_August_ 15th. Mrs. C----, AEt. 60. Ascites, anasarca, diseased
viscera, paucity of urine, and total loss of appetite. These
complaints had heretofore existed repeatedly, and had been removed by
deobstruent and diuretic medicines; but in this attack the symptoms
were suffered to exist a longer time and in a greater degree, before
assistance was sought for. The remedies that used to relieve her were
now exhibited to no purpose. Mild mercurials, soap, rhubarb, and
squill were tried; but she grew rapidly worse. Saline draughts with
acetum scilliticum seemed for a few days to check the progress of her
complaint, but they soon lost their effect, and diarrhoea ensued
upon every attempt to increase the frequency of the dose. Draughts
with Infus. Digital. were then directed to be taken twice a day. The
effect was a powerful action on the kidneys, and a reduction of the
swellings, but without sickness. A degree of appetite returned, but
still the tendency to diarrhoea existed, and kept her weak. Tonic
medicines were then tried, but without advantage, and in a month it
was necessary to have recourse to the Digitalis again. It was directed
in a half pint mixture; an ounce to be taken thrice in twenty-four
hours. On the 2d day, finding her symptoms very much relieved, she
took in the absence of her nurse, nearly a double dose of the
medicine. The consequence was great sickness, languor continuing for
several days, and almost a total stop to the secretion of urine, from
the time the sickness commenced.
The case now became totally unmanageable in my hands, and, after a
fortnight, I was dismissed, and another physician called in; but she
did not long survive.
This was not the first, nor the last instance, in which I have seen
too large a dose of the medicine, defeat the very purpose for which it
was directed.