ADDITIONS TO THE REVISED EDITION OF 1880. 107 



ADDITIONS TO THE REVISED EDITION OF 1880. 



SECTION II. DISEASES OF THE TKACHEA AND BRONCHI. 



1. P. 78. 



Although the existence of a bronchial catarrh is so easily recog- 

 nized by the presence of cough and of expectoration, yet mistakes 

 are often made, as regards the significance of the disease, as to 

 whether the attack be an independent affection or symptomatic of 

 some other disorder. If, as often happens, besides the tracheal pain 

 proper to catarrh, there should be a pain in the side, due perhaps to 

 muscular soreness from coughing, or perhaps to some mild rheumatic 

 or neuralgic complication, a suspicion of the existence of grave 

 thoracic disease, of consumption for instance, might readily arise. 

 A more common and much graver error consists in mistaking a 

 subordinate secondary bronchitis, such as is a part of almost every 

 chronic disease of the lungs or pleura, and of many other disorders, 

 for the real disease, and overlooking the latter. How often do we 

 see the catarrh which precedes phthisis regarded even by physicians 

 as an insignificant ailment ! Therefore, if a cough prove very in- 

 tractable ; if it do not yield to the warmth of summer or to the 

 shunning of cold air ; should the pulse be too frequent and the 

 respirations hurried ; if, too, there be fever and the aspect of the 

 patient alter for the worse ; then, especially in a young patient, a 

 suspicion of phthisis would be warranted, even though the results 

 of a physical exploration were wholly negative. 



2. P. 92. 



Chloral hydrate deserves trial. Liebreicli states that several ob- 

 servers have used it upon his recommendation. From the reports 

 it appears that the respiratory disturbance of nervous asthma dis- 

 appears in a few minutes, and then subsidence is followed by quiet 

 sleep. Chloral is to be given in solution in one large dose, followed 

 by smaller ones. LiebreicJi advises that in feeble constitutions the 

 first dose should be 1.50 gramme, which, however, if ineffectual, 

 may be repeated in half an hour. $. hyd. chloral., 3.0; aqua3 

 dest., cort. aurant., aa 20.0. S. one-half for a dose. 



3. P. 95. 



The idea of a living contagion dates from the time of Linnaeus. 

 Letztereich has lately found in the glairy sputa of this disease a 

 characteristic spore, and claims to have induced all the symptoms of 

 pertussis in rabbits by implantation of this sputum upon their fauces. 



