318 PRACTICE OF PHYSIC. 



But, after the inflammatory symptoms have much abated, if 

 the cough should still continue, opiates afford the most effectual 

 means of relieving it ; and, in the, circumstances just now men- 

 tioned, they may be very safely employed. See CCCLXXV. 

 " In many persons affected with catarrh, coughing is habit- 

 ual, or is readily renewed upon every slight application of cold ; 

 and in such cases and persons, opium is a sovereign remedy. 

 Whenever, therefore, there is little fever and much coughing, 

 it may be employed very freely, that is, in doses which have se- 

 dative effects without heating the system. But there is a ca- 

 tarrh arising occasionally only from a strong application of cold, 

 almost always attended with a phlogistic diathesis of the sys- 

 tem, and probably with a more or less inflammatory state of the 

 mucous glands of the bronchiae. Such a disease is to be cured 

 by blood-letting and the antiphlogistic regimen ; and the early 

 use of opium, by confirming the inflammatory state, is hurt- 

 ful. M.M. 



After the inflammatory and febrile states of this disease are 

 almost entirely gone, the most effectual means of discussing all 

 remains of the catarrhal affection, is by some exercise of gesta- 

 tion diligently employed. 



" I find the use of the bark somewhat nice and difficult in ca- 

 tarrhal affections. In these, arising, as they commonly do, from 

 cold, an inflammatory diathesis is, I believe, constantly present, 

 and this seems to reject the use of the bark altogether. But 

 there are two cases in which it may be admitted : the one is 

 when the catarrhal affection is combined with an intermittent 

 fever ; and I have often observed the most frequent and violent 

 fits of coughing to be joined with the paroxysms, and particu- 

 larly with the cold stage of such paroxysms. In such cases, I 

 not only do not avoid the bark, but fly to it with more haste. 



There is also another case of catarrhal affections, in which the 

 bark is of great service. This is in those habitual and frequent- 

 ly returning catarrhs which depend upon a weak and imperfect 

 perspiration by the skin; and this again upon a weaker 

 force in the action of the heart and arteries. In these cases, 

 I suppose there is a greater determination to, and a greater 

 than usual accumulation of fluids in, the lungs ; and that 

 these circumstances and their effects, are only to be obviated by 



