_November_ 2d. Mr. P---- of T----, AEt. 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 dyspnoea 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. [Symbol: dram]ii.
Aq. bull. [Symbol: pound]ss.
Sp. Vini rectif. [Symbol: ounce]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.