h, the case seems to have been of this kind,
complicated with vertigo and consequent affection of the stomach. The
remote cause seems to have arisen from ossifications of the coronary
arteries; and the immediate cause of his death from fixed spasm of the
heart. Other histories and dissections are still required to put this
matter out of doubt; as it is possible, that either a fixed spasm of the
diaphragm, or of the heart, which are both furnished with but weak
antagonists, may occasion sudden death; and these may constitute two
distinct diseases.

Four patients I have now in my recollection, all of whom I believed to
labour under the angina pectoris in a great degree; which have all
recovered, and have continued well three or four years by the use, as I
believe, of issues on the inside of each thigh; which were at first large
enough to contain two pease each, and afterwards but one. They took besides
some slight antimonial medicine for a while, and were reduced to half the
quantity or strength of their usual potation of fermented liquor.

The use of femoral issues in angina pectoris was first recommended by Dr.
Macbride, physician at Dublin, Med. Observ. & Enquir. Vol. VI. And I was
further induced to make trial of them, not only because the means which I
had before used were inadequate, but from the ill effect I once observed
upon the lungs, which succeeded the cure of a small sore beneath the knee;
and argued conversely, that issues in the lower limbs might assist a
difficult respiration.

Mrs. L----, about fifty, had a small sore place about the size of half a
pea on the inside of the leg a little below the knee. It had discharged a
pellucid fluid, which she called a ley-water, daily for fourteen years,
with a great deal of pain; on which account she applied to a surgeon, who,
by means of bandage and a saturnine application, soon healed the sore,
unheedful of the consequences. In less than two months after this I saw her
with great difficulty of breathing, which with universal anasarca soon
destroyed her.

The theory of the double effect of issues, as above related, one in
relieving by their presence the asthma dolorificum, and the other in
producing by its cure an anasarca of the lungs, is not easy to explain.
Some similar effects from cutaneous eruptions and from blisters are
mentioned in Class I. 1. 2. 9. In these cases it seems probable, that the
pain occasioned by issues, and perhaps the absorption of a small