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eretory duAs arc lUus obftrufted ; and that broncliocelt; con- 

 fills altogether in this laxity or atonic ftate of the organ. 

 But, fiirt'ly, a'.l this is hypothetical ; for, tven fuppofing the 

 imbibition of moilt air to take place (which, however, re- 

 mains to be proved), would it not be received into the ab- 

 forbent veffcls, and tranfmitted to the thoracic duft ? And, 

 why (hnuld it b^' imagined, that the thyroid gland imbibes 

 the moilt atniofphcrical air, more than other parts of the 

 body vvhic!\ are equally expofed ? 



Upon the whole, we fee no reafon for adopting the above 

 opinion, however refpedtably it has been fupported ; and we 

 do not feel competent to ofier any explanation ourlelvcs of 

 the proximate caufe of this difeafe. Perhaps fome light will 

 be thrown on the inqniry, when we are better informed as 

 to the economy and natural ufe of the thyroid gland ; but, 

 for the prefent, we are without Jd/ti, or luitable analogies, 

 to afford a legitimate conclufion. We proceed, therefore, 

 to the means whic.i have been employed for the prevention 

 and cure of this complaint ; a fiibjeft on which much has 

 been faid and written, although not to the entire fatisfaC\ion 

 of praftitioners or patients in general. 



As to preventive meafurcs, they mull chiefly confift of fuch 

 as tend to meliorate the foil and air of thofe places wherein 

 the bronchoccle is endemial. If it be a fadi, that marlhy 

 lands, an humid atmofphere, deep and woody vales, fur- 

 rounded by lofty hills, which intercept the falubrious breezes, 

 are among the phyfical caufes of tliis difeafe, the prevention 

 mull partly depend upon the removal or avoidance of fuch 

 caufes ; and tliis fhould be efpeciallv attended to by perfons 

 who are naturally of a delicate or loft fibre, and are there- 

 fore predifpofed to debilitating complaints. 



The curative means are either medical or furgical. The 

 internal remedies, which have acquired the greatell reputa- 

 tion, are burnt fponge, foap, fulphurated kali, prepared 

 natron, and artificial foda-water. It has been advifcd to 

 exhibit a dofe of ealomel and neutral falts once a week, 

 during the ufe of the other medicines; likewife to keep the 

 reck warm ; to refide in a di-y, pure atmofphere ; and to 

 fwallow the above-named remedies very flowly, which is par- 

 ticularly infilled on if the patient take thefe medicines in a 

 folid form. Authors have alfo allei.;ed, that benefit is fome- 

 times derived from the external application of mercurial oint- 

 m'Cnt, bliftering plaller, foap liniment, camphorated oil, dry 

 friftions, moderate conipreffion, and electrical fparks. But 

 of all thefe means, the burnt fponge, made into lozenges, 

 has received the higlieft encomiums. For our own part, we 

 have been difappointed in our expeflations from thefe lo- 

 zenges; although many pradlitioncrs confider them as almoft 

 infallible, if properly adminiftered and perfevered in. The 

 following is the formula recommended by Mr. Ring : 

 Take of Burnt fponge, two ounces ; 



Powdered gum Arabic, two drams ; 

 Powdered cinnamon, half a dram ; 

 Simple fyrup, enough to form the whole into 

 a mafs, which is to be divided into forty-eight troches. 

 Care mull be taken that no more fyrup be ufed, than is abfo- 

 lutely necelTary to make the dry ingredients properly cohere ; 

 for which reafon, it mud be added flowly, and the mafs mull 

 be well beaten. The lozenges are to be dried before a fire, 

 on a plate which has been (lightly oiled, to prevent them 

 from nicking ; and they mull be kept in a bottle or gallipot, 

 tied over with a bladder. 



One of thefe tablets is to be exhibited three times a day, 

 for a confiderable time. Some praftitioners, indeed, have 

 given fo much as fix or eight drams of the burnt fponge 

 daily, without any inconvenience ; and, too often, without 

 any benefit to their patients. It would be deferving the at- 



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tcntion of furgcoiis, to afcertain, if poflible, the caufe of 

 this diverfity in their fuccefs ; and whether the nature of the 

 a(le(Slion, in the cafes faid to have been curedby tlieufeof the 

 fponge, does not elTeutially differ from thofe in which this 

 remedy has been taken largely to no good poi-pofe. 



Dr. Ilerreiifchwand, of I'erne, thinking that the burnt 

 fponge has a tendency to injure the lloniacli, and ])roduce a 

 Icucorrhosa, advifes that it Ihould not be calcined, but em- 

 l)loyed in decoAion ; and this, he fays, id equally efficacious. 

 Whereas, M. Fodcrc prefers it to be only half-burnt, and 

 mixed with honey and canella alba ; of which the bulk of a 

 large nut is to be taken three tinies a day, for feveral week:.. 



This kill author tells us, he has feen an extremely large 

 fwelling of the neck difpcrfed by the daily ufe of thirty 

 grains of the fu'])hate of potafh, dilfolved in a pint of water: 

 and he confidcrs the cure as more eafily cfledled, by requiting 

 the patient to take a cathartic evi-ry week, during the whole 

 time of tlie medicinal courfe ; by keeping the neck very 

 warmly covered ; by fwallowing the burnt fponge, S:c. infen- 

 fibly, or holding it a confiderable while in the mouth ; bv 

 beginning the remedy at the decline of the moon ; and by 

 changing the air to a dry or open fituation, which, indeed, 

 he regards as indifpenfably necclfary. 



The fuccefs will alfo much depend on the jjalient's being 

 young, and othcrwife healthy ; but if the fwehiiig be of a 

 Icirrhous or indurated nature, there is very little hope of 

 relief, except by a manual operation, fuch as Cornelius Cel- 

 fus long ago recommended. However, the extirpation (if 

 the tumour can hardly be undertaken, unlefs it be detaclicd, 

 encyfted, and feated at the fore-part of the neck. 



The fwelling being fituated in the vicinity of fo many im- 

 portant organs, will deter a furgeon from hallily propofing 

 its entire excifion : befides, there are cafes related, in which, 

 the mere opening of the cyll has effcdled a cure ; and, in 

 thefe cafes, the contents were either evacuated at once, or 

 gradually lelTened by fuppuration. When there is an evident 

 fluctuation of matter, a feton drawn through the tumour 

 might perhaps be advantageous ; or, as Cellus and others 

 have fuggelled, the application of a caullic might be par- 

 tially ufetul : but, if the life of a patient be not endangered 

 by this difeale, it would be prudent to avoid fuch irritating 

 means. Although the ulcer which remains after tlie ufe of 

 a caullic will fometimes be exceedingly dillrefling and diffi- 

 cult to heal, we are not of opinion, with Mr. Benjamin Bell, 

 that it ever " degenerates into a cancer." 



We ought not to conclude this article without alluding 

 to a celebrated remedy, prepared and fold at Coventr)-, for 

 the cure of bronchocele. It is generally fuppofed to be 

 lefs efficacious than burnt fponge alone, and to confift of 

 equal parts of fponge, cork, and pumice Hone, calcined ; 

 which is formed into a bolus, with fugar or fyrup, to be laid 

 under the tongue every night. Mr. Proffer, who publillied 

 an account of the bronchocele and its treatment in 1771, 

 recommends the following powders, in preference to the 

 Coventry medicine : 



i^ Cinnab. Antimon. opt. levig. 3j. 

 Milleped. pp. & pulv. 

 Spong. calcin. 3a gr. xv. m. f. pulvis. 



One of thefe is to be taken an hour or two before break- 

 faft, for two or three weeks ; and after the interval of about 

 a fortnight, they are to be again renewed ; and three of the 

 following pills are to be taken at bed-time, during the fecond 

 couife of the powders : 



R Pil. Mercurial, ph. nov. J 15. 

 F. Pil. N° 48. squales. 



The dofe is to be adjufted to the age and conftitutiot* of 

 the patient, who (hould be prepared for thij courfe by two 



or 



