70 FOTHERGILL'S MEDICAL PAPERS CHAP. 



mental prostration. He suspects the presence of arsenic, as 

 well as lead or copper, in some of these cases. In a note he 

 adds that he has found similar pains in the feet as the almost 

 constant companion of dram-drinking, especially in women ; 

 this may be the earliest allusion to alcoholic neuritis. 1 



IPECACUANHA IN DIARRHOEA 



Ipecacuanha was then commonly and freely used in cases of 

 Chronic Diarrhoea. In the last of his medical papers Fother- 

 gill states his own method of using the drug in small and 

 infrequent doses. He gives one or two grains only, early in 

 the morning ; this has either an emetic or cathartic effect, 

 which is assisted by a basin of thin gruel. The dose is repeated 

 daily or at longer intervals, and a cordial anodyne is taken 

 every night to insure digestive quietude. The cure partly 

 depends in Fothergill's view on the diaphoretic qualities of 

 the drug, since these throw off through the skin the acrimony, 

 which is a cause of the diarrhoea. The food should be regulated 

 especially in quantity, and animal food restricted to one kind 

 only ; thus a cure ensued in a patient who dined off mutton 

 for a month continuously. A long course of gentle tonics, 

 bark or iron, is helpful ; besides it enables the doctor to keep 

 control of the regimen. 2 



INFLUENZA 



Influenza was a disease well known to Fothergill. Again 

 and again in the middle part of his century in 1762, in 1775, 

 in 1782 was it epidemic in Europe, sweeping rapidly over 

 whole countries, and burning itself out, as it were, in a few 

 weeks. Fothergill studied the outbreak of October and 

 November 1775, which smote half London with catarrh. He 

 is said to have had sixty patients on his own daily list. Directly 

 it ceased he drew up a concise " Sketch of the late Epidemical 

 Disease," under heads, which he printed on four pages of 

 letterpress having very wide margins, and circulated it among 

 his medical friends in town and country, begging them to add 

 their own observations, so that a more complete history of the 

 distemper might be obtained. Replies were furnished by 



1 Observations on Disorders to which Painleis in Water-Colours are exposed, 

 read 1775. Med. Obs. & Inq. v. 394 ; Works, ii. 269 ; Med. Trans, i. 175. 



z On the Cure of Fluxes by Small Doses of Ipecacuanha, read Aug. 21, 1780. 

 Med. Obs. & Inq. vi. 186 ; Works, iii. 245. 



