i68 DISEASES CLASS II. i. 2. 



their chhls, in any cough or difficulty of refpiration, fince if the] 

 ilip down in their bed the friction of the night-cap on the pil- 

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

 and fuffocate them. After the patient is greatly debilirated, fc 

 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 folid 

 opium, with great advantage, and I believe in feveral cafes I 

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

 flate of debility cannot be ufed without hazarding the life of the 

 perfon. This fmall quantity of an opiate mould be given about 

 {ix in the evening, or before the accefs of the evening paroxyfrn, 

 and repeated three or four nights, or longer. 



There is a peripneumony with weak pulfe, which may be 

 termed peripneumonia inirritata, as defcribed in Seel:. XXVII. 2. 

 which belongs to this place. See alfo Superficial Peripneumo- 

 ny, Clafs II. i. 3. 7. 



Peripneumonia arthritica. Gouty peripneumony. I believe, 

 that there exilts a peripneumony, and a pleurify which owe their 

 inflammation to the fympathy of thofe membranes with fome 

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

 rheumatic or gouty peripneumony, or pleurify. And that the 

 coagulable lymph left upon the inflamed membranes has gener- 

 ally been owing to thefe fympathetic inflammations, and that hy- 

 drops thoracis, and anafarca pulmonum are generally caufed by 

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

 ra, and not by the more common idiopathic inflammations of 

 thofe membranes. See Oafs I. 2. 3. 14. and Clafs IV. i. 2. 

 1 6. and Clafs IV. i. 2. 9. 



Peripneumonia tracbealis. Croup. The croup is an inflam- 

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

 part of the fame organ, viz. the trachea or wind-pipe. Sec 

 Clafs I. 1.3. 4. But as the inflammation is feldom, I believe, 

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

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

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

 che trachealis fhould be changed for peripneumonia trachealis. 



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

 of Millar, or hives, has been confounded with the angina polypofn, 

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

 ment recommended by authors *, as the difeafe has been efteem- 

 ed inflammatory by fome, and fpafmodic by others. 



The convulfive afthma, which I have witneffed in one child, 

 was readily diftinguiftied from the croup ; as there wasfimply a 

 great exertion in breathing, but without the harih found which 



attends 



