William Withering and the beginnings of modern therapeutics
Digoxin is a modern drug used to treat irregular heartbeat, atrial fibrillation, and congestive heart failure and to relieve symptoms of edema associated with congestive heart failure. The Western world of medicine’s knowledge of Digoxin’s incredible ability to help treat certain heart diseases was due to the efforts of an English physician called William Withering.
William Withering was born on March 17, 1741, in Wellington, Shropshire and died Oct. 6, 1799, in the town of Sparkbrook in England. He was influenced by his father, Edmund, who was an apothecary, the equivalent of a modern day pharmacist, and his uncle, Brook Hector, who was a physician. In the modern medical school, medical students participate in a residency program, which is akin to an apprenticeship, after 4 years of medical school. During Withering’s time in 1762, Withering enrolled in the University of Edinburg in Scotland after 4 years as an apprentice, the opposite of today’s system. The medical curriculum of this period was heavily focused on botany, probably playing a part in shaping Withering’s intellectual understanding of plants and human health.
After his schooling, Withering relocated to the town of Stafford, where he visited private patients and worked as a founding physician of the Stafford General Infirmary. During this time period, Withering participated in his hobby of botany and, through this, met his wife, Helena Cookes, who sketched the plants he collected. In 1779, Withering served as a founder of Birmingham General Hospital, where many poor people were treated free of charge
Experiments with Foxglove
William Withering started to conduct experiments to demonstrate the uses of the foxglove plant in 1776 after an experience with one of his patients. Withering had been treating a lady suffering from edema and had expected her to die, but he was surprised to discover that she had recovered after ingesting a folk cure prepared from digitalis, a plant commonly called foxglove. This lead him to write An Account of the Foxglove, and Some of Its Medical Uses, a book published in 1785 that gave him a lasting reputation. The P.I. Nixon Medical Historical Library owns a copy of this book.
The book describes Withering’s clinical experience with the purple foxglove, a weed containing therapeutic substances called cardiac glycosides used in modern drugs such as digoxin. The book basically details a 10 year clinical trial of digitalis (the modern name for the drug after the Latin name for the plant, Digitalis purpure) and was published to guard the medical community of the time period against misuse of this powerful drug. In the book he discusses treating 158 patients with foxglove and how 101 of them experienced relief from heart failure. He also wrote about the correct single dosage that should be used when administering foxglove, which is only slightly less than today’s modern digoxin tablet. The method that Withering detailed for creating medicine from the foxglove plant is also the same method that modern drug manufactures use, albeit on a grander scale, to extract digitalis from the foxglove plant.
Manasseh “Manny” Ngigi, Nursing School student
“Foxglove.” WebMD. Viewed 1/23/ 2015. http://www.webmd.com/vitamins-supplements/ingredientmono-287-DIGITALIS.aspx?activeIngredientId=287&activeIngredientName=DIGITALIS .
Wilson, Philip. “William Withering.” Encyclopaedia Britannica. Viewed 1/23/ 2015. http://www.britannica.com/EBchecked/topic/646127/William-Withering .
“The lifesaving foxglove.” UCLA Mildred E. Mathias Botanical Garden. Viewed 1/23/ 2015. http://www.botgard.ucla.edu/html/botanytextbooks/economicbotany/Digitalis/index.html
“Digitalis.” Wikipedia. http://en.wikipedia.org/wiki/Digitalis Viewed 1/23/2015.
Norman, Jeremy. “William Withering and the Purple Foxglove: A Bicentennial Tribute.” Jeremy Norman’s History of Science. Viewed 1/23/2015. http://www.historyofscience.com/articles/jmnorman-william-withering.php
“William Withering” by After Carl Frederik von Breda –  . Licensed under Public Domain via Wikimedia Commons –http://commons.wikimedia.org/wiki/File:William_Withering.jpg#mediaviewer/File:William_Withering.jpg
Book images are from the copy owned by the P. I. Nixon Medical Historical Library.
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