SPASMODIC AFFECTIONS. 451 



MCCCLXXXV. This disease, as coming by fit?, may be 

 generally distinguished from most other species of dyspnoea, 

 whose causes being more constantly applied, produce therefore 

 a more constant difficulty of breathing. There may, however, be 

 some fallacy in this matter, as some of these causes may be liable 

 to have abatements and intensities, whereby the dyspnoea pro- 

 duced by them may seem to come by fits ; but I believe it is 

 seldom that such fits put on the appearance of the genuine 

 asthmatic fits described above. Perhaps, however, there is still 

 another case that may give more difficulty : and that is, when 

 several of the causes, which we have assigned as causes of sev- 

 eral of the species of difficult breathing referred to the genus of 

 Dyspnoea, may have the effect of exciting a genuine asthmatic 

 fit. Whether this can happen to any but the peculiarly pre- 

 disposed to asthma, I am uncertain; and therefore, whether, 

 in any such cases, the asthma may be considered as sympto- 

 matic ; or if, in all such cases, the asthma may not still be con- 

 sidered and treated as an idiopathic disease. 



MCCCLXXXVI. The asthma, though often threatening 

 immediate death, seldom occasions it ; and many persons have 

 lived long under this disease. In many cases, however, it does 

 prove fatal ; sometimes very quickly, and perhaps always at 

 length. In some young persons it has ended soon, by occasion- 

 ing a phthisis pulmonalis. After a long continuance, it often 

 ends in a hydrothorax ; and commonly by occasioning some 

 aneurysm of the heart or great vessels, it thereby proves fatal. 



MCCCLXXXVII. As it is seldom that an asthma has been 

 entirely cured, I therefore cannot propose any method of cure 

 which experience has approved as generally successful. But 

 the disease admits of alleviation in several respects from the use 

 of remedies; and my business now shall be chiefly to offer some 

 remarks upon the choice and use of the remedies which have 

 been commonly employed in cases of asthma. 



MCCCLXXXVIII. As the danger of an asthmatic fit arises' 

 chiefly from the difficult transmission of the blood through the 

 vessels of the lungs, threatening suffocation, so the most prob- 

 able means of obviating this seems to be blood-letting ; and 

 therefore, in all violent fits, practitioners have had recourse to 

 this remedy. In first attacks, and especially in young and ple- 



