82 DISEASES OF THE TRACHEA AND BRONCHI. 



doubtful, to say the least, if the flores sambuci, spiritus miridereri, anti- 

 monial wine, and other so-called diaphoretics actually do have a diapho- 

 retic effect; nay, it seems to be of no consequence as to the result, 

 whether we cover up the patient in a good bed and in warm blankets, 

 or whether we wrap him closely in cold wet clothes and then cover him 

 up, as these cold applications, from the retained heat of the body itself, 

 are very soon converted into warm ones. Perhaps a stronger fluxion to 

 the skin is produced by the latter process than by the former. Upon 

 similar principles, in chronic catarrh, even where there is no scrofulous 

 nor rachitic taint, determination to the skin by the use of salt baths is 

 indicated, particularly such baths as contain an extra amount of brine, 

 like those of Kreutznach. This treatment is particularly adapted to the 

 cases of all patients in whom a protracted acute bronchitis is threat- 

 ening to become chronic, but in whom it has not as yet assumed an in- 

 veterate character. But, even in inveterate and grave cases of chronic 

 bronchial catarrh, I have produced most striking results, at my clinique, 

 by means of energetic diaphoresis. I have kept patients for half an 

 hour at a time in a bath of a temperature of at least 100 Fahrenheit, 

 and then enveloped them in hot blankets, in which they remained from 

 one to two hours longer. At first, as long as the dyspnoea was very 

 severe, the patient suffered greatly, not only while in the bath, but 

 during the sweating. Soon, however, generally toward the end of the 

 first week, as the perspiration began to flow more readily and freely, 

 they became satisfied at their improved condition, and were willing to 

 continue the treatment. After eight or ten baths the dyspnoea had 

 abated in the most striking manner, and the cyanosis had disappeared. 



Rash as it may seem to persons unfamiliar with this mode of treat- 

 ment, to plunge a patient, panting with dyspnoea and blue with cyanosis, 

 into a hot bath, yet such of my pupils as have witnessed the results of 

 the procedures described above will be more successful than such as fear 

 to resort to forced diaphoresis in treating this distressing malady, which 

 often mocks all remedial measures. 



Allied to treatment by general diaphoresis, there is a class of reme- 

 dies by means of which a sort of local diaphoresis, or, at all events, a 

 local derivation, is set up upon the integument of the chest, and in 

 whose favor experience speaks strongly. In cases of protracted catarrh 

 of the bronchi, make the patient wear flannel ; put a pitch-plaster upon 

 his chest We must not, however, be too hasty in the employment of 

 blisters and of sinapisms, the use of which is not indicated by the 

 catarrh itself, but only by certain symptoms. While fever exists, they 

 ire best omitted. 



The introduction of the inhaling apparatus has resulted in a consid- 

 erable advance in our mode of treating bronchial catarrh. We refer 



