68 FOTHERGILL'S MEDICAL PAPERS CHAP 



imaginary, which occur at this period of life, might easily 

 have been drawn to-day. 1 



OBESITY 



" A strict vegetable diet," Fothergill observes, " reduces 

 exuberant fat more certainly than any means I know." Two 

 striking examples follow, in which this regimen and the 

 limitation of alcoholic liquors effected a cure. One of these 

 patients, a lady who could with difficulty walk across the floor 

 of her apartment, was sent to drink the Scarborough water, 

 until she was able to climb the ascent to the spa. 2 



ANGINA PECTORIS 



Two papers were written by Fothergill on Angina Pectoris, 

 a disorder which had only lately been denned and named by 

 Heberden, although isolated cases may be found in the records 

 of Morgagni and others. Fothergill describes two cases, out 

 of many that had come under his notice, in which he had 

 been able to obtain a post-mortem examination. The clinical 

 history is related with fulness by his graphic pen, including 

 the special characteristics of the pain, the effect of sudden 

 agitations, whether from passion or exercise, the influence of 

 a full meal, and of states of the weather, and the frequent 

 association with a gouty habit of body. Of the autopsies on 

 his two patients, the first was inconclusive ; the second was 

 performed by John Hunter it might have been a forecast 

 of his own tragical end and revealed, besides pleural effusion, 

 much evidence of " ossification " in the structures of the 

 heart. The substance of the ventricles was pale, ligamentous, 

 and in parts whitish and hard ; the mitral valves were stiffened 

 and contained many similar patches ; there were ossifications 

 in the wall of the aorta ; and " the two coronary arteries, 

 from their origin to many of their ramifications upon the 

 heart, were become one piece of bone." 



This seems to be the earliest dated record of lesion of the 

 coronary vessels in a case of angina pectoris. Jenner and 

 Parry made further observations, and coronary atheroma 

 and its results were in course of time recognised as the char- 

 acteristic lesions of one type of angina, whilst Heberden's 



1 Of the Management proper at the Cessation of the. Menses, Med. Obs. & Inq. 

 v. 160 ; Works, ii. 201 ; Conseils aux Femmes, etc., 3 editions in France ; 

 the 2nd, Paris, 1800, was enlarged by Petit- Radel. 



* Med. Obs. & Inq. v. 248, 250 ; Works, ii. 260, 261. 



