English Physician, Pharmacologist and Botanist
William Withering placed the medical use of digitalis on a firm scientific foundation. His 1785 book of digitalis cases, observations, and experiments is a classic in the history of therapeutics and pharmacology.
Withering was born in Wellington, Shropshire, England, the only son of Edmund Withering, an apothecary. He was tutored in Greek and Latin at the home of Rev. Henry Wood in Ercall, then entered the University of Edinburgh in 1762. Upon receiving his M.D. at Edinburgh in 1766, he established a private medical practice in Stafford. In 1772 he married one of his patients, Helena Cooke. In 1775 he moved his practice to Birmingham, and soon was among the most prosperous physicians there.
In Birmingham Withering made friends with Joseph Priestley (1733-1804), Erasmus Darwin (1731-1802), and several other prominent scientists. He joined the Lunar Society (so called because it met monthly during the full moon), a scholarly fraternity of scientists, technologists, industrialists, and other professionals. Inspired by Priestley, he conducted investigations in chemistry, mineralogy, and meteorology. In 1782 he discovered that barium carbonate is distinct from other barium compounds. In 1796 the German mineralogist Abraham Gottlob Werner (1749-1817) honored him by naming the twin crystalline form of barium carbonate "witherite." In the 1790s Withering opposed the controversial phlogiston theory of combustion.
Although primarily a medical practitioner, Withering always had a strong interest in plants. He was a keen observer of physical phenomena and an astute classifier of his observations. In 1776 he published A Botanical Arrangement of all the Vegetables Naturally Growing in Great Britain, the first sustained attempt to catalog and describe British flora according to Linnaean principles. By 1830 it had gone into seven editions and was the standard work in its field.
The first of his two medical books dealt with epidemiology. In An Account of the Scarlet Fever and Sore Throat, or Scarlatina Anginosa, Particularly as it Appeared at Birmingham in the Year 1778 (1779), he accurately described the symptoms, prognosis, and aftereffects of scarlet fever, and argued that containment of the contagion should be part of an effective treatment for this disease.
Edema or hydrops, the accumulation of water in various cavities of the human body, was then called "dropsy." In 1775 Withering learned a secret herbal treatment for dropsy from an old woman in Shropshire. He determined that among the twenty or so herbs she concocted, purple foxglove (digitalis purpurea) was the active ingredient. This ancient folk remedy proved effective in controlled clinical medicine. For ten years Withering carefully studied it, then presented his results in An Account of the Foxglove and Some of its Medicinal Uses with Practical Remarks on Dropsy and Other Diseases (1785). This book is a model of sober, empirical medical writing. He reported the failures as well as the successes of digitalis therapy, developed guidelines to avoid overdosage and underdosage, and documented his findings with case histories.
Withering's pioneer work made possible such medical classics as Augustin Eugène Homolle's "Mémoire sur la digitale pourprée" [Memoir on the Purple Foxglove] (1845), Johann Ernst Oswald Schmiederberg's "Untersuchungen über die pharmakologisch wirksamen Bestandtheile der Digitalis Purpurea" [Investigations of the Pharmacologically Effective Components of the Purple Foxglove] (1875), Sir James McKenzie's "New Methods of Studying Affections of the Heart" (1905), Walter Straub's "Digitaliswirkung am isolierten Vorhof des Frosches" [Action of Digitalis on the Isolated Heart Auricle of the Frog] (1916), and Arthur Robertson Cushny's The Action and Uses in Medicine of Digitalis and its Allies (1925). The full significance of digitalis for heart disease was recognized only after McKenzie.
ERIC V.D. LUFT