CHAMBERS'S INFORMATION FOR THE PEOPLE. 



possible by nutritious diet, bathing, exercise in the 

 open air, and attention to the choice of digestible 

 articles of food. He should eat frequently, and 

 little at a time ; above all, avoid late suppers. 

 During the attack, admit air freely into the room. 

 The remedies for asthma are numerous, and 

 should be taken only with medical advice. 



4. The Lining Membrane of the Chest. The 

 chest is lined by a delicate and smooth membrane 

 called the pleura, which is reflected over the sur- 

 face of each lung. There are thus two pleural 

 spaces, one for each lung ; but in health there is, 

 in reality, no space, the pleural surface of the lung 

 always coinciding with, and gliding upon, the 

 pleural surface of the wall of the chest. When 

 this membrane is inflamed, we have a disease 

 called pleurisy. As in pericarditis, inflammation 

 first renders the membrane dry and hard ; after- 

 wards, it becomes covered with a layer of matter 

 called lymph, and serum may be exuded so as to 

 separate the two pleural surfaces. The quantity 

 of serum thus exuded may be very small, or there 

 may be many pints of fluid. This latter condition 

 is called hydrothorax, or water in the chest. The 

 fluid may become absorbed, in which case the 

 pleural surfaces frequently adhere together. At 

 other times the serum may become purulent, when 

 we have empyema, or pus within the chest. This 

 accumulation of pus may become absorbed ; or it 

 may pass into the lung, and be coughed up ; or it 

 may escape by an opening through the walls of the 

 chest. Pleurisy is not usually a fatal disease, but 

 it requires skilful medical treatment. The symp- 

 toms are well marked. The most distinctive are 

 an acute pain in the side, called a stitch, limited 

 to one spot, which is aggravated by deep inspira- 

 tion or coughing. There is feverishness. On 

 placing the ear over the chest, a peculiar rubbing 

 or crackling sound is heard, produced by the fric- 

 tion of the roughened pleural surfaces. When 

 fluid accumulates, this sound disappears, and the 

 chest may bulge out on one side. The patient 

 instinctively prefers to lie on the affected side, so 

 as to allow the healthy lung to act freely. In the 

 early stage of pleurisy, apply hot poultices or 

 fomentations to the chest, and send for a doctor. 



5. The Lungs. Acute inflammation of the 

 lungs is called pneumonia. It is divided by 

 physicians into three stages. In the first stage 

 the lung becomes congested with blood. The 

 patient is feverish, has difficulty in breathing, and 

 suffers from pain in the side, more diffused over a 

 surface than that of pleurisy, which is limited to 

 a spot. There is cough, with expectoration of 

 viscid mucus, tinged with blood so as to have a 

 rust-colour. In the second stage, the lung loses 

 its healthy spongy character altogether, becoming 

 hard and solid. The third stage is characterised 

 by diffuse suppuration of the lung tissue. The 

 sputa then becomes quite purulent. Pneumonia 

 of a portion of one lung is not usually a fatal dis- 

 ease if it occur in a young and vigorous adult ; 

 but when uncomplicated, tends towards recovery 

 on or about the fourteenth day from the beginning 

 of the attack. If the disease occur in an aged 

 person, or in one whose constitution has been in 

 any way debilitated, the result may be death. 

 The disease may affect one lung or both : inflam- 

 mation of even a portion of both lungs is, of course, 

 a more serious affection than inflammation of one. 

 The right lung is oftener affected than the left, 



774 



and the bases of the organs are oftener inflamed 

 than their apices. The disease is usually compli- 

 cated with bronchitis, and occasionally, when the 

 disease affects the superficial parts, the pleura 

 becomes involved, and we have then a case of 

 pleuro-pneumonia. The treatment of this disease 

 has undergone a great change in recent times. 

 Twenty or thirty years ago, patients were freely 

 bled, and were subjected to the action of strong 

 salines, tartar emetic, mercury, and other debili- 

 tating drugs. Now, however, with the view of 

 conducting the disease to a natural termination, 

 and to ward off complications, the treatment 

 may be described as consisting chiefly in the 

 administration of a nutritious and easily assimi- 

 lated diet, such as good beef-tea, along with a 

 moderate allowance of stimulants. Small doses 

 of sweet spirits of nitre, along with acetate of 

 ammonia, are given to allay feverishness (No. 9). 

 In this respect, there has been a great improve- 

 ment in practice, and a considerable decrease in 

 the mortality of the disease. In the early stages 

 of the disease, apply hot fomentations, or, still 

 better, poultices made of oatmeal, linseed meal,, 

 or bran, so large as even to enwrap the chest. 



Phthisis, or Consumption. The disease we have 

 now to describe is, unfortunately, very common in 

 the British Islands, nearly one-fourth of the total 

 number of deaths occurring in one year being due 

 to it. Phthisis may be hereditary, or it may be 

 acquired by habitual exposure to impure air, ex- 

 cessive study, the use of a non-nutritious diet, in- 

 temperate or unchaste habits, or by any cause 

 which weakens the vital energy of the body. It 

 may occur in all ranks, and at all ages ; but it is 

 much more frequent before than after forty years 

 of age. In most cases, it runs its fatal course in 

 from twelve to twenty-four months ; but occasion- 

 ally it proves fatal in twelve, eight, or even six 

 weeks. The morbid change in the lung which is 

 at the root of the disease, so far as this organ is 

 concerned, is the formation in the tissues around 

 the ultimate air-cells, and even in the cells them- 

 selves, of tubercle. Some pathologists main- 

 tain that this substance is due to the presence 

 of microscopic organisms called bacilli; others 

 that it originates in an exudation from the blood, 

 or is a morbid development of part of the lung 

 tissues. It appears at first in the form of small 

 round, grayish masses like millet-seeds, and is 

 then called miliary tubercle. These are usually 

 deposited in the apex of the lung, which is 

 beneath the collar-bone. The disease rarely com- 

 mences in the lower lobes of the lung. The 

 masses fuse together, and undergo a sort of fat 

 degeneration or change, so as to form a matt 

 like friable cheese, of a yellow colour. The pre 

 ence of this morbid product in the lung excite 

 inflammation and suppuration, the tubercular 

 matter softens and breaks down, the tissues 

 around it become more or less ulcerated, and the 

 de'bris is coughed up, leaving cavities behind 

 various sizes, from that of a split pea to that of ; 

 orange. These cavities may contract and cor 

 pletely heal up, leaving a cicatrix ; but, unforti 

 nately, the disease advances by fresh tuberculs 

 matter being deposited in an adjacent part 

 the lung. The symptoms are : failure of 

 general health, loss of appetite, a strong dislil 

 to fat in any form in the food, a short 

 cough, and a quick pulse. In some cases, the 



