VOMITING IN COUGH. 571 



remain, more or less, lymphoid cells, instead of developing into 

 proper epithelium. They so rapidly form, and are thrown of! 

 so quickly, that they have not time to get proper nutriment, 

 and if they are to grow properly we must supply them, not 

 with an ordinary kind of nutriment, but with one which is 

 much more rapidly absorbed, and is capable of much more 

 rapid transformation in the cell itself than the usual one. This 

 power is, I believe, possessed by cod-liver oil, and to its quality 

 of nourishing the rapidly-formed cells in the lungs in cases of 

 bronchitis and catarrhal pneumonia I believe its great curative 

 power is owing. 



The next subject we will consider is the action of some drugs 

 in the vomiting associated with cough. The action of vomiting, 

 like that of coughing, is reflex ; the nervous centre for it is also 

 in the medulla oblongata, closely associated with the respiratory 

 centre, and it is excited by various afferent nerves, the chief of 

 them being the branches of the vagus distributed to the 

 stomach. When congestion of the stomach is present, these 

 become irritated, and we get loss of appetite, nausea, and 

 vomiting. Like coughing, vomiting may be prevented by the 

 removal of the irritant. For example, where the irritant is 

 indigestible food, the vomiting ceases after the ejection of the 

 offending substances. When the irritation depends on inflam- 

 mation of the walls of the stomach, it may be soothed by 

 sedatives having a local action upon the nerves, such as ice and 

 hydrocyanic acid, or by drugs having the power of lessening 

 the irritability of the nerve centre of the medulla, such as 

 opium. In the chronic vomiting of plithisis, all these drugs 

 may be employed, but there is one other which has been useful 

 in this affection, and which probably has no effect either upon 

 the nerve centre or the nerve ends. This is alum. Its mode of 

 action probably is that by its astringent power it contracts the 

 vessels of the stomach, and thus lessens the congestion and 

 consequent irritation produced by the continued coughing in 

 the manner already described. 



