enting the paroxysms by decreasing the sensibility of the system. This,
I am informed by Dr. Beddoes, has been used with decided success by Dr.
Ferriar. See Class II. 1. 1. 7.

11. _Asthma dolorificum._ Angina pectoris. The painful asthma was first
described by Dr. Heberden in the Transactions of the College; its principal
symptoms consist in a pain about the middle of the sternum, or rather
lower, on every increase of pulmonary or muscular exertion, as in walking
faster than usual, or going quick up a hill, or even up stairs; with great
difficulty of breathing, so as to occasion the patient instantly to stop. A
pain in the arms about the insertion of the tendon of the pectoral muscle
generally attends, and a desire of resting by hanging on a door or branch
of a tree by the arms is sometimes observed. Which is explained in Class I.
2. 3. 14. and in Sect. XXIX. 5. 2.

These patients generally die suddenly; and on examining the thorax no
certain cause, or seat, of the disease has been detected; some have
supposed the valves of the arteries, or of the heart, were imperfect; and
others that the accumulation of fat about this viscus or the lungs
obstructed their due action; but other observations do not accord with
these suppositions.

Mr. W----, an elderly gentleman, was seized with asthma during the hot part
of last summer; he always waked from his first sleep with difficult
respiration, and pain in the middle of his sternum, and after about an hour
was enabled to sleep again. As this had returned for about a fortnight, it
appeared to me to be an asthma complicated with the disease, which Dr.
Heberden has called angina pectoris. It was treated by venesection, a
cathartic, and then by a grain of opium given at going to bed, with ether
and tincture of opium when the pain or asthma required, and lastly with the
bark, but was several days before it was perfectly subdued.

This led me to conceive, that in this painful asthma the diaphragm, as well
as the other muscles of respiration, was thrown into convulsive action, and
that the fibres of this muscle not having proper antagonists, a painful
fixed spasm of it, like that of the muscles in the calf of the leg in the
cramp, might be the cause of death in the angina pectoris, which I have
thence arranged under the name of painful asthma, and leave for further
investigation.

From the history of the case of the late much lamented John Hunter, and
from the appearances after deat