vi THE EVOLUTION OF A DISEASE 53 



to which it can adapt itself, it tends to produce a uniform 

 reaction, capable of reproduction in other like hosts, and a 

 specific disease with a defined course and symptoms is the 

 result ; to this we give a name. There is some evidence for 

 the belief that in Fothergill's time diseases of the fauces were 

 in process of evolution, and that out of various epidemic 

 types, one of which he so carefully described, the specific 

 disorders well known to us have been developed. 



Fothergill took great pains with the composition of this 

 monograph, devoting every leisure hour to the task, and 

 being, he tells his friend Cuming, much exhausted when he 

 had finished it. 1 In some of his views on treatment he 

 followed the learned Dr. Letherland, whose retiring nature 

 caused him to decline any reference to himself. In the 

 preface to the fifth edition of the book in 1769, when Lether- 

 land was no longer living, Fothergill acknowledged the debt. 2 



The paper came out at the right moment and was well 

 received ; the 500 copies printed were sold off within a few 

 weeks, and six editions were called for within the author's 

 lifetime. His name became known and his practice widely 

 extended. The paper was translated into French and into 

 several other languages. 3 



The novelty and importance at this epoch of Fothergill's 

 views on treatment may be illustrated by a " Letter from a 

 Physician at Bath to Dr. Heberden " published in I758. 4 In 

 this letter the writer describes the " Malignant Sore Throat " 

 attended with dark grey sloughs on the tonsils. He alludes 

 to Fothergill without naming him, rejects his doctrines, and 

 urges the use of bleeding, purging and scarifying the tonsils 

 deeply, as well as giving the bark in large doses ; very few 

 cases however in his experience survived. The old methods 

 die hard ; even Fothergill's friend Gilbert Thompson in 1782 



1 MS. Letter, Dec. 7, 1748. C. Roberts Collection, Haverford College, Penna. 



2 A charge of plagiarism has been made against Fothergill on this slender 

 foundation. See Elliot, Works of Fothergill, pp. iii-v ; Works (Lettsom), iii. 

 p. xxix. 



3 Copies of the first and second editions of this work, bound together in one 

 volume, are preserved in the Library of the Royal Society of Medicine, London. 

 The former contains marginal notes in Dr. Fothergill's handwriting. At the 

 end of the volume is a list, also in his handwriting, of works dealing with the 

 same topic ; with an autograph letter from Dr. And. Cantwell, dated Paris, 

 1749, which accompanied six copies of the translation into French of Dr. 

 Fothergill's work, by M. de la Chapelle. The volume belonged to Alice Chorley 

 of Tottenham, niece of Dr. Fothergill, and afterwards in succession to Thomas 

 Thompson, Dr. T. Hancock and Dr. Thomas Bevan of London, and was 

 finally presented to the Royal Medical and Chirurgical Society by Dr. Thomas 

 B. Peacock. 



4 An imperfect copy is in the Library of the Roy. Soc. Med. Tr. D. 186, 16. 



