William Withering

William Withering (born March 17, 1741, Wellington, Shropshire, England—died October 6, 1799, Sparkbrook, Birmingham, Warwickshire) was an English physician best known for his use of extracts of foxglove (Digitalis purpurea) to treat dropsy (edema), a condition associated with heart failure and characterized by the accumulation of fluid in soft tissues. Withering’s insights on the medical uses of foxglove proved crucial to modern understanding of heart failure, and today drugs containing the active compound, known as digitalis, are still prescribed.

Education and early career in medicine

Influenced by his father, Edmund, who worked as an apothecary, and by his uncle, Brooke Hector, who worked as a physician in Lichfield, Withering enrolled at the University of Edinburgh in 1762, following four years of medical apprenticeship. In 1766, having shown little interest in botany, which formed a large part of the medical curriculum at the time, he prepared his thesis on malignant sore throat, titled De Angina Gangraenosa. This was also the year that—following a thorough self-study of the Bible and sacred history—Withering changed from an atheist to a Christian. While in Edinburgh, he also participated in Masonic activities.

Withering soon relocated to Stafford, where he attended private patients and served as a founding physician of the Stafford General Infirmary. He began to enjoy botany and met Helena Cookes, who sketched the plants he collected. They were married on Sept. 12, 1772, and had three children. Seeking a more substantial income, Withering decided to move to Birmingham to fill a vacancy created by the death of physician and Lunar Society cofounder William Small in 1775. (The Lunar Society was a gathering of naturalists and inventors who met monthly in the Midlands of England, traveling under the light of the full moon.) The move to Birmingham was suggested to Withering by Lichfield physician Erasmus Darwin. Together with fellow physician John Ash, Withering served as a founder of the Birmingham General Hospital, which opened in 1779. There he treated several thousand patients each year, many of whom were impoverished and received their care gratis.

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Botanical works

Withering’s lasting reputation lies primarily with his publication An Account of the Foxglove, and Some of Its Medical Uses (1785). Though foxglove (Digitalis purpurea) had been used in folk medicine for centuries, Withering drew upon 156 of his own cases to objectively demonstrate its efficacy in treating dropsy, the edematous bodily swelling that typically accompanied heart failure. In particular, he noted that foxglove leaf preparations were efficacious in small, nontoxic doses and that their action varied according to the plant’s stage of bloom. Withering’s publication created considerable furor with fellow Lunar Society member Erasmus Darwin, who claimed priority in having published on foxglove’s therapeutic use in managing dropsy. This was not the first conflict between Withering and Darwin. The previous year, Darwin, together with fellow members of the Lichfield Botanical Society, had published the first English translation of Swedish naturalist and explorer Carolus Linnaeus’s Genera et Species Plantarum (the translated text was published in 1784) without acknowledging Withering’s contributions.

Withering gained renown for his botanical writings, the first of which, following in the tradition of English naturalist John Ray, was A Botanical Arrangement of All the Vegetables Growing Naturally in G. Britain (1776). Withering’s later work, An Arrangement of British Plants (1787–92), was designed to show amateur botanists, many of whom were young women, the utility of the Linnaean classification system. In addition, this work introduced his specially designed field microscope, which subsequently became known as the Withering botanical microscope.

Influence on medicine and science

Withering contributed to the clinical distinction of scarlet fever and to the medical use of lead and rum. Following the Birmingham riots of 1791, he left England and went to Portugal, where, as he had done in Stafford and Birmingham, he analyzed the mineral content of spa waters. In 1783 he prepared the English translation of Swedish chemist and naturalist Torbern Bergman’s mineralogy treatise, and, in recognition for his study of the properties of barium carbonate, this mineral was subsequently named witherite. The flowering plant Witheringia solanacea (order Solanales) was also named in his honor.

In 1794 Withering returned to Birmingham, where he died following complications of tuberculosis. He was buried at Edgbaston Old Church in Edgbaston, Birmingham, where his memorial tablet is marked by the staff and snake of Asclepius, the Greco-Roman god of medicine, and sprigs of Digitalis and Witheringia. Today digitalis continues to serve as the active ingredient of the cardiac glycoside drugs digoxin and digitoxin.

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