William Withering and the Introduction of Digitalis Into Medical Practice

[From Schenckius: Observationum Medicarum, Francofurti, 1609.] ANNALS OF MEDICAL HISTORY New Series , Volume VIII May , 1936 Numbe r 3

WILLIAM WITHERING

AND THE INTRODUCTION OF DIGITALIS INTO MEDICAL PRACTICE

By LOUIS H. RODDIS, COMMANDER, M.C., U.S.N.

WASHINGTON, D. C.

Part II*

N interesting fea- as Dr. Fulton points out, there is no ture regarding the question that Darwin received his first early use of digi- acquaintancewithdigitalis from Wither- talis and the ques- ing. The evidence is indisputable as tion of the priority Withering himself cites the case (No. of Withering in its iv, M iss Hill) and says that Darwin was discovery, has been his consultant. Darwin mentions the brought out by case in his commonplace book but Professor John F. Fulton of Yale Uni- neither there nor in his published ac- versity School of Medicine. He has counts does he mention Withering’s shown that Erasmus Darwin, in an ap- name. His relations with Withering are pendix to the graduation thesis of his shown by some of his letters to have son Charles, which he published in been very unfriendly, at least after 1780, two years after Charles’ death. 1788, and he was probably jealous of gave some account of the use of fox- him. By our present standards Darwin’s glove with several case histories. March conduct in not mentioning Withering 16. 1785, Erasmus Darwin read a paper in either of his papers was distinctly which was dated January 14, 1785, and uncthical. which was published in the medical As he became more prosperous With- transactions, containing a reference to ering purchased a valuable piece of foxglove. These were probably the first property in Birmingham extending things in print in medical literature on back from High Street nearly to Can- the use of digitalis, as both were pub- non Street. Here he built a dwelling lished prior to Withering’s book. But, known as The Stone House though it is *Part I appeared in the March, 1936 issuc of Annal s of Medical History , n.s., vol. 8, P. 93. extremely doubtful if he lived there. In of the Mecfical Society of London, an- 1786 he leased the county seat of Lord other signal honor particularly to a Calthorpe, Edgbaston Hall. This house provincial physician. At Edgbaston Withering had for the first time a place of his own large enough to indulge his taste for country life. He began to build up a herd of Alderney cattle, or French cattle, as they were called then. Importation of these cattle to England, from the Chan- nel Islands of Jersey, Guernsey, and Alderney was just beginning to be made, and their excellence as dairy ani- mals was just beginning to be realized. Withering was thus one of the pioneers in the introduction and breeding of these cattle on the mainland. was a fine old mansion situated in a He was also a breeder of Newfound- beautiful and extensive park. This is land dogs and became much interested now in the suburb of Birmingham in the subject of hydrophobia. He be- known as Edgbaston, but when occu- lieved there were two forms of the dis- pied by Withering it was in the coun- ease, a canine and a human type; the try. The old Worcester road passed hrst was limited to dogs, the latter along one boundary of the park. could be transmitted to man. He did The first few years spent at Edgbas- not believe in the efficacy of any in- ton were among the busiest of With- ternal treatment (there were a vast ering’s busy life. Here he edited the number of therapeutic agents recom- enlarged and revised editions of his mended for internal administration at botany, in 1787 and 1792. His reputa- this time) but strongly advocated the tion as a botanist was now world-wide most thorough treatment of the wound, and he carried on an extensive corre- excision if practicahle, if not, copious spondence with botanists everywhere. washings with colcl and then with warm The Frencli botanist, L’Heritier de water. A syringe was to be used to wash Brutelle, at this time honored him by out punctures made by the teeth, the naming a genus of plants after him, the syringe being used as an exhaust pump “Witheringia.” De Brutelle made the to exert suction, and to follow this with designation in these terms, “In memo- a caustic. Soap maker’s lye was the caus- riam celeberr, Guilielmi Withering, tic he recommended to be applied to Doct. Med. Soc. Reg. Lond. Soc. With- the “least appearance of a razure or eringia solanacea . . .” wound.” Before the days of Pasteur this He was now at the zenith of his fame would be the very best treatment possi- both as a scientist and as a medical man. ble and, as we know, the cauterization In 1785, the same year as the publica- of the wound is stiil an important fea- tion of “An Account of the Foxglove,” ture of treatment. he was elected a Fellow of the Royal Withering had received as a present Society, the highest of scientific recog- some monkeys sent from Gibraltar. He nitions. He was also given the diploma noted in them the occurrence of tuberculosis with all the symptoms of cough, ning. This was in September, 1789. fever and loss of weight, and autopsies This publication, with carefully kept revealed the appearance of pulmonary meteorological journals and studies of phthisis. weather in relation to the phases of the There was a constant stream of visi- moon, constituted Withering’s princi- tors at Edgbaston, many of them bear- pal contributions to meteorology and ing names notable in the history of the climatology. period. Necker, the fmancier, the father He was elected a Fellow of the Lin- of Madame de Stael. the Abbé Raynal, naean Society in this same year, though Dr. Reinhold Forster of Halle, an his- he was prevented from taking any part torian of Arctic exploration, and Dr. in the proceedings of the Society by a Peter Camper, the anatomist and Pro- severe attack of pleurisy. In the follow- fessor of Medicine at Groningen. It was ing year occurred the celebrated “Bir- a mecca for foreign botanists and min- mingham Riots” whicli caused Wither- eralogists visiting England. One of the ing niuch trouble and anxiety, some most interesting of the botanists was loss of property, and which also no Count Castiglioni who was proceeding doubt further impaired his failing to North America to bring back trees health. and shrubs for the purpose of introduc- The French Revolution created ing them into Tuscany. Another visitor more of a stir then than the Russian who greatly interested Withering was Revolution has today, and a Jacobin the celebrated Polish dwarf Count Bo- was more hated than a Communist is rawlaski. At the time of this visit the now by the mass of the people and the Count was forty-seven years of age. He strongly reactionary element. There was a perfect miniature of a man. His was no widespread disorder but there height was thirty-nine inches and, un- were many serious riots and acts of vio- like many dwarfs, he was extremely well lence against persons who too frankly proportioned and his countenance or tactlessly expressed their advocacy of handsome and prepossessing. He was of the doctrines of the French revolution- a noble Polish family, well educated ists. In Birmingham the rancor of the and with fine intellectual abilities, or as anti-Jacobins was directed largely Withering himself well expressed it, against Joseph Priestley, the great “his talents and acquirements happily chemist, who had made himself obnox- bear no proportion to the scale of his ious by too open expression of revolu- body.” tionary ideas. His house was burned by In 1790 Withering communicated to the mob and his valuable library, in- the Royal Society a paper entitled “An struments, and many manuscripts and Account of Some Extraordinary Effects notes destroyed. Priestley and his family of Lightning.” In this paper he de- succeeded in escaping. Withering had scribed the destruction of a house at been sympathetic toward the French Sutton-Coldfield on the 24th of June, Revolution as an attempt to give civil 1787, during a severe thunderstorm. liberty to a people groaning under op- The latter part of the paper dealt with pression until, as he expressed it, the the death of a laborer who had sought spirit of freedom “assumed the face of shelter from a storm under an oak tree a demon and vanished in a shower of in the Earl of Aylesford’s park at Pack- blood.” He was known, however, as a ington, and had been killed by light- revolutionary sympathizer and he was informed that his house would be de- health which by this time had become stroyed. He removed part of his library very bad. and scientific collections. After some se- Withering struggled against illness

vere fighting a detachment of the mili- during the last twenty-five years of his tia arrived and the house was saved. life. He seems to have been a man of The anxiety and excitement, however, reasonably good natural endowments as had the worst possible effect upon his to health and constitution. He came of good stock physically, his mother hav- made an analysis of the waters of the ing lived to the age of eighty-one. Until celebrated hot springs at Caldas. He he was thirty-Hve years old Withering submitted a Memorial of the Caldas appears to have been remarkably well but in 1776 he had an attack of an ir- regular fever that probably marked the beginning of the tuberculous infection which eventually caused his death. He soon recovered from this attack but not a single winter season passed after that without some more or less serious pulmonary trouble. I11 1783 and again in the following year it was necessary for him to give up work entirely and to go to the country to recruit his health. In 1790 he had a very serious attack of pleurisy. He began to suffer from shortness of breath. hemoptysis became more fre- quent, and the decline of strength so characteristic of chronic pulmonary tuberculosis was more apparent. The damp cold of the English winters tended to cause exacerbations of his symptoms and he began to seek a milder climate in which to spend the winter months. This led to his making two journeys to Portugal, one in the winter of 1792 and one in 1793. Portu- gal was then a sort of Riviera for the English for whom it was a favorite winter resort. Withering took passage from Fal- mouth in September, 1792 and after an uneventful voyage reached Lisbon safely. After a short stay in Lisbon he waters to the Royal Academy of Portu- took a house five or six miles down the gal, to which he was admitted as an river 011 the road to Cintra, the “Para- honorary corresponding member. With- dise of Portugal.” Withering was ering returned to England in May but greatly interested in Portugal, the pro- went again to Portugal in the winter of fusion of tropical and semitropical 1793. His second sojourn was not so plants of the Algarve being sufficient to successful. He had a severe hemoptysis, delight any botanist. The weather was the weathcr was bad, and he returned delightful and the patient appeared to to England not much benefited. Ile be much benefited. His appetite, spirits landed at Falmouth and before return- and strength improved. He made a ing to Edgbaston he made a leisurely number of botanical excursions and tour of the coast from Lands End to thc Isle of Wight, visiting Stonehenge in effected. I could almost curse the unfeel- which, as a mineralogist, he was much ing hand which caused the ruin of tliis interested. His conclusions regarding stupendous work of the most remote an- the origin of these stones are remarka- tiquity. To dig for discovery was allowable, ble as being not far from what modern but 110t to replace the soil was shameful. research considers the correct source, If the story of the tin plate be true, it is clear that the inscription could not be in and showed at once his mineralogical Greek characters, consequently not Brit- knowledge and the natural shrewdness ish, for Caesar tells us the Britons used of his intellect. He decided that Stone- the Greek characters when they wrote. henge was not of Druidic or Celtic but I am disposed to think Stonehenge of a probably of Phoenician origin. He much older date, and the work of a much noted tliat the stones of the outer circle more enlightened people than our British (grey wethers) were of local origin ancestors. The Saxons called it Stone- while the basaltic blocks of the inner henge, the Britons Choir-Gaur and Me- circle must have been brought from a nambres, all which are descriptive, not ap- distance and believed the nearest source propriate names, the two latter signifying to be Antrim in Ireland, though mod- a superb or magnificent stonework. I be- ern geologists believe that they were lieve, therefore, that both these people were equally ignorant of its origin and perhaps brought from Pembrokeshire design. As it has fallen so very lately, let in Wales. The modern theory as to the me beg you, when you visit it, to be par- builders of Stonehenge is favorable to ticularly attentive to the shape of the ten- Oriental rather than Celtic peoples. ons in the uprights, and the mortises in A letter of Withering’s on Stone- the cross piece, and to measure them witli henge is so fine an example of his corre- great exactness. They are probably now spondence on scientific subjects, and quite perfect, and thougli somewhat like shows to such advantage his inquiring the section of a spliere, perhaps tliat is not and active mind and interest in experi- tlieir real figure. Men who first made ten- ment and observation, that it is repro- ons and mortises, would naturally make duced here. It is addressed to James the former a cylinder or a parallelopipe- Norris, Esq., of Non-such House, Wilt- don; tliey would hardly think of a seg- ment of a sphere, but perhaps the real shire. shape of these will demonstrate a much February 4th, 1797. higlier degree of mathematical knowledge. Dear Sir, I regret not having visited the monuments I begin upon a large sheet, foreseeing at Abury; but, perhaps, you can tell me that the varied and interesting subjects of whether the cross stones there are mortised your last letter, will require more ani- in the sarne manner, or only simply laid madversions than a common size would on the uprights. If the former, I shall be contain. disposed to rob our rude Celtic ancestors You will probably have visited Stone- of the credit of that labour, as I do of the henge since the late downfall, to examine erection of the cromlech, for this word (I what lichens have grown upon the upper believe) simply signihes a lieap of stones, parts of those stones which have been out and is therefore by 110 means a name of the ordinary reach of man for so many likely to be imposed by the authors of thousand years, and if you fmd any rare such monuments. I allow the Druids the species, I hope you will have the goodness loggin-stone; at least the use they made to remember me. of it, its name being strictly the oracular You will, doubtless, be attentive to any stone. disclosure which this overthrow may have I quite agree in the opinion that the materials of Stonehenge have been se- author refutes with ease the common lected and brought from the Grey Weth- opinions of their formation, but scarcely ers. Is it true that one of these stones with offers any of his own. The provincial its tenon, (or mortise, I know not which) ready formed, has been left on the road, and still lies in the water at Fighelden? I know your description of these stony masses to be just; they are what I would call a granulated quartz. Having no proper tool, I could not bring away a piece, as I wished to have done, in order to decide whether tlie particles are only firmly impacted together, or conglutinated by a cement of the same nature. You will readily determine this point by slowly heating a piece to a full red heat, and slowly cooling it. If the granules are not cemented, this piece will then readily be broken down. Are you not under a decep- tion about its imbibing water? If you weigh a fresh broken piece, suppose of two or three ounces, and then weigh it again after it has imbibed all the water that it can, you will ascertain tlie matter. Should it prove that it does imbibe a quantity of water, it will be difficult to say why it is not torn to pieces when the action of frost comes upon it in its wet state. We may yet have sufficient frost to allow of this experiment also. Granulated quartz has hitherto been mentioned by mineralogists as found only in detached masses; but a mountain* of it exists within five miles of this place. I ought to apologize for writing so dif- name, he says, is “lynchets.” Where tliey fusely on these subjects, and acknowledge range along the sloping sides of a small a degree of enthusiasm when thinking valley, particularly if that valley be closed about Stonehenge, and other real antiques at one end, they have much the appear- of our country; for all my inquiries are ance of an immense amphitheatre, ancl I directed to an earlier period than the in- believe that some of our antiquarians vasion of Julius Caesar; but I suspect you have described and figured them as such. are not devoid of the same spirit, and if I remain, dear sir, so you will readily forgive me. Your obliged friend, When at Edgbaston I asked you about W. WlTHERING. certain lands in Dorset and Wilts laid out in a kind of terrace, one above another, P.S.—The large blackish flat stone lying like the seats in a theatre. In the “Gentle- before the great trilithon at Stonehenge, man’s Magazine” for October, they are and called the altar-piece, is said to be very justly and extremely well described niarble, which it certainly is not. I cotikl in a well written paper of inquiry. The not break off a piece for examination, but * The Lickey-hills, in Worcestershire. I thought it niost like a black basalt. Do you know what it is, and can you guess ham. His most unique contributions, from whence it came? however, were: (a) An attempt to create in his li- On his journey Withering examined brary at Edgbaston an artificial climate 377 by the use of double sashes and flues for the introduction of air at 65° F., with a device to maintain this tempera- ture. This is of interest as a pioneer attempt at what we now know as air con- ditioning. (b) The use of carbonic acid gas in- halations which he believed prolonged the life of many of his patients. He was thus a forerunner in the work of Yan- dell Henderson and others in the use of carbon dioxide as an addition to oxygen in asphyxia. (c) He strongly expressed the opinion that the disease was infectious. Withering from his own experience deprecated the sending of tuberculosis patients to hot climates and believed that in all favored localities of England were to be found places where the early case would benefit. He concluded that the most satisfactory place in England was the south shore of the Isle of Wight. Although so busy in so niany ways Withering nevertheless found time to carry 011 a tremendous correspondence. Tliere are a great many of tliese letters still in existence. One of the most im- the tin mines of Cornwall and a cele- portant collections of them is in the brated coal mine at Bovey, which library of the Royal Society of Medicine showed in a remarkable manner, in de- in London and this collection has been scending strata, the change of successive catalogued and described by Sir Wil- forests into coal. liam Hale-White at the request of the Withering’s attention was now drawn Library Committee of the Society, and very forcibly to the subject of tubercu- his account published in the Proceed- losis and it is not surprising that so ings in May, 1929. These letters were great a clinician should have left us bequeathed to the Royal Society of some important notes on the disease. Medicine by Sir William Osler. In He recorded the immunity of workers Cushing’s “Life of Osler”* an interest- about lime kilns, butchers, and makers ing letter from Osler to Dr. Pratt of of catgut, and pointed out the high in- Boston is quoted in which Osler tells cidence of pulmonary tuberculosis how he acquired the letter. among the brass workers of Birming- * Vol. 2, p. 616. Did you know that I made a great haul cure the Queen’s insanity. He lives of Withering letters etc.? A man came in upon vegetables, milk, honey, and one day with a hag and said are you in- water, and reads the Bible from morn- terested in W? I said rather, and he pulled out a hig bundle of letters and papers and his Edin. diploma. He was a great man and his plan, to which you refer, is the only one in giving Digitalis. I read his book iirst in the Lib. at Montreal. This collection contains about thirty letters written by Withering and over a hundred written to him. In the Reference Library at Birming- ham are two folio volumes of letters from and to the members of the family of Withering, three letters of John Ash and two of Joseph Priestley to Wither- ing. There are undoubtedly a number of letters in private hands. Dr. K. Douglas Wilkinson of Edgbaston has a large number of letters, mostly written to Withering. Dr. Wilkinson, who hopes to publish these letters, has kindly given me some account of them. Many were requests for botanical information or for assistance in obtaining posts as ing to night.” The cabins were crowded naturalists, particularly in Australia, and yet a wretched berth cost ten which the voyages of Captain Cook had pounds. He describes the pleasant social opened as a new field for botanical ex- life of the English colony in Lisbon. As ploration. One writer describes experi- he has come there for his healtli he de- ments in the crossing of tall and short clines most invitations and declines to peas, a suggestion of Mendel. Swedish see patients. He writes of his house sur- steel enjoyed then as now a high reputa- rounded by orange, lemon and olive tion and Withering was in correspond- trees and with a beautiful view of the ence with a Swedish iron founder in Tagus. respect to the best steel for lancets. In a letter written to his son, then a A number of Withering’s letters con- medical student at Edinburgh, he says tain accounts of his voyages to Portugal that “a real physician in this country and his life there. One of these, dated ranks high in the estimation of every October 20, 1792, describes a ten-day class of society,” an observation which passage from Falmouth to Lisbon. has probably been true in all ages. In 1 here were thirty-two passengers, one another letter to his son the following of whom was the celebrated London year, 1796, he says that people were eat- quack Graham, who “warned by a ing too little in order not to grow fat, vision makes a voyage to Portugal to from which we may infer that the fad for slimness is not new. He wishes his land because of the greater political son to live in a house where French is tranquillity, and on account of the cli- spoken so he can learn the language the mate, one of the few compliments

better. which the much malignecl British cli- There is a letter from Withering’s mate ever received. Other letters are mother written in 1789, the year of her from R. Relhan of King’s College, death, giving him advice in regard to Cambridge, Robert Brown, and J. H. his health and concluding with: “In de Magellan. The latter was a great ad- fear you should set light by my advice mirer of Withering and says he will I must put you in mind of the fable of urge his friends on the Continent to the old hen and the young cock.” There read Withering’s book on the foxglove. is a letter from Withering to his wife, There is a hne letter to cle Magellan asking her to hasten with the children from Withering, on the treatment of to the deathbed of his mother. asthma. A correspondent of de Magel- Among the botanists was Joseph Cor- lan, who had asthma, askecl him to in- rea de Serra, who had been Portuguese quire of Withering regarding digitalis Minister to the Unitecl States, who tells as a remedy for it. Withering in his Withering he intends to reside in Eng- reply says that asthma is incurable, does not shorten life and that much can be by a shrewd physician. A sea voyage or done to alleviate it. He recommcnds a change of residence frequently allevi- sea voyages. change of place, sleeping in ates asthma because of removal from

a large curtainless bed and using a mat- the particular allergic agent or agents tress and not a feather bed. Regularity in the patient’s environment. It was of habits and temperance in all respects noticed, no doubt, that the elimination are enjoined. The legs and feet should of curtains and feather pillows was fol- be kept warm and high pillows used at lowed by relief. night. Drugs recommended are tar There were those who thought the water or tar pills, strong coffee, asafet- world was going to the dogs in Wither- ida and amber mixture. The whole is ing’s day just as there are now. One pes- of interest as a picture of the treatment simist, David Giddy, tells Withering of asthma at the time, and shows the that in the present state of the country empirical results obtained were noted it is insane to marry and urges him to buy a saber, rifle, a brace of pistols, Tarmouth, a Mrs. Gresley. The orig- muskets with bayonets, and a blunder- inator of this accusation was the Rev- buss. A pretty fair arsenal! He thinks erend J. Watkins who was Mrs. Gres- that mobs will overrun the cities as they ley’s brother, and who was finally did Paris and is certain that a revolu- forced to apologize. tion is coming. A letter of interest is one from the There are a number of interesting United States. It was written by Dr. letters from Dr. F. Swediar, in one of Hall Jackson of Portsmouth, New which he asks Withering for the rem- Hampshire, in 1796, who informed edy he gave to Benjamin Franklin for Withering that dropsy was very com- the stone. He wishes to use it on a pa- mon there due to the drinking of rum! tient of his, for he had heard that He has sent for copies of Withering’s Franklin had been greatly benefited. book and also for some digitalis from I am indebted to Captain F. L. Plead- London, and proposes to introduce the well, Medical Corps, United States treatment into North America. Navy, Retired, for two fine letters from Among the names signed to the cer- the poet Campbell. In response to a re- tificate, or diploma, of admission to the quest Campbell sends some verses of no students’ medical society at Edinburgh, great merit and mentions that he has the “Societas Medicinae Studiosorum,” been injured by a Mr. Watt, witli is that of James Boswell. In his account whom he has had a controversy. of the Withering letters, Sir William Whether this is the inventor of the Hale-White, who has written an article steam engine is somewhat doubtful. In 011 the “Medical Boswells,” assumed one letter he calls him Watts and from this to be the great biographer, though other circumstances it appears that it was not known that he had ever stud- James Watt was not the person of ied medicine. In a letter to me, Sir Wil- whom he complains. liam says that his subsequent investiga- Withering himself was engaged in a tion shows that the James Boswell, good many controversies. Mention has whose name appears on the diploma, been made of difficulties with Erasmus was not the biographer but his cousin, Darwin. The latter, in a letter ad- also a James Boswell, and the son of Dr. dressed to Dr. Johnson of Birmingham, John Boswell. asks Johnson what he thinks of publish- Withering’s health by 1796 had being this letter addressed to Withering: come so bad that he was incapable of “Were not you consulted along with any sustained effort whatever and he Dr. Johnson in the case of Mr. Francis gradually sank into almost complete in- of The Moat, Birmingham? Did you by validism. He suffered from shortness of your solemn quackery of large serious breatli and attacks of hemoptysis. It promises of a cure get the management often became troublesome for him to of this patient into your hands and did even sit up at a table and write. At you not, Sir, on the night before he otlier times he was fairly comfortable died, congratulate his son of his perfect and able to walk about on level ground, recovery?” This letter was written in though climbing stairs or going up a 1788 and it is evident that there was not slight incline was difficult. He felt that much good feeling toward Withering Edgbaston, situated in a hilly and roll- on the part of Darwin. Withering was ing park and much exposed to the also accused of neglecting a patient at sweep of the winds, was unsuited for him. Though much attached to the pun that will always be classic: “The place he nevertheless gave it up and flower of English physicians is indeed purchased a place called Fairhill near Withering.” Sparkbrook, formerly the home of Withering’s death occurred on the Priestley. The house had been de- evening of October 6, 1799, eight days stroyed in the riots, but Withering re- after his removal to his new home. He built it and renamed it “The Larches,” was buried in a vault in Edgbaston and removed there on the 28th of Sep- Church. The mural in the church has tember, 1799. After all arrangements an entablature of black marble. On the had been made for the tnove Mrs. base is sculptured the emblem of Aes- Withering was taken suddenly ill and culapius, the serpent-wreathed staff. On could not accompany him. Anxiety in the right side of the tablet are repro- regard to her, as well as the fatigue in- ductions of the foxglove, on the left the cident to the journey, aggravated With- Witheringea, cut from living speci- ering’s condition and he never rose mens. In the words of Garrison “the from his bed again. foxglove appropriately adorns his mon- Withering was a man of an affection- ument.” In addition to the usual in- ate and domestic nature and was description of name, dates of birth and votedly attached to his wife and chil- death, and age, there is a commemora- dren, who reciprocated his attachment tive verse similar in character to that and whose devotion did much for his found on many such tablets. The whole comfort in the last years of illness. Bot- monument is surmounted by a Grecian any, the science which he had spoken vase entwined with flowers. of so lightly, was also a solace to him, Though only fifty-eight years of age and he spent much time in revising his at the time of his death Withering had work on British botany and in studying lived a life full of activity and achieve- his herbarium or fresh specimens ment and, aside from illness, a life of brought to him by his family and happiness. The period in which he friends. He still continued to see a few lived was one of the most interesting in patients, some of whom almost de- the history of the world. He saw the manded consultation with him. Just be- development of the steam engine, the fore his removal to The Larches he saw development of gas lighting, the inven- a patient for whom he wrote his last tion of the spinning jenny and the cot- regular prescription. A few days later, ton gin. In his time England became at The Larches, and when Withering the master of Canada, India and Aus- was really a dying man, he saw another tralia. He saw the American and French patient, a venerable peer who had come revolutions. He was a contemporary of far to seek a consultation. Scarcely able such men as Pitt, Burke, Samuel John- to hold a pen Withering “wrote a few son, Oliver Goldsmith, Robert Burns, general notes for a plan of treatment, Voltaire, Frederick the Great, Wash- by this act closing his career of medical ington, Haydn, Beethoven, Mozart, practice.” Franklin, Scheele, Lavoisier, and Lin- We have a reminiscence of Wither- naeus. He was a friend of such great ing’s deathbed which should be quoted men as Boulton, Watt, Wedgwood, for this generation. One who had vis- Murdock, Baskerville and Priestley. ited him a few days before his death We have a record, either in letters, made in all kindness and sympathy a papers, or recorded conversations, of Withering’s views on a number of sub- Rush in America had published his cel- jects, such as slavery, duelling, pro- ebrated pamphlet “An Inquiry into the hibition, euthanasia, the learning of Effects of Spirituous Liquors on the languages, the best authors to read in Human Body, and their Influence upon medicine and in natural history, and re- the Happiness of Society,” which ligion. His opinions on many of these stamped Rush as one of the pioneer ad- controversial subjects are of interest vocates of prohibition in the United both as representing the viewpoint of a States. notable figure of the eighteenth century Euthanasia. Suffering himself from and because they throw light upon his an incurable disease, Withering’s views character. on this subject are of peculiar interest. Slavery. He was a member of the so- He said in a letter to a friend consid- ciety for promoting the abolition of the ered to be almost on his deathbed: slave trade, which he felt was an un- To encourage a desire to die is an un- worthy commerce for a free and Chris- worthy tendency to desert the post allotted tian nation to countenance. to us; and if such desires once become Duelling. Among Withering’s papers motives to make us neglect the means of was found the following answer to a restoring or preserving health, such mo- challenge: tives and such conduct directly or indi- rectly tending to cut short our existence, Sir, are, perhaps, altogether as indefensible I received your note; the purport of and as wicked as the still shorter modes of which if I am not mistaken, is a request the pistol or the halter. that I would fix upon a time and place that you may have an opportunity to kill The Learning of Languages. Wither- me. But it further implies that I may ing did not take kindly to the necessity also have an opportunity of killing you; of learning other languages than his and this you call satisfaction. It may be own, or as he expressed it in the most so to you. Permit me, however, to assure sensible manner: “I deem it a heavy you that it would be no satisfaction to task, during the short space of our ex- me to kill you, or any other man; there- istence, to be compelled to learn so fore, until our ideas can be more prop- many signs to indicate the same thing.” erly adjusted, you must allow me to This was a very heretical opinion in the decline to meet you. days of classical learning. It may be re- Alcohol. “Those who have been only called that one of the first recorded ut- a few years in medical practice become terances of the poet, J. Thomson, was, aware that by far the greater number “Confound the Tower of Babel!” of diseases which imbitter and cut short Favorite Authors in Medicine and our existence, are the effect of intem- Natural History. Withering urged the perance in strong liquors; nor does study of Celsus as the best of the an- there seem much choice of them.” In cients. In natural history he urged the the first part of this letter he urged ab- study of Ray. stention from the use of strong liquors Religion. Withering was a man with and says that “you never have had any definite and deep convictions respect- counsel for which you will have reason ing religion and was an active member to thank me so much, as that on the of the Episcopal Church throughout his present subject.” It is of interest that a life. few years before, in 1787, Benjamin Charity. His charitable liberality to the poor was notable even in a profes- practice was evidence of his great popu- sion in which such charity is a tradi- larity and success as a clinician. tion. For many years he gave an hour a His achievements in other fields of day to charity patients and saw as many science would have made the separate as a thousand poor patients annually. reputations of a botanist, a mineralogist Withering’s principal claim to fame, and a chemist. He had European celeb- of course, will always be his introduc- rity as a botanist, justified principally tion of the use of digitalis into medical by his extensive and excellent work on practice. If one were asked to write the British flora. As a mineralogist his down a list of the ten drugs most indis- discovery of natural barium carbonate pensable in medical practice, digitalis is commemorated by its title of wither- would have to be included. Further- ite. As a chemist he was, in the opinion more, he laid down the correct princi- of Mr. G. Fowles, the first to note reac- ples for its use which are in the main tion between the barium compounds still in effect today. It is true that With- and sulphuric acid, the reaction on ering believed the beneficial effects of which the well-known qualitative an- digitalis to be largely due to its action alysis tests for the sulphates are based. as a diuretic. Yet he noted that “it has a As a climatologist and meteorologist power over the motion of the heart to Withering made no discoveries but his a degree yet unobserved in any other lifelong interest in these subjects, re- medicine, and this power may be con- ports and meteorological journals converted to salutary ends.” tributed to the advancement of these Withering and Jenner lived and sciences. He was one of the numerous worked not far apart, the distance be- medical climatologists and, as has been tween Birmingham and Berkeley being pointed out previously, a pioneer in no more than sixty miles. Withering what we would now call air condition- was born in 1741 and Jenner in 1749. ing of dwellings. In 1795 Withering There is a close parallel between their gave an excellent description of one of lives and work. Both were essentially the few earthquakes occurring in Eng- country bred and country doctors inter- land of sufficient violence to be gener- ested in natural history as well as medi- ally felt. cine, Withering a botanist and Jenner In appearance Withering was a man an ornithologist. Both took a country- rather above the average size, well pro- side tradition, in Withering’s case a portioned and with a well-knit frame. local herb remedy, in Jenner’s case a His features, as may be seen from the disease of the dairy cattle of Gloucester- beautiful portrait by the Swedish shire. The herb remedy and the local painter von Breda, were quite regular. tradition regarding cowpox were each The forehead is good, the whole head converted into agents of inestimable finely shaped. The nose is a little long value in the treatment and the preven- but straight and well formed, the tion of disease through the genius of mouth and chin very finely molded. these two country doctors. The hair is drawn back and tied with a Withering’s reputation as a medical ribbon and apparently lightly pow- man is enhanced by his excellent de- dered. This portrait was painted in scription of scarlet fever and streptococ- 1792 and we have the testimony of a cic sore throat, and his shrewd observa- classmate and lifelong friend of With- tions on tuberculosis. His tremendous ering’s that it was an excellent likeness. There is a bust of Withering in Edg- count of Withering and his work was pub- baston Old Church and a portrait in lished by Dr. W. H. Wynn, and printed in Malin’s Collection of Warwickshire the Birmingham Medical Review, New Se- ries, Vol. 1, No. 1, 1926. Portraits taken from an edition of Ra- The collection of letters in the Library of pin’s History of England. Withering the Royal Society of Medicine, London, and was very neat in his dress and personal in the Reference Library at Birmingham, appearance. His manner was affable and England, throw much light on Withering yet with a slight touch of reserve. At and his life. It has been stated that Wither- ing’s extensive herbarium, said to contain a the death of his mother he wrote, “both specimen of every flowering plant indigenous she and my father were unerring exam- to England and many of the native crypto- ples of the strictest integrity.” Their gams, was given to the Midland Institute famous son followed in their footsteps but there appears to be no record of it now in this respect. Sir William Osler was a nor could any of the collection be located. The Literary Supplement of the London great admirer of Withering, in itself a Times kindly inserted in the January 5, 1933, great tribute, and had chosen as the issue the following notice: subject of his address to the British Bo- Sir, tanical Society in January, 1920, “Notes I am preparing a biography of William on the Life and Correspondence of Withering, the eighteenth-century English William Withering.” Sir William’s ill- physician and botanist, the discoverer of ness and death prevented his prepara- the use of digitalis in heart disease. tion of this address. I am anxious to obtain any old letters, Withering possessed the virtues typi- journals, portraits, or any other material on him. Would you be so kind as to let me cal of the Anglo-Saxon, strength of in- request anyone with information about tellect combined with shrewdness, com- Withering to communicate with me? mon sense, simplicity and integrity. Louis H. Roddis, They are the qualities distinctive of the Lieutenant-Commander (M.C.), U. S. Anglo-Saxon, and are seen to perfection Navy. U.S.S. West Virginia, Battleships, in such men as Lincoln, Washington, Battle Force, San Pedro, California. Samuel Johnson, Sir Isaac Newton, As a result of this notice a number of people James Watt, John Wesley and Ben- sent me notes regarding Withering and his jamin Franklin. These qualities may be letters; Dr. K. Douglas Wilkinson of Edgbas- ton, Sir William Hale-White, of London, A. said to be characteristic of English med- Marshall of Kingston - on - Thames, Mr. icine and displayed in an eminent de- George Fowles of London, England, and gree by such men as Linacre, Harvey, Captain F. L. Pleadwell, Medical Corps, U. Sydenham, John Hunter, Jenner, S. Navy, Retired. Mr. Fowles drew my atten- Bright and Lister. The name of Wil- tion to the fact that Withering was the virtual discoverer of the well-known test for liam Withering will always be written sulphates, a point that as far as I can find high on any list of examples of Anglo- has not been noticed or mentioned before. Saxon genius. Many others furnished information of value or assisted in obtaining illustrations. Mr. Bibliog raph ical Notes H. M. Cashmore of the Municipal Reference The most important source of information Library at Birmingham, England, supplied on Withering is the memoir by his son, a information regarding the works of Wither- book long out of print and difficult to pro- ing and the letters and books making men- cure. Cushny, the eminent pharmacologist, tion of him contained in the Reference published an excellent short sketch of Wither- Library. Mr. Cashmore also obtained for the ing in the Proceedings of the Royal Society writer seeds of the foxglove from the church- of Medicine, 1914-15. Another excellent ac- yard at Edgbaston for planting in a medical plant garden in the United States. Mr. Up- Botanical Arrangement of British Plants. shur Smith of Foxglove Farm, Wayzata, Min- Ed. 2, 3 vols., 8vo, Birmingham, 1787-92. nesota, supplied a number of interesting Third edition. Author’s annotated copy. pictures including the picture of Withering’s 4 vols., 8vo, Birmingham, 1796. tomb in Edgbaston Old Church. Dr. J. F. Chemical Analysis of the Water at Caldas Fulton of Yale University School of Medi- da Rainha. (In Portuguese and English.) cine drew my attention to the early pub- 8vo, 1795. lished account of the use of digitalis by The Fox-glove, and Some of Its Medical Erasmus Darwin. Uses. 8vo, 1785. Among books relating to Withering is Boulton’s “The Lunar Society,” published Papers by Withering in Philosophical Trans^ in 1888. One of the best accounts of this actions of Royal Society famous Society and its members is found in old Samuel Smiles’ excellent “Lives of the Experiments upon the different kinds of Engineers” in the volume on Boulton and Marle found in Staffordshire. 63:161-162, Watt. 1773- An analysis of two mineral substances viz., List of Works by Will iam Wither ing the Rowley-rag-stone and the toad-stone. 72: Account of the Scarlet Fever and Sore 327-336, 1782. Throat, or scarlatina anginosa; particularly Experiments and observations on the as it appeared at Birmingham in 1778. 8vo, Terra ponderosa &c. 74:293-311, 1784. 1779- Additional experiments and observations Second edition, with some remarks on the relating to the principle of acidity etc. by nature and cure of the ulcerated sore throat. Joseph Priestley. With letters to him on the 8vo, 1793. subject by Dr. Withering and James Keir. Miscellaneous tracts, to which is prefixed U88- a memoir of his life, character and writings An account of some extraordinary effects (by the editor W. Withering, Jr.; with of lightning. 80:293-295, 1790. meteorological and thermometrical observa- Withering’s views on tuberculosis were tions at Edgbaston, etc.) 2 vols., 8vo, 1822. expressed to Dr. Thomas Beddoes in a “Let- Botanical Arrangement of Vegetables. 2 ter on Phthisis Pulmonalis” and as such were vols., 8vo, 1776. published by Beddoes.