I had the favour of your letter last week; and I shall be very happy if I can give you any intelligence relating to the Foxglove, that can answer the purpose in which you are so laudably engaged.
It is true that my brother, the late Dr. Cawley, was greatly relieved, and his life, perhaps, prolonged for a year, by a decoction of the Foxglove root; but why it had not a more lasting effect, it is necessary I should tell you that he had all the signs of a distempered viscera, long before any watery swellings appeared; it was manifest that his dropsy was merely symptomatic, and he could therefore only from time to time have any relief from medicine. In the year 1776, he returned from London to Oxon. having consulted several physicians at the former place, and Dr. Vivian at the latter, but without any success; and he was then told of a carpenter at Oxon. that had been cured of a Hydrops pectoris by the Foxglove root, and as he was a younger, and in other respects an healthy man, his cure, I believe, remains a perfect one.
I did not attend my brother whilst he took the medicine, and therefore I cannot speak precisely to the operation of it; but I remember, by his letters, that he was dreadfully sick and ill for several days before the secretion of urine came on, but which it did do to a great degree; relieved his breath, and greatly lessened the swelling in his legs and thighs; but the two instances I have lately seen in this part of the world, are much stronger proofs of the efficacy of it than my brother's case.
I am, &c.
ROBERT CAWLEY.
N. B. Whenever I have another opportunity of giving the Foxglove, it shall be in small doses:—In which I should hope it might succeed, although it might be more slowly. If you should try it with success, I should be glad to know what mode you made use of.
Dr. Cawley's prescription.
R. Rad. Digital. purpur. siccat. et contus. ℥ii.
Coque ex aq. font. ℔ii. ad ℔i. colat. liquor. adde aq. junip. comp. ℥ii.
Mell. anglic ʒi. m. sumat cochl. iv. omni nocte h. s. et mane.
—I have elsewhere remarked, that when the Digitalis has been properly given, and the diuretic effects produced, that an accidental over-dose bringing on sickness, has stopped the secretion of urine. In the present instance it likewise appears, that violent sickness may be excited, and continue for several days without being accompanied by a flow of urine; and it is probable that the latter circumstance did not take place, until the severity of the former abated. If Dr. Cawley had not had a constitution very retentive of life, I think he must have died from the enormous doses he took; and he probably would have died previous to the augmentation of the urinary discharge. For if the root from which his medicine was prepared, was gathered in its active state, he did not take at each dose less than twelve times the quantity a strong man ought to have taken. Shall we wonder then that patients refuse to repeat such a medicine, and that practitioners tremble to prescribe it? Were any of the active and powerful medicines in daily use to be given in doses twelve times greater than they are, and these doses to be repeated without attention to the effects, would not the patients die, and the medicines be condemned as dangerous and deleterious?—Yet such has been the fate of Foxglove!