INFLAMMATION OF THE TRACHEA. 
59 
obstruction preponderates: in fact, you have discovered the seat 
and the state of the disease. Try this for yourselves, and value 
or discard this mode of exploration, according to the result. 
Treatment. —We have then evident inflammation of the larynx, 
and the course to be pursued is sufficiently plain. We must bleed, 
and that from the jugular; for we shall then have the combined 
advantage of general and local bleeding. We must bleed co¬ 
piously, depending indeed upon the degree of inflammation ; but 
yet copiously, for we have inflammation of a mucous membrane \ 
and that which we do, we must do quickly—we must adopt decisive 
measures, for we shall not have opportunity when the disease has 
altered its character, and debility succeeds. We must do that 
which I have already urged upon you, and shall again and again 
entreat you to adopt as the rule of your practice: we must not make 
up our minds to any determitate quantity of blood, and leave our 
assistant or the groom to abstract it, but we must ourselves bleed, 
and until the pulse flutters, or the constitution is evidently af¬ 
fected. 
Next we must give the fever medicine already recommended; 
the digitalis, nitre, and emetic tartar, with aloes. We may give 
aloes safely, because we have ascertained that the chest is not 
yet implicated. To this we must add, and immediately, a 
blister, and a sharp one too. We are sure of the part, and we 
can bring our counter-irritant almost into contact with it. 
Necessity of prompt Measures. —Inflammation of the larynx, 
if not speedily subdued, produces sad disorganization in this cu¬ 
riously formed and important machine. Lymph is effused,—mor¬ 
bidly adhesive, and speedily organized ;—the membrane becomes 
thickened, considerably, permanently so ; the submucous cellular 
tissue becomes cedematous; the inflammation spreads from the 
membrane of the larynx to the cartilages, and so we shall have 
difficulty of breathing, and, at length, confirmed roaring. 
Inflammation of the Trachea. —Inflammation of the membrane 
of the larynx, and especially when it has run on to ulceration, as 
you see in this specimen, may rapidly spread, and involve the 
greater part or the whole of the lining membrane of the trachea. 
Auscultation will tell you when this is taking place, for the free 
and uninterrupted, but sonorous rush of air, will be changed for 
wheezing and rattling, and that in proportion as the cause of either 
sound exists. If the disease is extending downi the trachea, you 
must follow it; your blister must reach as low as you can detect 
the rattling sound, and something beyond : your fever medicines 
must be administered in somewhat increased doses ; and your 
bleeding must be repeated, if the state of the pulse does not 
indicate the contrary. 
