Medical topography of Upper Canada

influenced by Cullen, to the eight initial years of practice in Stafford. It was during this period, perhaps around 1770, that he seems to have taken up field botany seriously. In 1775, seeking a larger stage for his abilities, he was told by Erasmus Darwin of a promising opening in the nearest city, the then fast-growing Birmingham. There, he speedily prospered, to such an extent that eleven years later he was wealthy enough to lease one of the local big houses, Edgbaston Hall. The career was not without its traumas, however, and latterly he fought a losing battle with consumption, twice having to spend winters in Portugal. He died a year or two just short of sixty. It was soon after the move to Birmingham that a patient asked him for his opinion of a recipe for the cure of dropsy which had been handed down within the family. It had come from an old Shropshire herb-woman, he discovered, and consisted of a "cocktail" derived from twenty or more different plants. Thanks to his botanical knowledge, Withering spotted at once that the foxglove was the key one of these, and there then followed ten years of patient experimenting by him to establish the therapeutic limits of the drug. The methods he used, his detailed and careful reporting of his results, the attention he gave to product quality and standardization, and his development of the technique of dose titration were all very advanced for the time and are what he primarily deserves to be remembered for-rather than (as popular legend wrongly has it) as the discoverer of digitalis. At the same time, Withering is rightly hailed today as a pioneer of the view that there is something to be learned of the properties and virtues of natural substances from "the empirical usages and experience of the populace". Here his expertise in botany came into its own. How far that expertise was crucial in his digitalis detective work is a matter for conjecture, but it is clear that it was important in a general way in giving him a wider awareness. It is therefore disappointing that the treatment in the book of the botanical dimension is so thin, for Withering is a figure of almost equal significance in the history of field botany as in that of clinical pharmacology. Indeed the second (1787) edition of his Botanical arrangement, the other publication he …