142 DISEASES OF THE PARENCHYMA OF THE LUNG. 



lung depends essentially upon its exciting causes. Fluxions, if they dc 

 not proceed from adventitious productions in the lung, are generally of 

 less serious character, and are more amenable to treatment than obstruc- 

 tions, the causes of which are usually difficult to allay. Prognosis of 

 the various forms can be derived from the description of the course of 

 the disease. 1 



TREATMENT Indicatio causalis. As increased action of the heart 

 is a frequent cause of fluxion to the lung, and as, in youthful subjects, 

 habitual palpitation of the heart, accompanied by hyperaemia of the lung, 

 is often the forerunner of tuberculosis, a regimen and treatment suitable 

 to such condition are demanded. Strictly forbid the use of spirits, tea, 

 coffee, and order all food or drink to be allowed to cool somewhat be- 

 fore it is taken. In like manner inexorably forbid dancing and riding, 

 and other violent bodily exertion, at the same time enjoining regular 

 and moderate exercise. Shield the patient, as far as possible, from all 

 psychical excitement. Besides these precautionary measures, the lung is 

 to be protected from injury. Let all hot and smoky rooms and all 

 dusty places be avoided, and do not let the patient inhale very cold air. 

 Acidulated drinks, lemonade, cream-of-tartar water, are to be recom- 

 mended. The milk and whey treatment is especially suitable for such 

 cases, and, above all, the " grape cure " of Dttrkheim, Meran, on the 

 lake of Geneva, and other places with a mild clime, where sweet grapes, 

 which do not purge, are cultivated.* It merely hastens the end of 

 patients, in an advanced stage of phthisis, to remove them from the 

 quiet and comforts of home in order to try the grape or whey cure. 

 On the other hand, these cures often do most brilliant service in the 

 instances under discussion, which may not incorrectly be regarded as 

 cases of incipient tuberculosis. 



In the collateral form of pulmonary hypersemia the indicatio causa- 

 lis coincides with the treatment of the main disease. In obstruction in 

 the lungs the indicatio causalis cannot be met. In disease of the heart, 

 above all, in contraction of the mitral valve, the use of digitalis is to be 

 recommended as a palliative until the heart's action has become retard- 

 ed. The weaker the action of the heart becomes in the course of an 

 asthenic fever, so much the more urgently are stimulants and nourish- 

 ing food indicated. In like manner cause the position of patients with 

 threatening hypostasis to be changed from time to time, in order to pre- 

 vent a settling of the blood. 



With regard to the indicatio morbi, bold venesection from a large 

 opening is demanded hi fluxion to the lung, arising from excessive car 



* The very fine sweet grapes, which grow in the better vineyards of my present 

 home, purge so strongly as to be inapplicable to the grape-cure. I have seen a severe 

 diarrhoea set in after eating three to four pounds of Wiirtemberg grapes. 



