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. [Symbol: ounce]ii.
Coque ex aq. font. [Symbol: pound]ii. ad [Symbol: pound]i.
colat. liquor. adde aq. junip. comp. [Symbol: ounce]ii.
Mell. anglic [Symbol: ounce]i. 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!
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, AEt. 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 [Symbol: dram]i. cons. cynosbat. [Symbol: scruple]ii.
fol. Digital. pulv. gr. xv. f. pil. xxiv. capt. ii. omni nocte hora
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, AEt. 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.