Class III. i. i. ii. OF VOLITION. 293 



Opium. Afafcetida. Warm bath. If the caufe can be detect- 

 ed, as in toothing or worms, it fhould be removed. As' this 

 fpecies of afthma is fo liable to recur during ileep, like epileptic 

 fits, as mentioned in Section XVIII. 1 5 . there was reafon to be- 

 lieve, that the refpiration of an atmofphere mixed with hydro- 

 gen, or any other innocuous air, which might dilute the oxygen, 

 would be ufeful in preventing the paroxyfms by decreafmg the 

 fenfibility of the fyftem. This, I am informed by Dr. Beddoes, 

 has been ufed with decided fuccefs by Dr. Perriar. See Oafs 

 II. 1. 1. 7. 



11. Afthma dolorificum. Angina pectoris. The painful 

 afthma was firft defcribed by Dr. Heberden in the Tranfactions 

 of the College ; its principal fymptoms confift in a pain about 

 the middle of the fternum, or rather lower, on every increafe of 

 pulmonary or mufcular exertion, as in walking fader than ufual, 

 or going quick up a hill, or even up flairs ; with great difficul- 

 ty of breathing, fo as to occaiion the patient inltantly to flop. 

 A pain in the arms about the infertion of the tendon of the pec- 

 toral muicle generally attends, and a defire of retting by hang- 

 ing on a doqr or branch of a tree by the arms is fometimes ob- 

 ferved. Which is explained in Clafs I. 2. 3. 14. and in Seel:. 

 XXIX. 5. 2. 



Thefe patients generally die fuddenly ; and on examining the 

 thorax no certain caufe, or feat, of the difeafe has been detect- 

 ed ; fome have fuppofed the valves of the arteries, or of the 

 heart, were imperfedt \ and others that the accumulation of fat 

 about this vifcus or the lungs obitructed their due action ; but 

 other obfervations do not accord with thefe fuppofitions. 



Mr. W , an elderly gentleman, was feized with afthma 



during the hot part of laft fummer ; he always waked from his 

 firlt lleep with difficult refpiration, and pain in the middle of 

 his fternum, and after about an hour was enabled to ileep again. 

 As this had returned for about a fortnight, it appeared to me to 

 be an afthma complicated with the difeafe, which Dr. Heberden 

 has called angina pectoris. It was treated by venefedlion, a ca- 

 thartic, and then by a grain of opium given at going to bed, with 

 ether and tincture of opium when the pain or aithma recurred, 

 and iaftly with the bark, but was feveral days before it was per- 

 fectly fubdued. 



This led me to conceive, that in this painful afthma the dia- 

 phragm, as well as the other mufcles of refpiration, was thrown 

 into convulfive action, and that the fibres of this mufcle not hav- 

 ing proper antagonifts, a painful fixed fpafm of it, like that of 

 the mufcles in the calf of the leg in the cramp, might be the 

 caufe of de?.th in the angina pectoris, which I have thence ar- 

 ranged 



