42 PRACTICE OF PHYSIC. 



sician to observe it. And considering how lately only it has 

 been common to examine disease by dissection, we can easily 

 perceive why, for so long a time, this affection has passed en- 

 tirely unobserved." 



CCCXXIII. This disease seldom attacks infants till after 

 they have been weaned. After this period, the younger they 

 are, the more they are liable to it. The frequency of it becomes 

 less as children become more advanced ; and there are no instan- 

 ces of children above twelve years of age being affected with it. 

 It attacks children of the midland countries, as well as those 

 who live near the sea. It does not appear to be contagious ; 

 and its attacks are frequently repeated in the same child. It is 

 often manifestly the effect of cold applied to the body ; and 

 therefore appears most frequently in the winter and spring sea- 

 sons. It very commonly comes on with the ordinary symptoms 

 of a catarrh ; but sometimes the peculiar symptoms of the dis- 

 ease show themselves at the very first. 



CCCXXIV. These peculiar symptoms are the following : 

 A hoarseness, with some shrillness and ringing sound, both in 

 speaking and coughing, as if the noise came from a brazen tube. 

 At the same time, there is a sense of pain about the larynx, 

 some difficulty of respiration, with a whizzing sound in inspira- 

 tion, as if the passage of the air were straitened. The cough 

 which attends it is commonly dry ; and if any thing be spit up, 

 it is a matter of a purulent appearance, and sometimes films re- 

 sembling portions of a membrane. Together with these symp- 

 toms, there is a frequency of pulse, a restlessness, and an uneasy 

 sense of heat. When the internal fauces are viewed, they are 

 sometimes without any appearance of inflammation: but fre- 

 quently a redness, and even swelling appear : and sometimes in 

 the fauces there is an appearance of matter like to that rejected 

 by coughing. With the symptoms now described, and parti- 

 cularly with great difficulty of breathing, and a sense of strang- 

 ling in the fauces, the patient is sometimes suddenly taken off. 



" It frequently happens that the Cynanche maligna, which 

 has its first and principal seat in the mucous membranes of the 

 tonsils and uvula, communicates and spreads down to the glottis 

 and trachea, and to a considerable length in the bronchise, and 

 is there attended with the same sloughs that happen in the 



