vri ANGINA PECTORIS 69 



original theory of spasm was developed by Trousseau and 

 others, who discerned the neurotic nature of the disorder, as 

 well as its anatomical basis. 



When Fothergill comes to the question of the treatment 

 of angina his resourcefulness contrasts with the brief recom- 

 mendations of Heberden. He lays stress, as is his wont, 

 upon diet ; spices and all heating things are to be shunned ; 

 food is to be sparing in quantity, and animal food to be 

 abstained from so far as health permits ; little fermented 

 liquors should be taken. Temperance and moderation are 

 enjoined in the habits and work of life ; guarding against 

 passion, anxiety or any vehement emotions ; with some 

 exercise on horseback in suitable cases. The emunctories 

 are to be attended to, and gentle laxatives employed ; to 

 disperse flatulence and control distension of the stomach, 

 warm cordials are proper, especially peppermint ; bitters 

 should be taken for a fortnight at a time, and sometimes a 

 mild chalybeate ; Fothergill gives soap and native cinnabar 

 pills to one patient. If needful an anodyne of opium and 

 antimonial wine may be taken at night. The Bath waters 

 may be drunk in the summer time. The scheme here outlined 

 would still form a good basis of treatment, to which the further 

 and more potent means which modern knowledge has supplied 

 could be added. 1 



PIGMENT POISONING 



Colica Pictonum, or of Poitou, had long been known as a 

 disease, the cause of which poisoning by lead was demon- 

 strated in a masterly paper by Dr., afterwards Sir George 

 Baker in 1767. A few years after this Fothergill brought 

 forward cases of artists in water-colours who suffered with 

 symptoms of poisoning, due, as he showed, to their placing 

 the brushes charged with metallic pigments between their 

 lips in the course of their work. He tells of violent colic 

 and constipation ; of feebleness of the hands ; again, of 

 exquisite pains in the soles of the feet, of loss of speech and 



1 Fothergill's papers on angina pectoris seem to have been read in 1774 

 and 1775. See Med. Obs. & Inq. v. 233, 252, and Works, ii. 249, 263 ; Heberden 

 (1768) in Med. Trans, ii. 59, iii. i, 12 ; and his Comment. (1782), c. 70. 

 Rougnon, 1768 (see Osier, Angina Pectoris) ; Parry, Syncope Anginosa, 1799. 

 See also Coelius Aurelianus, Chron. ii. i ; Morgagni, De Sedibus, ii. Ep. xxiii. 8, 

 xxvi. 31 ; Mem. Lettsom, iii. 46 ; Trousseau, Clin. Mid. i. xx. Seneca was 

 probably the subject of this disorder, which has struck down some men of the 

 strongest and keenest minds, such as John Hunter, Dr. T. Arnold, Matthew 

 Arnold and Dr. Chalmers. 



