46 FOTHERGILL'S MEDICAL PRACTICE CHAP. 



At this stage Dr. FothergilTs aid was sought for her relief. 

 He delivered a carefully reasoned opinion. It was tactfully 

 suggested that the necessity of frequent bleedings had 

 weakened the patient's habit and depraved her blood, and 

 laid her open to a scorbutic acrimony, and to a varicose state 

 of the haemorrhoidal vessels ; the hemicrania and the sphincter 

 pains were in his opinion alike due to this acrimony in the 

 blood, acting upon a habit debilitated by frequent bleedings. 

 When proper applications had checked the haemorrhage and 

 the pain, " the cause was thrown upon the skin, the part to 

 which acrimonious humours are naturally directed." " It 

 appears to me," so the doctor summed up his opinion, " that 

 the properest method of cure would be to strengthen her 

 habit in general, and promote the natural secretions ; to 

 intermix gentle evacuations ; to make an artificial ulcer near 

 the part affected ; and to attempt, by specifics, to correct 

 the peccant acrimony." Alluding to diet and exercise, he 

 forbade " garden-stuff, fruits, acids, salt, butter and cheese, 

 in any quantity." Tepid water was to be drunk, and a glass 

 or two of red wine allowed. A mild mercurial pill was to be 

 taken, composed of the pure metal with guaiacum, almond 

 oil, colocynth and liquorice. An issue was to be established 

 capable of holding two or more peas. Sal Martis (sulphate of 

 iron) made up in pills with ammoniacum, Venetian soap and 

 extract of gentian, should be administered an hour before 

 dinner, with a decoction of cinchona and winter's bark, mixed 

 with compound wormwood water. When the eruption re- 

 turned, she was to have a draught, in which a few grains of 

 pilula Rufi (aloes and myrrh) were suspended by rubbing 

 with rue and bryony waters and some syrup of saffron. 

 The chalybeate purging waters of Scarborough were also 

 advised. 



This young lady recovered of her disorders, and lived to be 

 a grandmother, enjoying good health. It is not difficult to 

 see that in this case, which we should now describe as one of 

 chlorosis, haemorrhoids, and neuralgia, Fothergill's instinct 

 led him to a line of rational and successful treatment. Avoid- 

 ing the frequent venaesections, which had aggravated if they 

 had not caused the disease, and discarding the powerful 

 mercurial purges and innumerable herbal palliatives which 

 had been used, he placed the patient on a supporting basis, 

 gave iron, cinchona and mild laxatives, and left the local 

 trouble very much alone. 1 



1 Works, iii. 131. 



