ACUTE BRONCHIAL CATARRH. 85 



restrain the secretion. The stimulants excite the bronchial muscles to 

 more energetic contraction, just as they cause the pulse to rise and the 

 heart to beat more vigorously. But it may happen that the bronchial 

 muscles become so debilitated as no longer to afford any assistance in 

 expectoration, and the cough alone is inadequate for the expulsion of 

 the sputa. This state has been called " incipient palsy of the lung," but 

 the lung takes no active part either in inspiration or expiration. It may 

 be detected when, immediately after the act of coughing, the rdles, in- 

 stead of subsiding for a time, persist with scarcely any diminution. In 

 such an emergency, should the expectorants fail, an emetic is impera- 

 tively indicated. Let no time be lost, lest the access of air to the alveoli, 

 being cut off by the accumulating secretion, and the bronchial palsy 

 already commencing, be aggravated by carbonic-acid poisoning. An 

 emetic is the surest expectorant. If, during retching, the abdominal 

 muscles be energetically shortened, and the thorax powerfully contract- 

 ed, the air, which, as we have already explained, is expelled in violent 

 puffs, drives the secretion out of the bronchi, or at least out of the 

 larger of them. Unfortunately emetics fail us altogether where we 

 have to overcome obstruction in the finest bronchial tubes, and this it is 

 which renders the latter stage of capillary bronchitis so dangerous. 

 Even firmly-adhering croup membranes are often enough loosened and 

 expelled by the act of vomiting ; but an inspiration of twice the force 

 of that which accompanies this act is incapable of driving a current of 

 air into the smallest bronchi and of forcing out the mucus contained in 

 them. On the other hand, compression of the air-vesicles thus produced 

 is accompanied by an equally firm compression of the capillary bronchi, 

 by which they are still more firmly closed. 



4. In the treatment of symptoms it may become our task to mod- 

 erate the redundant bronchial secretion, which threatens to exhaust the 

 patient. A great par* of the means recommended for this purpose, the 

 lime-water, acetate of lead, tannin, ratanhia, folise uvse ursi, are either 

 inert or of doubtful efficacy. The resins and balsams, recommended 

 upon the same ground, are more serviceable in diminishing mucous 

 secretion, of which then* efficience in treatment of gonorrhoea furnishes 

 striking proof. Peruvian balsam, balsam copaibae, myrrh, gum ammo- 

 niac, belong to this class. A very favorite prescription is the Griffiths 

 mixture 



B Myrrhapulv. 3j. 



Potas. carb. et tart. gr. xxv. 

 Aqua menth. crisp. viij. 

 Ferri sulph. crystal. 3j. 

 Sacc. alb. ^ ss. 

 M. 



S., a tablespooiifiil four times a day. 



