72 PRACTICE OF MEDICINE. 



period ; but not if the disease be allowed to run into the second and 

 third stages. 



When the practitioner is called in early in this disease, he should 

 have recourse to copious bleedings, holding in mind that they not 

 only act as in all other inflammations, but that they have also the 

 effect of directly diminishing the quantity of blood which, in a given 

 time, must traverse the lung in order to be subjected to the action of 

 the air. But bleeding, although to be performed with determination, 

 must yet not be done indiscriminately, so as to empty the patient's 

 veins, and take away ths strength necessary for the laborious work 

 of respiration and expectoration. 



" We want some remedy," says Dr. Watson, " to assist the lancet, 

 or to employ alone when the lancet can do no more ; and we have 

 two such in tartarized antimony and in mercury. The tartarized 

 antimony I believe to be best adapted to the first degree of the in- 

 flammation, that of engorgement ; and the mercurial plan to the 

 second — that of hepatization." 



The tartar emetic may be given in doses of gr. \ dissolved in 

 water, with a few drops of syrup of poppies or laudanum, every 

 hour : — after two or three doses the quantity may be doubled ; — and 

 after two or three more it may be increased again, to a grain every 

 hour. If the medicine acts favourably, it will relieve the dyspnoea, 

 without causing more than very slight vomiting or purging. 



In those cases where tartarized antimony is inadmissible, or in- 

 efficient, the mercurial treatment must be had recourse to ; calomel 

 and opium ought to be given internally, and mercurial inunction be 

 employed. 



Aperients should be occasionally given in this disease, so as to 

 keep the bowels open ; but too much purging is always injurious. 

 When the patient is under the influence of antimony, enemata should 

 be employed. 



Ijocal depletion is also highly important in this disease. When 

 the acute stage has passed^ blisters may be applied to the chest. 



" After the inflamed lung has become solid and impermeable," 

 says Dr. Watson, " the treatment must be regulated rather by the 

 state of the system at large, than by the actual or present condition 

 of the lung ; we must look more for guidance to the general symp- 

 toms than to the physical signs. If the pulse continues firm and 

 steady, wait patiently the efiect of the mercury. But when sunken 

 features, a pallid face, coldness of the surface or extremities, a ten- 

 dency to delirium, and above all, a feeble and irregular pulse, pro- 

 claim that the vital powers are giving way, it will be requisite, as in 

 other cases where death is threatened by asthenia, to administer 

 cordial and stimulant medicines ; the carbonate of ammonia in a de- 



