he 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