CHAPTER VI 



THE MALIGNANT SORE THROAT 



Non fingendum aut excogitandum sed inveniendum quid natura 

 faciat aut ferat. BACON. 



FOTHERGILL is best known in medical literature as the 

 author of " An Account of the Sore Throat Attended with 

 Ulcers," a memoir published in the year 1748. 



Epidemics of a severe form of angina had occurred in 

 several parts of the country, and in particular had swept over 

 London in the warm dry autumns of 1747 and 1748, and had 

 carried off, not only the poor, but members of the highest 

 families, including two young scions of the house of Pelham. 

 Fothergill studied the disease closely, and worked out a plan 

 of treatment for it, not of a depleting or depressing nature, as 

 had commonly been practised, but generous and cordial. His 

 paper deals first at some length with the history of epidemics 

 of angina maligna in Spain and Italy during the two previous 

 centuries ; these he illustrates by copious extracts and 

 references. He then describes the symptoms and course of 

 the disorder as they have come under his own observation. 

 He paints the clinical picture of an acute disease, attacking 

 whole families of children, as well as weakly adults, and 

 proving fatal in many cases. It began with giddiness, rigor, 

 fever, a quick pulse, severe headache, vomiting or purging or 

 both, sometimes bleeding at the nose ; there was sore throat 

 and stiffness of the neck. The fauces were of a florid red 

 colour, and there were commonly ulcers or whitish patches 

 on or about the tonsils. A skin eruption of a deep erysipelatous 

 aspect generally came out on the second day, especially upon 

 the face, breast and arms, down to the finger-tips. The 

 white patches on the tonsils, if these were present, were at 

 first thin and pale, but became ash-coloured, and later even 

 black in hue, evidently consisting of sloughs, whose separation 

 had been known to give rise to fatal haemorrhage. An acid 



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