An account of the foxglove, and some of its medical uses. Bound with: An account of the scarlet fever and sore throat. William Withering.

An account of the foxglove, and some of its medical uses. Bound with: An account of the scarlet fever and sore throat.

Publisher Information: Birmingham: M. Swinney for G. G. J. & J. Robinson, 1785-1793.

Withering, William (1741-99). (1) An account of the foxglove, and some of its medical uses. . . . [2], xx, [2], 207, [1]pp. Large folding engraved fronts. by James Sowerby, version with the artist's name and with lower leaves pointing to the left. Birmingham: printed by M. Swinney for G. G. J. & J. Robinson, London, 1785. Frontispiece skillfully repaired. (2) Withering. An account of the scarlet fever and sore throat, or scarlatina anginosa, . . . 8vo. [2], 127, [1]pp. Birmingham: M. Swinney for G. G. Robinson, 1793. Possibly lacking half-title. Together 2 works, 210 x 128 mm., bound together in quarter calf c. 1793, marbled boards, rebacked. Engraved bookplate. Preserved in a cloth slipcase. The Honeyman copy.

(1) First Edition. Garrison-Morton 1836 & 2734.31. Discovery of the efficacy of digitalis in heart diseases, and one of the first modern clinical studies of a drug. Withering's work contains the results of ten years of observations and clinical trials: of the 158 patients he treated with the foxglove, 101, who suffered from congestive heart failure, experienced relief after treatment with the drug, which is today known as digitalis after the foxglove's Latin name, Digitalis purpurea. Modern analysis of Withering's case reports suggests that many of the 57 other cases, such as those with pulmonary tuberculosis, did not involve diseases amenable to treatment with digitalis. Withering himself was aware that these factors might be affecting his results and warned against generalizing on the basis of his cases.

Over the ten years of his researches on digitalis, Withering derived what he believed to be the optimum quantity of a single dosage-an amount only slightly less active than the tablet used in contemporary practice. The incidence of side effects of the drug declined as Withering gained clinical experience; Estes and White observed that "it appears that the overall incidence of side effects attributable to digitalis in Withering's patients approximates the incidence recorded by physicians today. One could learn to use digitalis effectively and safely if one had no other text than Withering's Account of the Foxglove".

Withering honestly recorded both successes and failures in his trials . . . He stressed that care must be taken in adjusting the dose, and he accurately described the signs and symptoms of digitalis toxicity and established clear guidelines for its rational use. Despite Withering's modest but definite claims for the efficacy of the foxglove, the drug became for nineteenth century clinicians a kind of panacea . . . Only in the past few decades has the real merit of Withering's work on the foxglove been recognized (DSB).

Le Fanu, Notable Medical Books in the Lilly Library 139 points out that the frontispiece is colored in some copies but not all. There are two versions of the plate: one, with artist's name and with lower leaves pointing to the left, was copied from the original which Sowerby had engraved for Curtis's Flora Londinensis; the other is the original version borrowed from Curtis, without artist's name and with lower leaves pointing to the right; our copy represents the latter. Estes & White, "William Withering and the purple foxglove," Scientific American 212 (1965), pp. 110-119. Henrey 1505. Hunt II, 676. Norman 2255.

(2) Second edition, first published in 1779. A return to the subject of Withering's medical thesis of 1766, his first published work. See Garrison-Morton 5079.

Book Id: 40287

Price: $15,000.00

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