A Letter to the Author, from Mr. Boden,
Surgeon, at Broseley, in Shropshire.
Broseley, 25th May, 1785.
Dear Sir,
Have inclosed the prescriptions that contained the fol. Digital. which I gave to Thomas Cooke and Thomas Roberts.
Thomas Cooke, Æt. 49, had been ill about two or three weeks. When I saw him he had no appetite, and a constant thirst: a fullness and load in the stomach: the thighs, legs and hands, much swell'd, and the face and throat in a morning; was costive, and made but little water, which was high coloured; the pulse very weak, and his breath exceeding bad. June 17th. R. Argent, viv ʒi. cons. cynosbat. ℈ii. fol. Digital. pulv. gr. xv. f. pil. xxiv. capt. ii. omni nocte horâ decubitus. He was likewise purged by a bolus of argent. viv. jallap, Digit. elaterium and calomel, which was repeated on the fourth day, to the third time. From June 17th to the 29th, the symptoms were mostly removed, making water freely, and having plenty of stools; in a week after he was perfectly well, and remains so ever since. The cure was finished by steel and bitters.
Thomas Roberts, Æt. 40, had a deformed chest, was obliged to be almost in an erect posture when in bed; the other symptoms were nearly the same as Cooke's. August 3d. The pills prescribed June 17th for Cooke.—17th. A purging bolus of jalap and Digitalis, once a week. He continued the medicines till the latter end of August, when he got very well; but the complaint returned in Jan. worse than before. He is now much better, but I have great reason to believe the liver to be diseased.
I am, with the greatest respect,
Your very obliged humble servant,
DANIEL BODEN.
P. S. The second patient, on his relapse, took Digitalis again, combined with other things.
CASE communicated by Mr. Causer,
Surgeon, at Stourbridge, Worcestershire.
Mr. P—— of H—— M——, in the parish of Kingswinford, aged about 60; had been a strong healthy, robust, corpulent man; worked hard early in life at edge-tool making, and drank freely of strong malt liquor; for many years had been subject to gout in the extremities; for a few years past had been very asthmatic, and the gout in the extremities gradually decreased. When I first saw him, which was Sept. 12, 1779, his legs were anasarcous, his belly much swelled, and an evident fluctuation of water. His breathing very bad, an irregular pulse, and unable to lie down. His easiest posture was standing with his body leaning over a chair, in which situation he would continue many hours together, labouring for breath, with the sweat trickling down his face very profusely; the urine in very small quantity. Diuretics of every kind I could think of were used with very little or no advantage. Blisters applied to the legs relieved very considerably for a time, but by no means could I increase the urinary discharge. Warm stomachic medicines were given, and at the same time sinapisms applied to the feet, in hopes of enticing gout to the extremities, but without any good effect.—November 22d. The swelling considerably increasing, an emetic of acet. scillitic. was given, which acted very violently, and increased the urinary discharge considerably. He continued better and worse, using different kinds of diuretic and expectorating medicines until September 1781, when the disease was so much worse, I did not expect he could live many days. The acet. scillitic. was repeated, a table spoonful every half hour, till it acted briskly upwards and downwards; but without increasing the urinary discharge.—On the 17th of September I infused ʒiii. of the fol. Digitalis in ℥vi. of boiling water, for four hours; then strained it, and added ℥i. of tinct. aromatica.—On the 18th he began by taking one spoonful, which he was to repeat every half hour, till it made him very sick, unless giddiness, loss of sight, or any other disagreeable effect took place. I had never given the medicine before, and had prepared him to expect the operation to be very severe. I saw him again on the 21st; he had taken the medicine regularly, till the whole quantity was consumed, without perceiving the least effect of any kind from it, and continued well till the evening of the following day, when a little sickness took place, which increased, but never so as to occasion either vomiting or purging, but a surprising discharge of urine. The saliva increased so as to run out of his mouth, and a watery discharge from his eyes; these discharges continued, with a continual sickness, till the swelling was totally gone, which happened in three or four days. He afterwards took steel and bitters; and continued very comfortably, without any return of his dropsy, until the 7th of April 1782, when he was seized with an epidemic cough, which was very frequent with us at that time. His swellings now returned very rapidly, with the greatest difficulty in breathing, and he died in a few days. Blisters and expectorating medicines were used on this last return.