1 68 DISEASES Class II. i, 2 



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their chins, In any cough or difficulty of refpiration, fmce if they 

 Hip down in their bed the friction of the night-cap on the pil- 

 low is liable to dra^f the tape or ribbon under the chin too tight, 

 ?.nd fufFocate them. After the patient is greatly debilitated, fo 

 that no further evacuation can be admitted, and the difficult 

 breathing and cough continue, I have given four or five drops 

 of tincture of opium, that is, about a quarter of a grain of folid 

 opium, with great advantage, and I believe in feveral cafes I 

 have faved the patient. A greater quantity of opium in this 

 ftate of debility cannot be ufed without hazarding the life of the 

 perfon. This fmall quantity of an opiate fhould be given about 

 fix in the evening, or before the accefsof the evening paroxyfm, 

 and repeated three or four nights, or longer. 



There is -a peripneumony with weak pulfe, which may be 

 termed peripneumonia inirritata, as defcribed in Seel:. XXVII. 2. 

 which belongs to this place. See alfo Superficial Peripneumo- 

 ny, Clafs II. 1. 3. 7. 



Peripneumonia arthritica. Gouty peripneumony. I believe, 

 that there exifts a peripneumony, and a pleurify which owe their 

 inflammation to the fympathy of thofe membranes with fome 

 other parts of the fyftem, and may then properly be termed 

 rheumatic or gouty peripneumony, or pleurify. And that the 

 coagulable lymph left upon the inflamed membranes has gener- 

 ally been owing to thefe fympathetic inflammations, and that hy- 

 drops thoracis, and anafarca pulmonum are generally caufed by 

 gouty affections of the lungs, or rheumatic affections of the pleu- 

 ra, and not by the more common idiopathic inflammations of 

 thofe membranes. See Clafs I. 2. 3. 14. and Clafs IV. 1. 2. 

 16. and Clafs IV. 1. 2. 9. 



Peripneumonia trachealis. Croup. The croup is an inflam- 

 mation of the upper part, and the peripneumonia of the lower 

 part of the fame organ, viz. the trachea or wind-pipe. See 

 Clafs I. 1.3. 4. But as the inflammation is feldom, I believe, 

 confined to the upper part of the trachea only, but exifls at the 

 fame time in other parts of the lungs •, and as no inflammation of 

 the tonfils is generally perceptible, the uncouth name of cynan- 

 che trachealis fhould be changed for peripneumonia trachealis. 



Dr. Wichmann, of Hanover, believes, that the acute afthma, 

 of Millar, or hives, has been confounded with the angina polypofa, 

 or croup, which h?s occafioned the great difference in the treat- 

 ment recommended by authors ; as the difeafe has been efleem- 

 ed inflammatory by fome, and fpafmodic by others. 



The convulfive afthma, which I have witnefled in one child, 

 was readily diftinguiihed from the croup ; as there was fimply a 

 great exertion in breathing, but without the harfh found which 



attends 



