fpirable diet; and reftrained him from all vifcid, flatulent, and acrimonious articles. By pursuing this course, he was foon apparently mended; but, after he had perfifted regularly in it for at least two months, he kept for fome time at a stand. I then ordered a large iffue to be opened in each of his thighs. Only one was made. However, as foon as it began to discharge, his amendment manifeftly increafed. The frequency and severity of the fits abated confiderably; and he continued improving gradually until, at the end of eighteen. months, he was restored to perfect health; which he has enjoyed, without the leaft interruption, till now, except when he has been tempted (perhaps once in a twelvemonth) to tranfgrefs rules, by making a large meal on falted meat, or indulging himself in ale, or rum-punch; each of which never failed to disorder him from the beginning of his illness; and, even on these occafions, he has felt no more than the flightest notion of his former fufferings; infomuch, that he would defpife the attack, if it did not appear to be of the fame ftock with his old complaint. No other caufe has had the leaft ill effect on him.

Though rum was conftantly hurtful, yet punch made with a maceration of black currants

in

in our vulgar corn fpirit, is a liquor that agrees remarkably well with him.

He never took any medicine after the iffue began to discharge; and I have directed that it fhall be kept open as long as he lives. The inflammations of his throat have difappeared for five years paft; he has recovered the strength and clearness of his fight; and his health seems now to be entirely re-established.

Doctor Macbride, in a letter to Doctor Duncan, gives the following additional obfervations on the angina pectoris.

Within these few weeks I have, at the defire of Doctor Smyth, visited, three or four times, a very ingenious man who keeps an academy in this city, of about 34 years of age, who applied to the Doctor for his advice in January last.

I fhall give you his fymptoms as I had them from his own mouth, which appear to me to mark his cafe to be an angina pectoris, and as deplorable as any that I have read of. It was ftrongly distinguished by the exquifite conftrictoVOL. V. No. 17.

G

ry

ry pain of the sternum, extending to each of his arms, as far as the insertion of the deltoid muscle; extreme anxiety; laborious breathing; ftrangling; and violent palpitation of the heart, with a moft irregular pulfe. The paroxyfmns were fo frequent, that he scarcely ever escaped a day, for fix or seven years, without one. They were usually excited by any agitation of mind or body, though flight. He had clear intervals of health between the fits. The diftemper feemed hereditary in him, as he fays his father was affected in the fame manner fome years previous to his death. He has a ftrong gouty taint, which never fhewed itself in his limbs; and he has led a life of uncommon fedentarinefs, from intense application to mathematical ftudies, attention of mind, and paffion, even from his boyish years. Thefe circunftances may, perhaps, account for his having been taken with this disease at so early an age as feventeen.

A large iffue was immediately opened in each of his thighs. In a month afterwards, he began to mend, and has gone on improving gradually. He can now run up ftairs brifkly, as I faw him do no latter than yesterday, without hurt; can bear agitation of mind; and has no complaint,

excepting a flight oppreffion of the breast, under the fternum, which he feels fometimes in a morning, immediately after dreffing himfelf; and which, he thinks, is brought on by the motion used in putting on his cloaths; though, for a compleat week preceding the day on which I faw him laft, he told me, that he had been entirely free from all uneafinefs, and was exulting, that he had not had fuch an interval of ease for these last seven years.

Doctor Smyth alfo fhewed me, in his adverfaria, the cafe of a gentleman who had been under his care in 1760, which he had forgotten when my book went to the prefs, and which he was reminded of the other day, by a vifit from his patient. It was a genuine angina pectoris, brought on by a very fedentary life, and great vexation of mind, clearly marked by the exqui fite pain under the fternum, that extended a cutely to the upper extremities, particularly along the left arm, together with the other symptoms of dyspnoea, anxiety, palpitation of the heart, &c. recited in the cafe above. The diforder went off in 1762, by large fpontaneous discharges from the piles, but returned upon him feverely in 1765. Iffues in his thighs were then recommended to

him, but not made. But, whether it was by the perfuafion of fome friend, or of his own accord, he went into a courfe of James's powder, in small alterative dofes, combined with a little caftor and affa foetida. This he perfifted in for about fix weeks; in the meanwhile, he had large acrimonious gleetings from the scrotum, and a plentiful discharge of ichor from the anus. From this time he began to find his complaints grow less and lefs diftreffing, and he has now been totally free from them for fix years past.

Here, then, you see a perfect cure performed by an antimonial alterative, and a copious dram. The caftor and affa foetida could have no share in it; for the most powerful nervous medicines had been ineffectually used before in large doses, fo that the fuccefs and efficacy of this practice appear to be now fufficiently established.

**

Mr Cruikshank, in a letter to Doctor Duncan, has the following observations respecting offifi

cation.

Doctor Hunter used to send round, at lectures, a preparation of the patella, in which he demon

ftrated,