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509 
«< circumftances have frequently occurred in the cafe of urinary 
« calculi palling the ureters, in which I have found it neceffary to 
*< employ opium and blood-letting at the fame time. 
" In like manner as opium is ufeful in moderating excretions, fo 
« when the irritation occalions an increafe of thefe excretions, which 
ded with affedions which irritate the whole fyftem, 'opium 
becomes efpecially ufeful. , Hence it becomes fo generally ufeful 
" in catarrhal affections, and the cough attending them ; and 
g mem ; ana pr 
bably it is this analogy that has brought the ufe of opium to be 
" frequently employed in pneumonic inflammations. It is poflible 
" that there may be cafes of fuch inflammations wherein the opium 
may be more ufeful in taking off the cough, than hurtful by agg 
« vating the inflammatory ftate of the fyftem : but I have hardh 
" met with fuch cafes ; and even in the recent ftate of catarrhs from 
cold, I have found the early ufe of opium hurtful : and in cafes of 
pneumonic inflammation, I have always found it to be very much 
fo, if exhibited before the violence of the difeafe had been mode- 
■ 
rated by repeated blood-letting. When that indeed has been done, 
I have found the opium very ufeful in quieting the cough, and I 
have hardly ever found it hurtful by flopping the expe&oi 
It may fufpend this for fome hours; but if the glands of the 
bronchia have been duly relaxed by bleeding, and bliftering, the 
expectoration after the ufe of opiates always returns with more 
advantage than before. The mucus which had iffued before had 
been poured out from the follicles in an acrid ftate ; but, by being 
made to ftagnate, it becomes milder, and is difcharged in what the 
ancients called a concocted ftate, with more relief to the lungs." * 
When opium is fo managed as to procure fweat, it will tend to 
remove an inflammatory ftate of the fyftem, and may prove generally 
ufeful; a notable inftance of this we obferve in the cure of acute, 
rlieumatifm by means of Dover's powder. 
In the fin all pox opium, fince the time of Sydenham, has been 
very generally and fuccefsfully prefcribed, efpecially after the fifth 
fcay of the difeafe ; but during the firft ftage of the eruptive fever 
we are told that it always does harm ; an opinion which our experience 
at the Small-pox Hofpital warrants us to contradict : for even at tha 
y 
I 
Cullea /, 
period 
