January 11th. Captain V——, Æt. 42. Had suffered much from residing in hot climates, and drinking very freely, particularly rum in large quantity. He had tried many physicians before I saw him, but nothing relieved him. I found him greatly emaciated, his countenance of a brownish yellow; no appetite, extremely low, distressing fulness across his stomach; legs and thighs greatly swollen; pulse quick, and very feeble; urine in small quantity. As he had evidently only a few days to live, I ordered him nothing but a solution of sal diureticus in cinnamon water, slightly acidulated with syrup of lemons. This medicine effecting no change, and his symptoms becoming daily more distressing, I directed an infusion of Digitalis. A few doses occasioned a copious flow of urine, without sickness or any other disturbance. The medicine was discontinued; and the next day the urine continuing to be secreted very plentifully, he lost his most distressing complaints, was in great spirits, and ate a pretty good dinner. In the evening, as he was conversing chearfully with some friends, he stooped forwards, fell from his chair, and died instantly. Had he been in bed, I think there is reason to believe this fatal syncope, if such it was, would not have happened.
CASE XXIX.
February 6th. Mr. H——, Æt. 63. A corpulent man; had suffered much from gout, which for the last year or two had formed very imperfectly. He had now symptoms of water in his chest, his belly and his legs. An infusion of Digitalis removed these complaints, and after being confined for the greater part of the winter, he was well enough to get abroad again. In the course of a month the dropsical symptoms returned, and were again removed by the same medicine. Bitters and tonics were now occasionally prescribed, but his debility gradually increased, and he died some time afterwards; but the dropsy never returned.
CASE XXX.
February 17th. Mr. D——, Æt. 50. Ascites and anasarca, with symptoms of phthisis. He had been a very hard drinker. The infusum Digitalis removed his dropsical symptoms, and he was sufficiently recovered to take a journey; but as the spring advanced, the consumptive symptoms increased, and he died soon afterwards, perfectly emaciated.
CASE XXXI.
March 5th. I was desired to visit Mrs. H——, a very delicate woman, who after a severe lying-in, had her legs and thighs swollen to a very great degree; pale and semi-transparent. I found her extremely faint, her pulse very small and slow; vomiting violently, and frequently purging. She was attended by a gentleman who had seen me give the Digitalis in a similar case of swelled legs after a lying-in (see [Case XXVI.]) about six months before. He had not considered that this patient was delicate, the other robust; nor had he attended to stop the exhibition of the medicine when its effects began to take place. The great distress of her situation was evidently owing to the imprudent and unlimited use of the Digitalis. I was very apprehensive for her safety; ordered her cordials and volatiles; a free supply of wine, chamomile tea with brandy for common drink, and blisters. The next day the situation of things was much the same, but with all this disturbance no increased secretion of urine. The same methods were continued; an opiate ordered at night, and liniment. volatile upon flannel applied to the groins, as she now complained of great pain in those parts. The third day the nausea was less urgent, the vomitings less frequent, the pulse not so slow. Camphorated spirit, with caustic volatile alkaly, was applied to the stomach, emulsion given for common drink, and the same medicines repeated. From this time, the intervals became gradually longer between the fits of vomiting, the flow of urine increased, the swellings subsided, the appetite returned, and she recovered perfectly.
CASE XXXII.
March 16th. Mr. D——, Æt. 70. A paralytic stroke had for some weeks past impaired the use of his left side, and he complained much of his breath, and of a straitness across his stomach; at length, an anasarca and ascites appearing, I had no doubt as to the cause of the former symptoms; but, upon account of his advanced age, and the paralytic affection, I hesitated to give the Digitalis, and therefore tried the other usual modes of practice, until at length his breath would not permit him to lie down in bed, and his other symptoms increased so rapidly as to threaten a speedy dissolution. In this dilemma I ventured to prescribe an infusion of the Fol. siccat. Digital. which presently excited a copious flow of urine, and made him very sick; a strong infusion of chamomile flowers, with brandy, relieved the sickness, but the diuretic effects of the Digitalis continuing, his dropsy was removed, and his breathing became easy. The palsy remained nearly in the same state. He lived until August 1782, and without any return of the dropsy.