Angina Pharyng.AEa. This species is particularly rare. It is described by Eller, De Cognoscendis et Cu-randis Morbis; and a case of it occurs in the third volume of the Medical Commentaries. The pain is felt behind the sternum, in swallowing only, and the breath is not affected. The cure is easy, and consists in swallowing slowly nitrous and mucilaginous medicines. The complaint is uncommon and trifling.

Angina spasmodica. See Asthma.

Angina pectoris. For the first account of this disease, the world is indebted to Dr. Wm. Heberden of London.

The patient is seized whilst walking, and more particularly if he walks soon after eating, with a painful sensation in his breast, extending to his arms; at first no further than the insertion of the deltoid muscle, but in succession to the elbows, wrists, and fingers' ends; the moment he stands still, this uneasiness vanishes: but, after this complaint hath continued some months, it does not cease so suddenly after resting; it will now come on even while the person is in bed, obliging him to rise every night for several months together. In some inveterate cases it hath been brought on by very trivial accidents, such as coughing, going to stool, by swallowing, speaking, or from any slight disturbance of mind. Sometimes, though rarely, it attacks while the patient stands or sits still. In some persons it is the worst in winter, in others during the summer season. When a fit approaches whilst the patient is walking, its duration is short; but if it comes on in the night, it will continue an hour or more. Sometimes, though rarely, there are several days before any remission is manifest; and, during this time, the danger is imminent. The pulse is, at least sometimes, not disturbed with the pain, consequently the heart is not affected by it.

Persons of fifty years of age and upwards, of gouty habits, with short necks, and who are inclined to be corpulent, are the most subject to this disease; it is, though rarely, met with in those who are younger.

The fatal event is generally sudden: yet some continue affected with it for twenty years; and in some it almost spontaneously disappears.

The seat seems to be in or about the sternum, but always more to its left side than to any other part; and the pain is more common in the left arm.

The cause is most probably a spasm, or convulsion, as appears from its sudden attack and speedy departure, the long intervals of"ease, the relief afforded by wine and spirituous cordials, its generally bearing the motion of a horse or carriage well, and its coming on in the night after the first sleep; at which time asthmas, the nightmare, convulsions, and other disorders attributed to the disturbed functions of the nerves, are peculiarly apt to return, or to be aggravated.

Dr. Parry has lately endeavoured to show, that the disease arises from an ossification of the coronary arteries of the heart; but, in general, it may be remarked, that it attends persons of advanced life, where such ossifications are not uncommon; and that we can perceive no connexion between the effect and the cause. If the functions of the coronaries were impaired, we may expect only a mortification, or a washing of that organ. In his dissections also, it has been observed, that, in the only case where ossifications were found, the disease was obscurely marked; while the others, more certainly cases of angina pectoris, offered no such appearance. In general, ossifications have been found near the valves, and in almost every portion of the heart or larger vessels; yet these are evidently effects only.

With regard to the cure, evacuations have been tried, but to no purpose; though wine and other cordials, taken at bed-time, will prevent or weaken the night fits, yet nothing does this so effectually as opium; ten, fifteen, or twenty drops of the tincture of opium taken at bed-time, will enable those patients to keep their bed until the morning, who have been forced to rise and sit up two or three hours every night for many months. A blister applied to the sternum, and kept open with nervous medicines, particularly the bark and valerian; and sometimes the preparations 'of copper seem to be most effectual; and, unless the disease be supposed to have vanished spontaneously, have cured it. Dr. Macbride advises issues in the thighs, with small doses of calomel; but this plan has either not been tried, or been unsuccessful. This quantity of opium, or more, may safely be continued as long as it is required. Dr. Bergius, a Swedish physician, says, that this disorder is a kind of spasmodic asthma, and that it is relieved by a solution of gum. ammon. ss. in aq. puleg. vel hyssop, ss. two spoonfuls to be taken two or three times a day. See the Lond. Med. Trans, vol. ii. p. 59. iii. I. 37. Medical Obs. and Inq. v. 233. 252. London Med. Journal, v. 162. Memoirs of the Medical Society of London, 238. 306.