Life with the pneumococcus. Notes from the bedside, laboratory, and library

The bicentenary of the publication of William Withering's Foxglove has been well and largely perceptively celebrated the world over, but the most permanent tribute comes in the form ofthis book by J. K. Aronson. Aronson is very well qualified for the job he has set himself. He is an eminent authority on the pharmacology and clinical practice involved, and he now shows himself to be a fine and meticulous historian. The first half of the book is a facsimile of the original Account of thefoxglove and some ofits medical uses. This has been annotated in the margins with helpful notes on people, diseases, practices, and drugs. Here Aronson reveals an encyclopaedic grasp of his material. The second half of the book consists of mostly historical chapters putting Withering and the Foxglove in perspective. The account is vastly more balanced than that of Peck and Williamson (1950, William Withering ofBirmingham) and forms a valuable addition to the insight already given by Schofield (1967, The Lunar Society of Birmingham). I noticed very few possible slips or omissions. The only one of any importance relates to George Eliot's reference in Silas Marner to the use of the foxglove for the "terrible symptoms of heart-disease and dropsy". Aronson says the source of the information is unknown to him. I think we can be almost certain that it came from George Henry Lewes, who, amongst his other accomplishments, was a physiologist with a formidable range of knowledge. It is inconceivable that he did not know of Withering's work. He and George Eliot frequently talked about his physiological work (some of her correspondence refers explicitly to this), and the medical parts of her novels are probably the main evidence of Lewes's influence on her. A novel feature of Aronson's book is the analysis of Withering's own results using statistical methods. In this way, Aronson fairly convincingly shows that Withering's success owed as much to his previous experience as to his switch of method of preparation. I also find Aronson's analysis of the contrasting characters of Withering and Erasmus Darwin rings true. Withering was "the sort ofman most likely to annoy Darwin". My own reading of this famous quarrel was that it cannot have been true that Withering was completely innocent, though he was clearly right. The book finishes with a brief and helpful review of work on digitalis during the twentieth century. As these lines are …