56 FOTHERGILL'S MEDICAL PAPERS CHAP. 



degree of M.D. Lettsom thinks it needful to tell us that it 

 was his genuine production, since too frequently such papers 

 seem to have been composed " by indigent individuals, who 

 are always to be found in colleges," ready to furnish students 

 at a price with a thesis which they are too indolent or ignorant 

 to write for themselves. The treatise is couched in eloquent 

 Latin, full of reference both to the ancients and to moderns, 

 and it demonstrates with the pardonable emphasis of a young 

 writer the usefulness of emetics in a wide range of diseases 

 and bodily conditions, especially in the sedentary habit. It 

 is fair to add that he concludes with a list of disorders in 

 which emetics should carefully be avoided. 1 



RUPTURED DIAPHRAGM CONGENITAL SYPHILIS 



In 1744 Fothergill wrote a Latin letter, addressed to Dr. 

 Mead (medicce juventutis pater atque princeps) and read before 

 the Royal Society, describing the case of an infant dying in 

 its tenth month, in whom was found a fissure in the diaphragm. 

 Portions of the stomach, ileum, caecum, appendix and colon 

 had passed through this fissure into the cavity of the thorax. 

 Fothergill gives a minute clinical history of the infant's case, 

 which is to modern eyes an accurate pen-portrait of congenital 

 syphilis, then apparently quite unrecognised. It shows how 

 closely and faithfully the young observer, although wholly 

 without guidance from authoritative knowledge of the subject, 

 could compose his records. 2 



SCIATICA 



Few diseases of the nervous system had been distinguished 

 in the days of Fothergill, and those that were known were 

 little understood until Marshall Hall and Duchenne had 

 thrown clearer light upon nervous processes. One of Fother- 

 gill's early papers deals with the treatment of Sciatica, a 

 disorder which he avers has too often proved intractable by 

 the remedies commonly used, such as bark, guaiacum and 

 turpentine ; or by Fontanelle's blisters and caustics applied 

 externally. He has come to rely upon calomel, prescribing 

 one grain of this drug in a pill to be taken nightly, with a 

 draught containing opium and antimonial wine. After ten 

 days' treatment the calomel is increased on alternate nights 



1 The work was considered worthy of inclusion in Smellie's Thesaurus, 1778. 

 8 Epistola de Diaphragmate fisso, etc., Phil. Trans, xliv. n ; Works, i. 21. 



