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not altogether disiimilar in that distinguishingcharacter, the constriction whicli the thorax fusi fers Upon accelerated motion, and where there was reason to suppose, from the symptorias, thalmost of the thoracich and abdominat viscera mere
in a morbid state, nothing of this kind appearedon dissection but a smali ossification in one of themitrat valves of the heari, some additional quantity of moisture in the pericardium, some in thecavlty of the thorax, and of the abdomen; butthe whole surface of the body was drenched, asit were in Water; a generat ana arca Covering
both the trunk and limbs, with an ulter inabilityto move Without feeling a very sharp strictureabout the thorax:
This circumstance induced me to request thegentiemen, Who opened the body, to attend tothe condition of the heari, With ali possibie accu- racy; and it appears froin the Preceding account,
that nothing preternatural Was therein observed, excepi, On the OutWard muscular part near thensex, a sim ali Whi te spol as big as a siXpence, resembling a cicatrix. Another circumstance likewi se induced me toinquire more particularly after the condition of the heari, Whicli is, that I have very sel dona metwith this diseasse, but it Was attended with an irregular and intermittent pulse, not only during the exacerbations, but osten When the patient Wasseee stom pain and at rest. No doubi, as there are no tWo human hodieq
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of symptonas; but there is one in this singular distemper, that, so sar as I have seen, alwaysmariis it distinetly, whicli is, that saup constrictive patia acrosis the breast, whicli always supervenes a certain degre e Os mus Ular motion, or whatever agitates the nervo us system. For the moti pari, the patient can Walli a certain pace; is he exceeds this, he is stopped: is he rides on horseback, it is the fame; he canbear the horse to walli, or trot; but is he quickens this motion beyond a certain pollit, he is obliged to stop. This is a constant attendant os
ali the cases I haVe seen. Is we consider the appearances of the presentcase on dissection, we may perceiVe there arethree whicli are evidently preternaturat :1. The quantity of fluid in the thorax; et . The unus ual quantity of tat on the media sinum, the pericardium, and omentum ; and , 3. Thescar-like appearance on the heart. The inflammatory appearange in the stomach, the litile protuberance on the liver, do not amount to any
thing like causes produective of such e Tects. The consequences of the increased quantity ofa watery fluid, and fiat in the breast, would doubi
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rably, especialty in an upright and decumbent posture, and would somelimes impede, somelimes accelerate the motion of the blood through the
heari and lungs considerably. This preternatural fui nesse of the thorax andi appendage to the diaphragna; though they assisti iis in part to account for the disease, yet stemi not to be the only causes of this distemper. Times and future opportunities must insorin us of thei test. However, the facts discovered on the disiection of this body, evidently suggest to us a nearer aP- proach to reas nable indications os cure. Onil reviewing severat of these cases which have fallens iander my observation, I thinla they have genet ratly attended persons Cho were disposed to bet corpulent; it is there re not Unreas nable tot suppose, that a part of their disorder has arisent Dom a deposition os salty matter in some paris of the thorax, Whicli, by hiridering the expansion of the lungs, interrupting the natural Dee action of the heari, and perhaps by pressing too much on me branches of nerves, distributed to these paris for the most necessary purposes of lise, is they are not the principat, yet are they among the causes of this diseasse. The collection of water in the thorax, contributes to the fame enda and it is not improbabie, but that in future dinsections these three preternatural appe aranCeswill be found : the substance of the heari itselfaffected ι Water in the thorax ; and an increasset of sat both in the thorax and abdomen.
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1 everat means employed for this purpose, os thaharine es pecialty : Anil to prevent the accumulation of fat. Thistast may be a disticuli task, and requires great circumspection, considering the time of life towhicli this dis asse is mosto peculiar. The case whicli I fircto saw, was in a person os that time of lisse, Which would have admitted officii a regimen as most commonly reduces the very COrPUlent to a competent siete. Past themeridian os lise, to conquer this tenden cy, might be both dicticuli and hazardotis. An exadet tem .perance in diei and in liquors, seenas absolutoly necessary towards the cure of this dis asse, not sosar as to wealien, but so as to cui osF ali superfluity of nourishment, as the redundancy wohaldmost probably in creasse the distemper.
A strict vegetable diei reduces exuberant sat more certain ly than any other means I know. A
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applied to me for assistance in a great difficulty of breathing, somnolency, and incapaci ty for any exercise. It was a hardship to be obliged to golip flairs, and at last to crosis the Boor of her
It seemed to me that mere Obesty Was her principat mala ly: indeed sine had no other complaint but such as apparently might be accounted forfrom this supposition. She was ordered to pur- sue a Vegetable diei, and in the summer to drin the waters at Scarborough. She consormed tothese directions, became more agile, tess fleepy, Iesi averse to exercisse. She walhed up the stes sat Scarborough from the spaw, a lassi of no litile difficulty to peopte much less encumbere l. ΙUrged a continuance of the same diei: me was
dissuaded from it by her frienda, and died os fat
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eto a Case of an Angina Pectoris.
in the twenty-seventh year of her age. She lest permisson with her sister, to be opened, is it was destred; the case was too singular to be neglected: ali the viscera were perseetly sound, but lardedwith sat beyond apprehension. In dividing the externat tegUments, we cut through at inches offat. She di ed suddenly. Some instances os a similar nature, in Whicli a vegetable diei has fas ely contributed to reduce
immoderate corpulency, induces me to thinkiliat a prudent triat in the case I am treating os would be adviseable. Perhaps a reasonable Use of Wine, not a generous one, should here be al-lowed, test the strength should be diminis1ed too much in proportion ; and is the power of absorption siould by this means fati, we may probablulose more ground , by the increasse of the serosa esluvies in the cavi ty of the thorax, than What wegain by subtracting the fiat.
All the means os increatag the thinner secretion si are eVidently potnted out as necessary, fronithis disiection ; and is to these we join sinali doses of chalybeates, or other medicines, and an abstinence from animal food, so far as the patient'shealth, siluation, and manner of life will admitos it, We are perhaps rendering ali the re ason ableassistance we cara, tili future discoveries mine Us helter ac quainted With the real causes of thi
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sonae circumstances relative to this distase, whichare here submitted to your consideration. H. R. Esq. aged 63, a gentieman rather inclined to corpulency, but active, and of a Very irritable habit, naiddling stature, and Desii complexion, employed in affairs that osten requiredattention and confinement, Uriting especially, complained to me three or sour years besore his death, that he osten found a dissiculty, or ratheran incapacity to walli up a moderate ascent,
especialty is he attempted to do it hastily. ΙΩon perceived that this obscure distase, which
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deavo tars to remoVe it, Was taking place. Ι ad-vised great temperance and moderation in diei, in drini ing, and application; to ride frequently, passi his summers in the Country, to sauia eVCrything that would agitate his spiriis, or depressthem: a gentie laxative medicine, and stomachbitter, to be continued for a sortia ight, and occasionalty to be repeated, promoted his generalhealth ; and his oWn care contributed greatly toprevent the increasse of this mala ly. In the summer of 177 , he sperat a seW Wecks at BUXton, where he bathed and drank the water, and re turned to t0wn in beller health than he had en-
diac draught, Which he found relieved hina, and pretiy osten some aloetic pilis, to prevent costive nessi; but pursued no Other plan of medicine, contenting himself with observin g, and with sonae degree os attention, the generat regulations I hadprescribed to him ; and though it did not appearthat much ground was hereby galned, the fame constri stion returning is he attempted any exercise beyonii a certain potnt, Whicli his own ex perience had taught him, yet he perceived noincreasse of the disse ase. He occasionalty Consulted me, but rather With a view to be confirmedin the plan proposed to him, than with a liope o obtaining effectual relies, as he Was Very apprehensive that he laboured Under the disse ase whicli
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The lungs were to ali appearance s Und. The heari to externat appearance Was also QUnd; but, Upon examination, I found that iis substance Was paler than common, more of a ligamentoUS consistence, and in many paris of thel est ventricle it mas become almost white and
osiification. I he vahulae mitrales had a vast number ossuch appe arances in them, and were less pliant than in a natural state ; but did not appear to beunfit for Use. The semiiunar valves of the aorta were thicher thala common, but Very readily filled the area os the artery.
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The aorta had severil smali ossifications on it, and severat White paris, Whicli are generalty the heginnings of ossifications, and which were similar to those found in the heari and GaIOes. The two coronary arteries, Dona their originto many of their ramifications Upon the heari, were become one Piece of bone. The abdominal visera appeared QUnd, CX-
many paris. Upon the fore-part of the falciformligament was a considerable os 1fication, whichlay between the anterior paris of the two hemispheres of the brain. The substance of the brain appeared to be verysound . There Was rather more mater in the ventricles than is common at that age ; and in generat, there was more Water abolit the brain than is
usualty found . The plexus choro ides had severat pretiy large hydatids in them, sime as large aS a Pea. The internat carotid and basilary artery Werebeginning to ossiff. There Was rather more blood abolit the brainthan usual ; but perhaps not more than what is common to those who maybe Did to die in health. The blood had not in the least coagulated in any part of the body, nor did it coagulate Uponbeing exposed, whicli is another caiise sor theappearance of more blood than usual, and also