It is now about ten years since I first began to use this medicine. Experience and cautious attention gradually taught me how to use it. For the last two years I have not had occasion to alter the modes of management; but I am still far from thinking them perfect.
It would have been an easy task to have given select cases, whose successful treatment would have spoken strongly in favour of the medicine, and perhaps been flattering to my own reputation. But Truth and Science would condemn the procedure. I have therefore mentioned every case in which I have prescribed the Foxglove, proper or improper, successful or otherwise. Such a conduct will lay me open to the censure of those who are disposed to censure, but it will meet the approbation of others, who are the best qualified to be judges.
To the Surgeons and Apothecaries, with whom I am connected in practice, both in this town and at a distance, I beg leave to make this public acknowledgment, for the assistance they so readily afforded me, in perfecting some of the cases, and in communicating the events of others.
The ages of the patients are not always exact, nor would the labour of making them so have been repaid by any useful consequences. In a few instances accuracy in that respect was necessary, and there it has been attempted; but in general, an approximation towards the truth, was supposed to be sufficient.
The cases related from my own experience, are generally written in the shortest form I could contrive, in order to save time and labour. Some of them are given more in detail, when particular circumstances made such detail necessary; but the cases communicated by other practitioners, are given in their own words.
I must caution the reader, who is not a practitioner in physic, that no general deductions, decisive upon the failure or success of the medicine, can be drawn from the cases I now present to him. These cases must be considered as the most hopeless and deplorable that exist; for physicians are seldom consulted in chronic diseases, till the usual remedies have failed: and, indeed, for some years, whilst I was less expert in the management of the Digitalis, I seldom prescribed it, but when the failure of every other method compelled me to do it; so that upon the whole, the instances I am going to adduce, may truly be considered as cases lost to the common run of practice, and only snatched from destruction, by the efficacy of the Digitalis; and this in so remarkable a manner, that, if the properties of that plant had not been discovered, by far the greatest part of these patients must have died.
There are men who will hardly admit of any thing which an author advances in support of a favorite medicine, and I allow they may have some cause for their hesitation; nor do I expect they will wave their usual modes of judging upon the present occasion. I could wish therefore that such readers would pass over what I have said, and attend only to the communications from correspondents, because they cannot be supposed to possess any unjust predilection in favour of the medicine: but I cannot advise them to this step, for I am certain they would then close the book, with much higher notions of the efficacy of the plant than what they would have learnt from me. Not that I want faith in the discernment or in the veracity of my correspondents, for they are men of established reputation; but the cases they have sent me are, with some exceptions, too much selected. They are not upon this account less valuable in themselves, but they are not the proper premises from which to draw permanent conclusions.
I wish the reader to keep in view, that it is not my intention merely to introduce a new diuretic to his acquaintance, but one which, though not infallible, I believe to be much more certain than any other in present use.
After all, in spite of opinion, prejudice, or error, TIME will fix the real value upon this discovery, and determine whether I have imposed upon myself and others, or contributed to the benefit of science and mankind.
Birmingham, 1st July, 1785.
INTRODUCTION.
The Foxglove is a plant sufficiently common in this island, and as we have but one species, and that so generally known, I should have thought it superfluous either to figure or describe it; had I not more than once seen the leaves of Mullein[1] gathered for those of Foxglove. On the continent of Europe too, other species are found, and I have been informed that our species is very rare in some parts of Germany, existing only by means of cultivation, in gardens.
[Footnote 1: Verbascum of Linnaeus.]
Our plant is the _Digitalis purpurea_[2] of Linnaeus. It belongs to the 2d order of the 14th class, or the DIDYNAMIA ANGIOSPERMIA. The essential characters of the genus are, _Cup with 5 divisions. Blossom bell-shaped, bulging. Capsule egg-shaped, 2-celled._--LINN.
[Footnote 2: The trivial name purpurea is not a very happy one, for the blossoms though generally purple, are sometimes of a pure white.]
DIGITA'LIS purpu'rea. Little leaves of the empalement egg-shaped, sharp. Blossoms blunt; the upper lip entire. LINN.
REFERENCES TO FIGURES. These are disposed in the order of comparative excellence.
Rivini monopet. 104. Flora danica, 74, parts of fructification. Tournefort Institutiones. 73, A, E, L, M. Fuchsii Hist. Plant. 893, copied in Tragi stirp. histor. 889. J. Bauhini histor. Vol. ii. 812. 3, and Lonicera 74, 1. Blackwell. auct. 16. Dodonoei pempt. stirp. hist. 169, reprinted in Gerard emacul. 790, 1, and copied in Parkinson Theatr. botanic. 653, 1. Gerard, first edition, 646, 1. Histor. Oxon. Morison. V. 8, row 1. 1. Flor. danic. 74, the reduced figure.
Blossom. The bellying part on the inside sprinkled with spots like little eyes. Leaves wrinkled. LINN.
BLOSSOM. Rather tubular than bell-shaped, bulging on the under side, purple; the narrow tubular part at the base, white. Upper lip sometimes slightly cloven.
CHIVES. Threads crooked, white. Tips yellow.
POINTAL. Seed-bud greenish. Honey-cup at its base more yellow. Summit cloven.
S. VESS. Capsule not quite so long as the cup.
ROOT. Knotty and fibrous.
STEM. About 4 feet high; obscurely angular; leafy.
LEAVES. Slightly but irregularly serrated, wrinkled; dark green above, paler underneath. Lower leaves egg-shaped; upper leaves spear-shaped. Leaf-stalks fleshy; bordered.
FLOWERS. Numerous, mostly growing from one side of the stem and hanging down one over another. Floral-leaves sitting, taper-pointed. The numerous purple blossoms hanging down, mottled within; as wide and nearly half as long as the finger of a common-sized glove, are sufficient marks whereby the most ignorant may distinguish this from every other British plant; and the leaves ought not to be gathered for use but when the plant is in blossom.
PLACE. Dry, gravelly or sandy soils; particularly on sloping ground. It is a biennial, and flowers from the middle of June to the end of July.
I have not observed that any of our cattle eat it. The root, the stem, the leaves, and the flowers have a bitter herbaceous taste, but I don't perceive that nauseous bitter which has been attributed to it.
This plant ranks amongst the LURIDAE, one of the Linnaean orders in a natural system. It has for congenera, NICOTIANA, ATROPA, HYOSCYAMUS, DATURA, SOLANUM, &c. so that from the knowledge we possess of the virtues of those plants, and reasoning from botanical analogy, we might be led to guess at something of its properties.
I intended in this place to have traced the history of its effects in diseases from the time of Fuchsius, who first describes it, but I have been anticipated in this intention by my very valuable friend, Dr. Stokes of Stourbridge, who has lately sent me the following
HISTORICAL VIEW of the Properties of Digitalis.
FUCHSIUS in his hist. stirp. 1542, is the first author who notices it. From him it receives its name of DIGITALIS, in allusion to the German name of Fingerhut, which signifies a finger-stall, from the blossoms resembling the finger of a glove.
SENSIBLE QUALITIES. Leaves bitterish, very nauseous. LEWIS Mat. med. i. 342.
SENSIBLE EFFECTS. Some persons, soon after eating of a kind of omalade, into which the leaves of this, with those of several other plants, had entered as an ingredient, found themselves much indisposed, and were presently after attacked with vomitings. DODONAEUS pempt. 170.
It is a medicine which is proper only for strong constitutions, as it purges very violently, and excites excessive vomitings. RAY. hist. 767.
BOERHAAVE judges it to be of a poisonous nature, hist. plant. but DR. ALSTON ranks it among those indigenous vegetables, "which, though now disregarded, are medicines of great virtue, and scarcely inferior to any that the Indies afford." LEWIS Mat. med. i. p. 343.
Six or seven spoonfuls of the decoction produce nausea and vomiting, and purge; not without some marks of a deleterious quality. HALLER hist. n. 330 from Aerial Infl. p. 49, 50.
The following is an abridged ACCOUNT of its EFFECTS upon TURKEYS.
M. SALERNE, a physician at Orleans, having heard that several turkey pouts had been killed by being fed with Foxglove leaves, instead of mullein, he gave some of the same leaves to a large vigorous turkey. The bird was so much affected that he could not stand upon his legs, he appeared drunk, and his excrements became reddish. Good nourishment restored him to health in eight days.
