THE TREATMENT OF COUGH 93 



spray, gargle, or inhalation. Similar treatment proves 

 beneficial in the later stages, by lessening congestion or by 

 exerting antiseptic effects. The washing out of the nostrils 

 is conveniently done by an ordinary syringe, by Higginson's 

 enema apparatus or by Key's nasal funnel. 



COUGH is a modified, usually involuntary, respiratory act, 

 whereby gaseous, liquid and solid substances are forcibly 

 removed from the air-passages. This sudden expulsive 

 expiratory effort is brought about by faulty mucus or other 

 irritant, lodged in the pharynx or larynx, by irritation of the 

 lower air-passages, and reflexly, by impressions produced on 

 surfaces other than the respiratory mucous tract, as by cold 

 applied to the skin, or by nasal, buccal, pleural, gastric, or 

 hepatic irritation. 



Soothing gargles and electuaries, even if they do not actu- 

 ally reach the seat of irritation, frequently abate cough. 

 Mechanically acting mucilaginous or saccharine substances 

 may be rendered more effectual by combination with mor- 

 phine, which diminishes irritability of the respiratory centre, 

 and decreases secretion of mucus. The latter result is still 

 more notably effected by atropine. A combination of these 

 alkaloids is hence specially valuable where there is trouble- 

 some cough and profuse secretion of mucus. A some- 

 what different effect is obtained by conjoining morphine 

 and apomorphine, which, with diminished excitability of 

 the respiratory centre, produce increased bronchial secre- 

 tion, and are hence serviceable where there is cough, 

 and the membrane is dry, or coated with thick, sticky 

 mucus. 



A comfortable loose box, with abundance of pure fresh air, 

 at a temperature of about 60 Fahr., in several ways benefits 

 the patient suffering with respiratory disease. More perfect 

 aeration of blood is secured, while the cool, pure air, more- 

 over, contracts dilated vessels, combats congestion, and 

 hence will often remove cough, especially when depending 

 upon irritation of the larynx, trachea, or larger bronchi. 

 But while in many stages of respiratory disease the breathing 

 of cool air is grateful and beneficial, draughts and cold must 

 be scrupulously guarded against, and the body and legs of 

 the patient kept comfortably warm, with extra covering, in 



