ACUTE BRONCHIAL CATARRH. S3 



the reader to what has already been said as to the local treatment of 

 larjngeal diseases, that unless the article inhaled be of a volatile na- 

 ture, such as oil of turpentine, it will not find its way beyond the 

 coarser ramifications of the bronchi. 



SYMPTOMATIC INDICATIONS. We shall now endeavor to lay down 

 rules for the exhibition of the so-called expectorants, as we believe that 

 the acceptation of this word is somewhat indefinite. 



As we have seen, the abatement of the hypersemia and a favorable 

 termination of the disease are announced by an increase in the amount 

 of liquid secretion and by a more copious production of young cells. 

 These symptoms, however, are the result, not the cause, of the improve- 

 ment ; hence the formation of sputa cocta will be best promoted by any 

 means which tend to bring about resolution of the catarrh. Then, too, 

 when there is an accumulation of sputa in the bronchi, its expulsion may 

 be hindered by so many causes, that the various remedies, which may be 

 useful in aiding the expulsion, cannot all be placed in the same category. 

 The following are the most important symptoms, which must be treat- 

 ed in accordance with the pathologico-anatomical phase of the disease : 



1. We have to do with catarrhs in which there has long existed an 

 excessive irritability of the mucous membrane, so that the patients are 

 tormented by incessant and most distressing cough. Although these 

 coughing-fits are only a result of catarrh, yet, from the friction of the 

 air upon the irritated mucous membrane, which they occasion, they are 

 also one of the causes of its aggravation and persistence. If, then, we 

 combat these paroxysms, we not only moderate the individual evil, but 

 tend to cut short the general course of the disease. The sweet, muci- 

 laginous decoctions and syrups are here both inefficient and injurious to 

 the digestion, as are also the cough-bonbons and caramels, in spite of 

 the illustrious names on the labels which testify to their efficacy. On 

 the other hand, the employment of the alkaline muriatic mineral waters 

 of Selters, Ems, Obersaltzbrlinnen, is here as urgently to be recom- 

 mended as the folly of resorting to them in every bronchial catarrh, or 

 in a bronchial blennorrhcea, is to be decried. Of these waters, of whose 

 beneficial action upon the irritable mucous membrane we have no phys- 

 iological explanation, let five or six glasses be drunk fasting in the 

 morning, while promenading ; or, in acute catarrh, let them be taken in 

 the course of the day instead of the customary ptisane. Be bold, too, 

 in administration of narcotics under these circumstances. If rest be dis- 

 turbed at night, give ten grains of Dover's powders in the evening ; or, 

 when incessant coughing torments the patient, administer, through the 

 day, a mixture containing opium or morphine. The cough will then be 

 less frequent, and the secretion from the bronchi, having more time for 

 accumulation, will, when expectorated, appear in greater quantity, so 

 that the patients are apt to praise the powder, which "has loosened theii 



