506 FRANCIS' CASES OF MORBID ANATOMY. 



of swallowing, and that the efforts which he made to get even small 

 quantities of food into the stomach gave him severe pain. He referred 

 to the gastric region as the seat of part of the distress which he suffered, 

 and more particularly to a circumscribed spot above the pit of the 

 stomach, under the breast bone. Under those circumstances medical 

 aid was deemed necessary, and he requested the attendance of Doctor 

 David Hosack. 



The patient is wholly at a loss to assign any cause for the existence 

 of the alarming complaint under which he labours. He arrived in this 

 country in the year ] 796, and, with the exception of occasional slight 

 attacks of cold affecting his chest, his constitution, previous to the year 

 1798, had never been impaired by disease, and he had uniformly enjoyed 

 excellent health. He was accustomed to the promiscuous use of animal 

 and vegetable diet, and his digestive powers were vigorous. In the 

 summer of 1798, during the prevalence of the malignant yellow fever, 

 in this city, he contracted this febrile disease, from which he with great 

 difficulty recovered. In his case, the yellow fever exhibited its most 

 striking characteristic symptoms ; and the affection of his stomach was 

 so severe, that he laboured under the black vomit and hiccup for many 

 days : the black vomit, which was similar in its appearance to coffee 

 grounds, was arrested by the free use of lime water and milk, and 

 lime water and porter ; then a novel mode of treating this distressing 

 symptom, and first introduced by Dr. Hosack. Since that time the 

 patient has not enjoyed his wonted share of health ; though he resumed, 

 and, with scarcely any intermission, continued engaged in his profes- 

 sional business, that of a blacksmith, his constitution he represented to 

 be more nervous than formerly. On account of inattention to dress,, 

 and exposure to cold, he has also,, since that period, suffered repeatedly 

 and severely, from inflammatory affections of his chest; and in 1809 he 

 had an attack of haemoptysis, from which he lost a considerable quantity 



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