William Withering


William Withering FRS was an English botanist, geologist, chemist, physician and first systematic investigator of the bioactivity of digitalis.

Introduction

Withering was born in Wellington, Shropshire, the son of a surgeon. He trained as a physician and studied medicine at the University of Edinburgh Medical School. He worked at Birmingham General Hospital from 1779. The story is that he noticed a person with dropsy improve remarkably after taking a traditional herbal remedy; Withering became famous for recognising that the active ingredient in the mixture came from the foxglove plant. The active ingredient is now known as digoxin, after the plant's scientific name. In 1785, Withering published An Account of the Foxglove and some of its Medical Uses, which contained reports on clinical trials and notes on digitalis's effects and toxicity.

Biography

Born in England, Withering attended Edinburgh Medical School from 1762 to 1766. In 1767 he started as a consultant at Stafford Royal Infirmary. He married Helena Cookes in 1772; they had three children. In 1775 he was appointed physician to Birmingham General Hospital, but in 1783 he diagnosed himself as having pulmonary tuberculosis and went twice to Portugal hoping the better winter climate would improve his health; it did not. On the way home from his second trip there, the ship he was in was chased by pirates. In 1785 he was elected a Fellow of the prestigious Royal Society and also published his Account of the Foxglove. The following year he leased Edgbaston Hall, in Birmingham, England. He was one of the members of the Lunar Society. During the Birmingham riots of 1791 he prepared to flee from Edgbaston Hall, but his staff kept the rioters at bay until the military arrived. In 1799 he decided that he could not tolerate another winter in the cold and draughty Hall, so he bought "The Larches" in the nearby Sparkbrook area; his wife did not feel up to the move and remained at Edgbaston Hall. After moving to The Larches on 28 September, he died on 6 October 1799.

Botany

In 1776, he published The botanical arrangement of all the vegetables naturally growing in Great Britain, an early and influential British Flora. It was the first in English based on the then new Linnaean taxonomy — a classification of all living things — devised by the eminent Swedish botanist and physician Carl Linnaeus. At the time he was criticised for having produced a bowdlerised version of Linnaeus, deliberately omitting any references to sexual reproduction, out of a desire to protect 'female modesty', notably by 'A Botanical Society, at Lichfield' - almost always incorrectly named as The Botanical Society of Lichfield or the Lichfield Botanical Society. In fact Withering explained on the Title page and his introduction that he avoided being explicit to allow his book to be used without any problems by a much wider audience and in particular women. However he found plenty of support for his position, and botany was considered a subject suitable for many women during the next century. A talented illustrator herself, his wife, Helena, sketched plants he collected.
Withering wrote two more editions of this work in 1787 and 1792, in collaboration with fellow Lunar Society member Jonathan Stokes, and after his death his son published four more. It continued being published under various authors until 1877. Withering senior also carried out pioneering work into the identification of fungi and invented a folding pocket microscope for use on botanical field trips. He also introduced to the general audience the screw down plant press and the vasculum. In 1787 he was elected a Fellow of the Linnaean Society in recognition of his contribution to botany. Subsequently, the plant Witheringia solanacea was named in his honour, and he became known on the continent of Europe as "The English Linnaeus". The William Withering Chair in Medicine at the University of Birmingham Medical School is named after him, as is the medical school's annual William Withering Lecture.

Discovery of digitalis

Allegedly, Withering first learned of the use of Digitalis in treating "dropsy" from "Mother Hutton", an old woman who practiced as a folk herbalist in Shropshire, who used the plant as part of a polyherbal formulation containing over 20 different ingredients to successfully treat this condition. Withering deduced that Digitalis was the "active" ingredient in the formulation, and over the ensuing nine years he carefully tried out different preparations of various parts of the plant documenting 156 cases where he had employed digitalis, and describing the effects and the best - and safest - way of using it. At least one of these cases was a patient for whom Erasmus Darwin had asked Withering for his second opinion. In January 1785 Darwin submitted a paper entitled "An Account of the Successful Use of Foxglove in Some Dropsies and in Pulmonary Consumption" to the College of Physicians in London; it was presented by Darwin in March of that year. A postscript at the end of the published volume of transactions containing Darwin's paper states that "Whilst the last pages of this volume were in the press, Dr Withering of Birmingham... published a numerous collection of cases in which foxglove has been given, and frequently with good success". After this, Darwin and Withering became increasingly estranged, and eventually a horrendous argument broke out apparently resulting from Robert Darwin having accused Withering of unprofessional behaviour by effectively poaching patients. This is a very early example of medical academic plagiarism. This was in reality orchestrated by Erasmus Darwin, a man whose anger and sarcasm when he felt slighted had in all likelihood contributed to the suicide of his own son and later to the estrangement of his son Robert.
In reality "Mother Hutton" was created in 1928 in an illustration by William Meade Prince as part of an advertising campaign by Parke-Davis who marketed Digitalis preparations. There is no mention of a Mother Hutton in Withering's works or anyone else's and no mention of him meeting any old woman directly. In his account he states that he is merely asked to comment on a family recipe that was originally an old woman's receipt or recipe by a colleague. Since 1928, Mother Hutton's status has grown from being an image in an advertising poster to an acclaimed Wise Woman, Herbalist, Pharmacist and Medical Practitioner in Shropshire who was cheated out of her true recognition by Dr. Withering's unscrupulous methods. The story often written around this is also totally apocryphal. Withering was in fact informed of the Brazenose College case by one of his medical colleagues Dr. Ash at Birmingham Hospital and the Dean was treated with Digitalis Root not Leaves. The details are in Witherings Account. The myth of Mother Hutton and how Withering chased her around Shropshire has been created by authors not going back to primary sources but instead copying and then embellishing the unreferenced work of others. See "Withering and The Foxglove; the making of a myth" by D.M. Krikler Br Heart J 1985 54: 256-257. In Withering's Account of the Foxglove printed in 1785 Withering mentions 7 different occasions when foxglove was brought to his attention. Recognising that Foxglove was the active ingredient in a family recipe would not have been difficult with his expert botanical knowledge. Withering had first published his Botanical Arrangement and had talked in Edinburgh University about Withering's experiments with the Foxglove. Erasmus Darwin was probably jealous that Withering had become the most famous and sought after doctor outside London and that Withering's English Botanical Arrangement became the standard reference source and far exceeded the botanical publications of Erasmus in popularity. Withering's Botanical Arrangement, although now almost forgotten, became the standard reference for English Botany for almost the next 100 years.

Chemistry and geology

He was an enthusiastic chemist and geologist. He conducted a series of experiments on Terra Ponderosa, a heavy ore from Cumberland, England. He deduced that it contained a hitherto undescribed element which he was unable to characterise. It was later shown to be barium carbonate and in 1789 the eminent German geologist Abraham Gottlob Werner named the mineral Witherite in his honour. The Matthew Boulton mineral collection of Birmingham Museum and Art Gallery may contain one of the earliest known specimens of witherite. A label in Boulton's handwriting records; "No.2 Terra Ponderosa Aerata, given me by Dr. Withering"
Withering also undertook analyses of the mineral content of a number of spa waters in England and abroad, notably at the medicinal spa at Caldas da Rainha in Portugal. This latter undertaking occurred during the winter of 1793-4, and he was subsequently elected to the Fellowship of the Royal Academy of Sciences of Portugal.

Memorials

He was buried on 10 October 1799 in Edgbaston Old Church next to Edgbaston Hall, Edgbaston, Birmingham, although the exact site of his grave is unknown. The memorial stone, now moved inside the church, has foxgloves and Witheringia solanaceae carved upon it to commemorate his discovery and his wider contribution to botany. He is also remembered by one of the Moonstones in Birmingham and by a blue plaque at Edgbaston Golf Club. Birmingham University School of Medicine established a Chair of Medicine post in his honour, named after him. The current holder is Professor Wiebke Arlt, an academic endocrinologist.
In July 2011 a J D Wetherspoon public house opened in Withering's birthplace, Wellington, and has been named after him.

Publications

This list is drawn from Sheldon, 2004: