GLASS III. 1. 1. 11. OF VOLITION. 



Opium. Asafoetida. Warm bath. If the cause can be detect- 

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

 species of asthma is so liable to recur during sleep, like epileptic 

 fits, as mentioned in Section XVIII. 15. there was reason to be- 

 lieve, (hat the respiration of an atmosphere mixed with hydro- 

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

 would be useful in preventing the paroxysms by decreasing the 

 sensibility of the system. This, I am informed by Dr. Beddoes, 

 has been used with decided success by Dr. Ferriar. See Class 

 II. 1. 1. 7. 



11. Jlsthma dolorificum. Angina pectoris. The painful 

 asthma was first described by Dr. Heberden in the Transactions 

 of the College; its principal symptoms consist in a pain about 

 the middle of the sternum, or rather lower, on every increase of 

 pulmonary or muscular exertion, as in walking faster than usual, 

 or going quick up a hill, or even up stairs; with great difficulty 

 of breathing, so as to occasion the patient instantly to stop. 

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

 toral muscle generally attends, and a desire of resting by hang- 

 ing on a door or branch of a tree by the arms is sometimes ob- 

 served. Which is explained in Class I. 2. 3. 14. and in Sect. 

 XXIX. 5. 2. 



These patients generally die suddenly; and on examining the 

 thorax no certain cause, or seat, of the disease has been detect- 

 ed; some have supposed the valves of the arteries, or of the 

 heart, were imperfect; and others that the accumulation of fat 

 about this viscus or the lungs obstructed their due action; but 

 other observations do not accord with these suppositions. 



Mr. W , an elderly gentleman, was seized with asthma 



during the hot part of last summer; he always waked from his 

 first sleep with difficult respiration, and pain in the middle of 

 his sternum, and after about an hour was enabled to sleep again. 

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

 bean asthma complicated with the disease, which Dr. Heberden 

 has called angina pectoris. It was treated by venesection, 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 asthma recurred, 

 and lastly with the bark, but was several days before it was per- 

 fectly subdued. 



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

 phragm, as well as the other muscles of respiration, was thrown 

 into convulsive action, and that the fibres of this muscle not hav- 

 ing proper antagonists, a painful fixed spasm of it, like that of 

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

 cause of death in the angina pectoris, which I have thence ar- 



