163 DISEASES CLASS II, 1. 2. 4* 



their chins in any cough or difficulty of respiration, since if they 

 slip down in their bed, the friction of the night-cap on the pillow 

 is liable to draw the tape or ribbon under the chin too tight, 

 and suffocate them. After the patient is greatly debilitated, so 

 that no further evacuation can be admitted, and the difficult 

 breathing and cough continue, I have given four or five drops of 

 tincture of opium, that is, about a quarter of a grain of solid 

 opium, with great advantage, and I believe in several cases I 

 have saved the patient. A greater quantity of opium in this 

 state of debility cannot be used without hazarding the life of the 

 person. This small quantity of an opiate should be given about 

 six in the evening, or before the access of the evening paroxysm, 

 and repeated three or four nights, or longer. 



There is a peripneumony with weak pulse, which may be 

 termed peripneumonia inirritata^ as described in Sect. XXVII. 2. 

 which belongs to this place. See also Superficial Peripneumo- 

 ny, Class II. I. 3. 7. 



Peripnewnonia arthritica. Gouty peripneumony. I believe, 

 that there exists a peripneumony, and pleurisy which owe their 

 inflammation to the sympathy of those membranes with some 

 other parts of the system, and may then properly be termed 

 rheumatic or gouty peripneumony, or pleurisy. And that the 

 coagulable lymph left upon the inflamed membranes has general- 

 ly been owing to these sympathetic inflammations, and that hy- 

 drops thoracis, and anasarca pulmonum are generally caused by 

 gouty affections of the lungs; or rheumatic affections of the pleu- 

 ra, and not by the more common idiopathic inflammations of 

 those membranes. See Class I. 2. 3. 14, and Class IV. 1. 2. 

 16. and Class IV. 1.2. 9. 



Peripneumonia Irachealis. Croup. The croup is an inflam- 

 mation of the upper part, and the peripneumonia of the lower 

 part of the same organ, viz. the trachea or wind-pipe. See 

 Class I. 1. 3. 4. But as the inflammation is seldom, I believe, 

 confined to the upper part of the trachea only, but exists at the 

 same time in other parts of the lungs; and as no inflammation of 

 the tonsils is generally perceptible, the uncouth name of cynan- 

 che trachealis should be changed for peripneumonia trachealis. 



Dr. Wichmann, of Hanover, believes that the acute asthma of 

 Millar, or hives, has been confounded with the angina polyposa, 

 or croup, which has occasioned the great difference in the treat- 

 ment recommended by authors; as the disease has been esteem- 

 ed inflammatory by some, and spasmodic by others. 



The convulsive asthma, which I have witnessed in one child, 

 was readily distinguished from the croup; as there was simply a 

 great exertion in breathing, but without the harsh sound which 





