A, 



1 70 DISEASES Class II. 1. 2. 4* 



of expiring, requires to be further explained. During infpira- 

 tion, the preffiire of the' atmofphere, when the cavity of the 

 cheft is enlarged by raifing the flernum, and depreffing the dia- 

 phragm, acts upon the external part of the larynx, us well as on 

 the aperture of it, and thus contracts it, and affifts the difeafe ; 

 whereas in expiration there is no increafe of atmofpheric pref- 

 fure on the outiide of the larynx, or trachea, to prevent the ex- 

 clufion of the air. In the fame manner, if a flexible pipe of foft 

 leather was extended upwards a few inches through the bottom 

 of a bucket of water, but very little of the water could be dis- 

 charged by it j as the preffiire on its fides would foon comprefs 

 the pipe, and thus (top up its mouth. 



After repeated venefeclion, and a cathartic of calomel, a blif- 

 ter was applied on each fide of the larynx, and the difficulty of 

 breathing became greatly relieved ; and though the child had in- 

 tervals of eafier reipiration, and without noife, yet it died on the 

 fucceeding day. 



Where the difficulty of breathing is very urgent in the croup, 

 bronchotomy is recommended by Mr. Field. Memoirs of a 

 Medical Society, London, 1773, Vol. IV. 



After repeated venefeclion, and cathartics, perhaps a drop or 

 two drops of tincture of opium, about fix in the evening, might 

 be of ufe to prevent the return of the evening paroxyfm, and this 

 efpecially if the difficulty of refpiration has an interval or remif- 

 fion, as mentioned below. 



A ilrong decoction of feneca root is recommended by Dr. 

 Archer, of America. He boils half an ounce of the root, from 

 eight ounces of water to four,* and gives a tea-fpoonful every 

 hour or half hour, fo as to produce vomiting or purging, and. 

 then gives it in fmaller quantities. He alfo rubs mercurial 

 ointment about the throat, and ufes calomel internally, fo as to 

 affect the glands of the throat as quickly as poffible, when the 

 difeafe is more advanced, and the difficulty of breathing with 

 harih and fhrill inspiration is more urgent. Medical and Physic- 

 al Journal, No. I. p. 83. Asa decoction of feneca root partic- 

 ulary ftimulates fome parts of the throat, occafioning a difagreea- 

 ble testation in it, it may in fome cafes contribute to loofen or- 

 difcharge the adhefive coagulable lymph, which has been fecre- 

 ted on the inflamed membrane of the wind-pipe, and occasions 

 the difficulty of inspiration by contracting its aperture ; and 

 may therefore be worth trial after repeated venefection, and 

 cathartics, and biifters on each fide of the throat. 



Dr. Wichmann oi Hanover, above mentioned, afferts, that in 

 the croup the difeafe continues regularly to increafe, from the 

 commencement of it, without intervals of relief from the great 



difficulty 



