66 PRACTICE OF MEDICINE. 



the bronchi ; the different varieties of emphysema and oedema of 

 the lungs; haemoptysis ; tubercular deposits, with which asthma 

 may be associated from its commencement ; hypertrophy and dilata- 

 tion of the cavities of the heart ; atrophy oC the heart ; effusions 

 into the pericardium ; effusions into the pleura ; and, in some severe 

 cases, congestions or effusions within the head, giving rise to coma, 

 or apoplexy. 



Treatment. — The indications during the interval are, to strengthen 

 the general health, and avoid all derangement of the stomach by im- 

 proper diet, and irritation of the lungs by unwholesome air. 



The treatment of the fit consists in administering narcotics and 

 antispasmodics. These should be given, if possible, as soon as the 

 Jimt sensations are felt, and then they may avert the attack ; and it 

 is noticed, that those do most good which produce expectoration. 

 Strong coffee; laudanum and ether; and stramonium smoked as 

 tobacco, are the most trustworthy. Ipecacuanha first given in an 

 emetic dose, and afterwards in small quantities, so as to keep up a 

 constant nausea, sometimes has a powerful effect on spasmodic asth- 

 ma. The tincture of lobelia injiata (Indian tobacco) is much used 

 in asthmatic cases ; it is nearly allied in its operation to stramonium 

 and tobacco, and often succeeds in checking the paroxysm when 

 given shortly before its invasion. Bloodletting is only required if ' 

 there is inflammatory complication. 



DISEASES AFFECTING THE TISSUE OF THE LUNGS. 



PNEUMONIA. 



Pneumo?iia consists in an inflammation of the parenchyma of the 

 lungs, and, according to the changes produced in the tissue, is 

 most commonly divided into three stages. 



Three stages. — The Jirst stage of pneumonia is the stage- of en- 

 gorgement, in which the organ is found intensely loaded with blood ; 

 the second^ is the stage oi" hepatization ; in which it is solidified by 

 an effusion of lymph : the third, is the stage o^ purulent softeni?ig, 

 or suppuration. 



Pneumonia may be single or double ; in other words, it may attack 

 but one lung or both at the same time. In one and the same lung 

 it may be general or partial, attack the upper or lower lobe, be con- 

 fined to the base, the root, or the centre {lobular pneumonia). It 

 has been said, that all these different seats of pneumonia have been 

 equally frequent. Some numerical results will settle the question. 

 Out of two hundred and ten pneumonias, there were — 



On the right side 121 



" left side • 58 



Both sides {double) 25 



Cases where the seat could not be detected 6 



