IIJEMOR11IIAGIES. 55 



in the case of a simple catarrh. This is more especially apt 

 to call for attention, if the increase and continuance of cough 

 comes on during the summer season. 



DCCCXCI. The cough which comes on (DCCCLXXXIX.) 

 is very often for a long time without any expectoration ; but 

 when, from repeatedly catching cold, it becomes more constant, 

 it is then at the same time attended with some expectoration, 

 which is most considerable in the mornings. The matter of 

 this expectoration becomes by degrees more copious, more vis- 

 cid, and more opaque; at length of a yellow or greenish colour, 

 and of a purulent appearance. The whole of the matter, how- 

 ever, is not always at once entirely changed in this manner : but 

 while one part of it retains the usual form of mucus, another 

 suffers the changes now described. 



DCCCXCII. When the cough increases, and continues very 

 frequent through the night, and when the matter expectorated 

 undergoes the changes I have mentioned, the breathing at the 

 same time becomes more difficult, and the emaciation and weak- 

 ness go on also increasing. In the female sex, as the disease 

 advances, and sometimes early in its progress, the menses cease 

 to flow ; and this circumstance is commonly the effect, although 

 the sex themselves are ready to believe it the sole cause of the 

 disease. " I have, when importuned in the cases, declined giv- 

 ing deobstruent remedies. I have here given a placebo, and 

 have thought it a pious, innocent, and natural fraud." 



DCCCXCII I. When the cough comes on, as stated in 

 DCCCLXXXIX. the pulse is often natural, and for some 

 time after continues to be so, but the symptoms have seldom 

 subsisted long before the pulse becomes frequent, and some- 

 times to a considerable degree, without much of the other symp- 

 toms of fever. At length, however, evening exacerbations be- 

 come remarkable; and by degrees the fever assumes the exquisite 

 form of hectic, as described in DCCCLVIIL DCCCLX. 



DCCCXCIV. It is seldom that the cough, expectoration, 

 and fever, go on increasing, in the manner now described, with- 

 out some pain being felt in some part of the thorax. It is 

 usually and most frequently felt at first under the sternum, and 

 that especially, or almost only, upon occasion of coughing: but 

 very often, and that, too, early in the course of the disease, a pain 



1 



