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without haetard ; it may abate a litile of that inflammatory disposition, Whicli is the consequenCC of continued irritation. It Would, perhaps, at tengili contribute to remove this hincertainty, is those who are appliedio on these interesting emergencies, would consider thenaseives as obliged by the honour of their profestion, and the ties of humanity, to note Withali possibie precision and impartiality every incident in the progress of this disease ; arad, whether they pursue the hinis here suggested, or talie up more rational ones from their own store, Would Communicate the result to the public. By this method the field of conjecture Would be contracted, and our succesors directed to new objects of investigation. The result would be notlesse honourable to those who engage in the search, than beneficiat to mankind in generat.
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a gentieman aged about fifty-eight, os a sigeabove the middling, his complexion rather Dirand sanguine than Marthy, plump and fuit, dinposed to corpulency, but not so as to render him infit for any kind of exercise. For the most part he had ei oyed very good health during the greatest part of his life, whichwas active, regular in common, temperate as to
. Medicat Observations and Inquirier, vol. V. P. 233.
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aso Case of an Angina Pectoris.
enti rely, though the intervals of the severer at tactis were frequently pretiy long. For this complaint he had at sirst a blister on his head , whichwas Lept open severat monilis; and a terwardshad one ut on his bach, which Was also kept opena good while. He took at different times vale- 1 ian, with sali of hartshorn, lac ammoniacum, de cochion of the bark with Valerian ; but, exceptingilie bl isters, nothing appeared to give him any materiai relies.
the second volume of the Medicat Transactions; . a distase .whicli I had reo osten met Mith as it
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terminated sor the most pari fatally, and with out iis being in my pomer in one single instanceto leam froni disseetion the seat of it, or to acquire any satisfactory information os iis nature, Dom the most attentive recollectiosi of the sev rat symptOmS.It was in the evening When I saw the patient; and at that time he was free from any complaint,as he sat stili, His heat was moderate; his pulselassiciently fuit, but for the most part irregular; his appetite good; and the discliarges as theyought to be, only rather disposed lo costivenes s. He complained that his giddinest vias stilltroublesionae at times; but that a disorder, Whichfrequently affect ed his breast, especialty on motion, and occasioned much dissic alty in breathia in g, gave him the greatest Uneasinesse. That in Walking, is he either Went up thesightest acclivity, or endeavoured to Walli sester than a certain pace; or is the Wind was high, and mel him as he Wallied even moderately; hewas obliged to stop. He described ii as a Lindos stricture surrounding his chest, principalty ina line With the mammae, in such a manner as torender it impossibie to talie a step further Without the hagard os immediate suffocation; a sita , pungent patia most particularly affecting the parta under the lest breast, extending itself upwardson that fide, and down the inner part of the lest arm, to the et boW. These symptoms, 'on turn
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as a Case of an Angina Pectoris.
os their severity, and a caution to proceed more deliberalely.
an opinion, that his disorder might partalae of this malady. He had sound too, that eructations osten terminated his palns; and that nothing facilitated these discliarges so much as simple peP- permini-water: it was always by him in the night, and gave him ease even when a rea sonable dos eos a paregoric had been given without benefit. Willing to hope that this Case might partalle considerably of a gouty nature, and consequently that there Was sonae chance of relieving it, I pro-
posed such a plan, both os diei and medicine, as
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Twenty-five drops of theb. With a like quantity of Uin. antim. at night, and tela drops of the sanae tincture in a litile draught early in themoriaing, procured for a considerable time theappearance of much benefit. This however Wasnot latting; upon any litile exertiori of muscular force, the di sorder stili discovered itself, and withas much violence as at sirst. With a view to assist his generat health, whic seemed now to be much aTedted by the conti nu ance of these complainis, he drank the Bath-water at Bath severat weelis. Some more paln
of his immediate death, and whicli at lengthhappened very suddenly, in the moria ing of the 1 oth of May. The fami ly condescended to have him operaed, which was persormed by my ingenious frien is the Langleys, fallier and son, judicious surgeons in the ne ighbourhood; from Whom I received the
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the sollowing account, not being able, throughsonae prior engagemenis, to be present at thedissection.
with fat ; a quantity of Water under the lUngs, about a quart on cach side, thin and transparent,nearly resembling urine. The lungs in good condition, excepi on the Upper part of the right side there Was an adhesion to pleura, of abo ut an incli, but without inflammation. The peri- cardium, on the ouiside, lotaed with a large quantity of suety fat, but more so on the lower side, nexi the di aphragm. The lymph in the insideabout the usual quantity. The heut of the usualsae. The auricles and ventricies With ait thevesseis and valves perfecto ; not the least ossification or appearance of disease, excepi on the out-ward muscular pari, near the apex, a smali white spol, as big as a siXpence, resembling a cicatrix. In the ABDOMEN. -The peritoneum persech. The omentum much enlarged and thichened, atteast: six times iis natural thiclines s. The fat ofa yelloW appearance, and much firmer than usual,
very hewy, and the loWer pari adhering to the
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He was rather of a loW stat ire than tali, amori necla, strong, temperate, and accustomed toregUlar, but not violent, exercise. Without any
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as 6 Cas of an Angina Pectorii
motion when his stomach was empty. From thedescription of the pain, iis course, whicli Wasacrost the breast, and doWn both arnas to theelbows, Ι could not forbear suspecting the fixilipair of nerves and their numerous connections
were the seat of this disease; that sonae irritatingCause, excited by motion, affected them; and that the paris they were principalty distributed to, suffered in consequence. The lungs did not appearto be affected ; no preceding cough or symptomsos inflammation, no Catarrhal deflUXion, no appearance of a dropsy of the thorax, nor any fugitive acrimony, that seemed capable os producingsuch sensations, had taken place. I recommended a sparing diei, to keep the
back ; not to talie long or fatiguing wallis. Helook s me pilis of soap, pil. gummos cinnab. natiυ. and a light chalybeate bitter for sonae monilis. Aster illis, he went to Bath severat successive sea- sons, and acquired his usual health. This is the only instance that has occurred tome of a perfect recoVery frona this obscure, and too osten fatal malady. Some have been muchrelieved sor a considerable time, and I have heardnothing farther concerning them; but for themost pari, is the distase attacks them late in lise, the prognostic is uni avoUrabie. Perhaps it will be dissiculi to account sor thesymptoms attending this dis easse satisfactorily, from the appearances on dissection. In a case