Blisters and drastic purgatives were tried, interposing salt of steel and gentian. I had all along felt a reluctance to prescribe the Digitalis in this case, from a persuasion that it would not succeed. At length I was compelled to it, and directed one grain to be given every two hours until it should excite nausea. This it did; but, as I expected, it did no more. The reason of this belief will be mentioned hereafter. Five days after this last trial I gave him assafetida in large quantity, flattered by a hope that his extreme sufferings from the state of his respiration, might perhaps arise in part from spasm, but my hopes were in vain. I now thought of using an infusion of tobacco, and prescribed the following:
R. Fol. Nicotian. incis. ʒii.
Aq. bull. ℔ss.
Sp. Vini rectif. ℥i digere per horam.
I directed a spoonful of this to be given every two hours until it should vomit. This medicine had no better effect than the former ones, and he died some days afterwards.