460 PRACTICE OF PHYSIC. 



it ; and therefore the disease necessarily continues for some time 

 but it is probable that the contagion in this as in other instances 

 ceases at length to act ; and that then the disease continues, 

 as in other convulsive affections, by the power of habit alone. 

 MCCCCXV. From this view of the matter, I maintain, that 

 the practice must be different, and adapted to two different in- 

 dications, according to the period of the disease. At the begin- 

 ning of the disease, and for some time after, the remedies to be 

 employed must be such as may obviate the violent effects of the 

 disease, and the fatal tendency of it ; but, after the disease has 

 continued for some time, and is without any violent symptoms, 

 the only remedies which can be required, are those which may 

 interrupt its course, and put an entire stop to it sooner than it 

 would have spontaneously ceased. 



MCCCCXVI. For answering the first indication. In ple- 

 thoric subjects, or in others, when, from the circumstances of 

 the cough and fits, it appears that the blood is difficultly trans- 

 mitted through the lungs> blood-letting is a necessary remedy : 

 and it may be even necessary to repeat it, especially in the be- 

 ginning of the disease. But, as spasmodic affections do not 

 commonly admit of much bleeding, so it is seldom proper in the 

 chincough to repeat this remedy often. " We must take care 

 not to bleed in every case where fever exists. I have seen the 

 disease go on for a month or six weeks, seemingly with violent 

 symptoms and very little fever : afterwards the fever came on 

 in an advanced stage of the disease ; and I have generally 

 found that such cases do not admit of bleeding, if the symptoms 

 do not render it absolutely necessary." 



MCCCCXVI I. As costiveness frequently attends this disease, 

 so it is necessary to obviate or remove it by laxatives employed ; 

 and keeping an open belly is generally useful : but large evac- 

 uations in this way are commonly hurtful. 



" There is a particular circumstance which has been thought 

 to render purging necessary. In younger children the mucus 

 brought up from the lungs is seldom spit out, but is swallowed 

 down into the stomach, and may give disturbance; so that purg- 

 ing is necessary to evacuate this quantity of mucus. 



" I have seen in several instances a spontaneous purging 

 coming on, but without either relieving or shortening the disease; 



