276 THE TREATMENT OF DISEASES. 



constantly expectorating. This may continue for years without causing much incon- 

 venience, the principal annoyance from which the patient suffers being in getting up 

 the phlegm in the morning. It is a remarkable fact that, though a person may cough 

 violently in his sleep, he never expectorates. 



An examination of the expectoration is useful not only in enabling us in many 

 cases to determine the nature of the disease, but as affording many a use- 

 ful hint for treatment. The sputa in pneumonia or inflammation of the lungs, 

 for instance, is very characteristic. It is of a brick-dust colour, and is so viscid that 

 the vessel in which it is contained may be inverted without spilling the contents. 

 In bronchitis, you may get many different kinds of expectoration. If the patient 

 do not expectorate till after a long fit of coughing, during which the air has been 

 many times inspired and expired, and has thus become intimately mingled with the 

 mucus contained in the air passages, the expectoration will contain numerous little 

 air-bubbles, and will be very frothy. After a time the mucus loses by degrees its 

 transparency, is mixed with masses or pellets that are opaque and of a yellow-white 

 or greenish colour, and these masses, few at first, increase more and more in number 

 until they constitute the whole of the sputa. Such expectoration as this is com- 

 monly marked by a remission in the symptoms. It will sometimes happen that the 

 expectoration, having thus become opaque and parti-coloured, will go back again to 

 its former condition of temporary stickiness and froth, and this is to be regarded as 

 a sign of a return or extension of the complaint. By the character of the expectora- 

 tion alone we are in the majority of cases enabled to distinguish between bronchitis 

 and pneumonia. In one kind of bronchitis pieces are expelled which are complete 

 casts of the bronchial tubes, and when spread out in water look like little trees. 

 This complaint is known as "plastic" bronchitis. Many different kinds of expecto- 

 ration are met with in consumption, but there is no form which to the naked eye 

 can be regarded as a positive indication of the existence of that disease. 



As we have said, the character of the expectoration may sometimes be employed 

 as a guide to treatment. Thus, when there is profuse easy expectoration with 

 nausea or vomiting, small doses of antimony w r ine are indicated. "When it is tough 

 and stringy and expelled with difficulty, bichromate of potash often does good. 

 When loose and worse on lying down, pulsatilla may be given, especially in the case 

 of women and children. Nitric acid is useful in old-standing cases, especially when 

 the more active lung symptoms have subsided. Brown-coloured expectoration is 

 considered by many to be an indication for the use of phosphorus. Sulphur is given 

 when the mucus is yellow or white, and when there is any concomitant skin erup- 

 tion. Arsenic is used when there is much debility and a tendency to asthma. 

 Details as to the mode of administration of these medicines will be found under the 

 head of COUGH and in other parts of this work. 



EYE, DISEASES OF. 



Black Eye. A black eye is of such common occurrence that it needs little or 

 no description. It is an effusion of blood beneath the skin of the lids and adjacent 

 parts. The blood is absorbed in a week or ten days, the bruise presenting in 



