294 DISEASES CLASS III. 1. 1. 11. 



ranged under the name of painful asthma, and leave for further 

 investigation. 



From the history of the case of the late much lamented John 

 Hunter, and from the appearances after death, the case seems to 

 have been of this kind, complicated with vertigo and consequent 

 affection of the stomach. The remote cause seems to have arisen 

 frotifi ossifications of the coronary arteries, and the immediate 

 cause of his death from fixed spasm of the heart. Other histo- 

 ries and dissections are still required to put this matter out of 

 doubt; as it is possible, that either a fixed spasm of the dia- 

 phragm, or of the heart, which are both furnished with but 

 weak antagonists, may occasion sudden death; and these may 

 constitute two distinct diseases. 



Four patients I have now in my recollection, all of whom I 

 believed to labour under the angina pectoris in a great degree; 

 which have all recovered, and have continued well three or four 

 years, by the use, as I believe, of issues on the inside of each 

 thigh; which were at first large enough to contain two peas 

 each, and afterwards but one. They took besides some slight 

 antimonial medicine for a while, and were reduced to half the 

 quantity or strength of their usual potation of fermented liquor. 



The use of femoral issues in angina pectoris was first recom- 

 mended by Dr. Macbride, physician at Dublin, Med. Observ. 

 and Enquir. Vol. VI. And I was further induced to make trial 

 of them, not only because the means which I had before used 

 were inadequate, but from the ill effect I once observed upon 

 the lungs, which succeeded the cure of a small sore beneath the 

 knee; and argued conversely, that issues in the lower limbs 

 might assist a difficult respiration. 



Mrs. L , about fifty, had a small sore place, about the size 



of half a pea on the inside of the leg a little below the knee. It 

 had discharged a pellucid fluid, which she called a ley-water, 

 daily for fourteen years, with a great deal of pain; on which 

 account she applied to a surgeon, who, by means of bandage and 

 a saturnine application, soon healed the sore, unheedful of the 

 consequences. In less than two months after this I saw her 

 with great difficulty of breathing, which with universal anasarca 

 soon destroyed her. 



The theory of the double effect of issues, as above related, 

 one in relieving by their presence the asthma dolorificum, and 

 the other in producing by its cure an anasarca of the lungs, is 

 not easy to explain. Some similar effects from cutaneous erup- 

 tions and from blisters are mentioned in Class I. 1. 2. 9. In 

 these cases it seems probable, that the pain occasioned by issues, 

 and perhaps the absorption of a small quantity of areated puru- 



