490 MATERIA MEDIC A AND THERAPEUTICS. 



threatening asphyxia. Nitrite of Amyl may instantly give 

 relief, but the spasm may as quickly return ; Nitre fumes suit 

 some cases. Small doses of Spirit of Ether or Chloroform in 

 solution are frequently most valuable, because so rapidly diffu- 

 sible ; and a mixture of Ammonia, Carbonate of Ammonia, 

 Spirit of Ether, and Aromatics is one of the best combinations 

 for general use. 



Cough has been already referred to as far as it is to be 

 encouraged, for the relief of movable obstruction and dyspnoea. 

 When it is not only ineffectual but harmful, for instance when 

 due to swelling, morbid growths, or purely nervous causes, it 

 demands immediate relief. It cannot, however, be too much 

 insisted on that the tendency of young practitioners is towards 

 an abuse of this class of remedies, by prescribing them in a 

 routine fashion for every case of cough, irrespective of its 

 cause. Narcotics are powerful depressants of the respiratory 

 centre, as well as of many other organs, including the heart ; 

 and, which is of equal consequence, they interfere with the 

 reflection which originates useful cough and increased breathing, 

 and ultimately aggravate the condition which they temporarily 

 relieve. It is only when the cause of cough cannot be removed, 

 that the irritability of the nervo-muscular apparatus may be 

 safely reduced by respiratory sedatives, such as Opium, Chloro- 

 form, Ether and Chloral, Alcohol and Conium, according to cir- 

 cumstances, although warm moist air, warm liquid food, poultices 

 to the chest, and acids or demulcents for the throat will often 

 suffice to give relief. Several of these measures may be 

 topically employed by insufflation, inhalation, gargling, or 

 direct application, and when given internally they are advan- 

 tageously combined with expectorants, which shall remove any 

 movable irritant from the passages. When all but powerful 

 opiates have failed to arrest protracted fits of coughing, as in 

 phthisis, frequent small meals of warm liquid nutritious food, 

 night as well as day, or pure alcoholic stimulants, will often 

 give great relief. When the sputa are excessive, anti-expec- 

 torant measures may be demanded, and will consist in a fresh 

 bracing atmosphere, dry simple food, the avoidance of alcohol, 

 and the exhibition of Acids, Bitters, and probably Iron 

 internally. 



Hcemorrhage from the respiratory organs must be treated on 

 general principles. .Rest must be secured not only by bodily 

 quiet, but by the reduction of the movements of the lungs to a 

 minimum, by strapping the chest locally and recommending 

 voluntary restraint of respiration and cough. 



Pain and the other forms of distress in connection with this 

 system are easily arrested by direct respiratory sedatives, such 



