294 DISEASES CLASS III. i . i . 1 1 . 



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

 investigation. 



From the hiftory of the cafe of the late much lamented John 

 Hunter, and from the appearances after death, the cafe feems to 

 have been of this kind, complicated with vertigo and confequent 

 affection of the ftomach. The remote caufe feems to have arifen 

 from offifications of the coronary arteries ; and the immediate 

 caufe of his death from fixed fpafm of the heart. Other hifto- 

 ries and directions are ftill required to put this matter out of 

 doubt ; as it is poffible, that either a fixed fpafm of the dia- 

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

 weak antagonifts, may occafion fudden death ; and thefe may 

 conftitute two diitinct difeafes. 



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

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

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

 years by the ufe, as I believe, of iffues on the infide of each 

 thigh ; which were at firft large enough to contain two peafe 

 each, and afterwards but one. They took befides fome flight 

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

 quantity or ftrength of their ufual potation of fermented liquor. 



The ufe of femoral iflues in angina pectoris was firft recom- 

 mended by Dr. Macbride, phyfician at Dublin, Med. Obferv. 

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

 of them, not only becaufe the means which I had before ufed 

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

 the lungs, which fucceeded the cure of a fmall fore beneath the 

 knee ; and argued converfely, that iffues in the lower limbs 

 might affift a difficult refpiration. 



Mrs. L , about fifty, had a fmall fore place, about the fize 



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

 had difcharged a pellucid fluid, which (lie called a ley-water, 

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

 account fhe applied to a furgeon, who, by means of bandage and 

 a faturnine application, foon healed the fore, unheedful of the 

 confequences. In lefs than two months after this I faw her with 

 great difficulty of breathing, which with univerfal anafarca foon 

 deftroyed her. 



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

 one in relieving by their prefcnce the afthma dolorificum, and 

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

 not eafy to explain. Some fimilar effects from cutaneous erup- 

 tions and from bliiters are mentioned in Clafs I. 1.2. 9. In 

 thefe cafes it feems probable, that the pain occafioned by iffues, 

 and perhaps the abforption of a fmall quantity of aerated puru- 

 lent 



