634 
ON EMPHYSEMA OF THE LUNGS. 
should not be considered as altogether incurable; and that, if we 
can diminish the intensity of the cause which keeps up the 
habitual distention of the cells, we may, in the end, hope that these 
will be actually lessened in volume. With this view the cause 
of the emphysema should be combated by prompt and active 
treatment, and the patient should be made to abstain from all the 
ordinary exciting causes of dyspnoea, as they not only produce 
present distress, but likewise keep up the over-distention of the. 
cells, and consequently increase the extent of the emphysema. 
It has already been stated that emphysema, in a moderate de¬ 
gree, is not a disease of great severity, and that it is from the 
supervention of attacks of asthma or bronchitis that the principal 
distress and danger are to be apprehended. Every precaution 
should, therefore, be adopted to remove these affections and pre¬ 
vent their recurrence. 
To detail the treatment of these diseases here would be to 
repeat what has been stated in other parts of this work: we 
therefore refer the reader to the articles Asthma, Bronchitis, 
and Catarrh, for all the information that can be obtained on 
the subject in the present state of our experience. 
Laennec recommends frictions with oil as useful in diminishing 
the susceptibility to be effected with catarrh; but a more effec¬ 
tual method of acomplishing this object is by sponging the chest 
every morning with vinegar and water, and afterwards dry¬ 
rubbing the part with flannel or a flesh-brush, as recommended 
in Asthma. In the case of pallid cachectic patients, the sub¬ 
carbonate of iron has occasionally seemed to have a similar effect, 
and to tend at the same time to diminish the congestion of the 
mucous membrane, and also the spasmodic stricture of the 
bronchi. It is also of importance.to attend to the state of the 
digestive organs, as experience has fully proved that irritation of 
the bronchial membrane is very often a sympathetic affection 
depending upon irritation of the stomach. Whatever, therefore, 
is improper for a dyspeptic patient should be avoided by those 
who labour under emphysema of the lungs. Warm clothing in 
all cases of delicate mucous membranes is particularly necessary, 
and flannel should be worn next the skin during the day ; the 
lower extremities should be kept especially warm, and other 
necessary precautions adopted to guard against the cold of the 
winter months. We have known many persons affected with 
emphysema of the lungs, and that to a very considerable ex¬ 
tent, whose breathing was quite good during the summer months, 
but who dreaded the approach of winter as the never-failing 
harbinger of their sufferings. For such cases the only alternative 
is to spend the winter in a more congenial climate. Indeed, there 
