250 DISEASES OF THE PARENCHYMA OF THE LUNG. 



chronic pneumonia than they do upon croupous pneumonia or typhus, 

 or upon any other of the many maladies in which they are so much 

 prescribed, often, indeed, without any very clear idea as to what is to 

 be expected of them. But, if we know that the discharge of mucus 

 and of pus-cells has but tittle to do with the exhaustion of the patient 

 (indeed, it is often far more profuse in a simple bronchial catarrh), and 

 that the fever is really his most formidable enemy, it follows, of course, 

 that we must use every means at hand of combating this enemy. 



Digitalis and quinia have a well-merited reputation, as means 

 whereby we often succeed in arresting the abnormal calorification, 

 and reducing the animal heat, in spite of the continuation of the dis- 

 ease. Digitalis is the principal ingredient of the much-employed 

 Heim's pill. ($. pulv. herb, digitalis $ ss., pulv. rad. ipecac., pulv. 

 opii puri aa. gr. v., extract helenii q. s. u. f. pil. no. XX. consp. 

 pulv. rad. irid. flor. S. a pill three times daily.) 



The addition of a scruple of quinine to the above prescription be- 

 comes all the more appropriate, the more periodical the type assumed 

 by the fever, the more severe its evening exacerbations become, and 

 the more pronounced the chills by which they are ushered in. I am 

 BO much in the habit of using Heim's pill with or without quinine, in 

 consumption, whenever the fever proves refractory to the other rem- 

 edies heretofore mentioned, that it has become a very common pre- 

 scription at my clinic. Now and then, when I am a good deal consult 

 ed by phthisical patients, I prescribe it three or four tunes in one day. 

 At the clinic, exhibition of the pills is suspended whenever a distinct 

 reduction of the temperature and of the frequence of the pulse becomes 

 apparent, and is resumed as soon as the effect subsides. In consulta- 

 tion practice, I have repeatedly found that the patients pretty soon 

 learn to judge for themselves when it is time to stop the pills, and when 

 to resume them. 



The subject of antipyretic treatment of consumption may, with 

 great propriety, be immediately followed by that of the diet of phthis- 

 ical patients, for the same reason which induced us to treat the sub- 

 jects of fever and emaciation in immediate conjunction. A man who 

 has fever which is rapidly consuming him, stands in far greater need 

 of a supply of nutriment than one who has no fever. The fever of a 

 consumptive patient often lasts for months, so that the danger that it 

 will wear him out is greater in his case than in one of acute febrile 

 disease of brief duration. Hence it follows that phthisical patients 

 require the richest possible diet which will agree with them. It is 

 often said, but without any proof whatever, that food excites the fever, 

 and (independently of the English practice) even here (in Germany) 

 we only keep a patient on fever-diet that is, we only deprive him of 



