182 
PATHOLOGY. 
much quickrefs of the pulfe, eight or ten drops of the 
tincture of Digitalis, or foxglove, may be combined with 
this medicine; a combination by which the cough is 
more relieved, and the quicknefs of the pulfe more per¬ 
manently diininiftied, than by the fe pa rate exhibition of 
either. 
While we have reafon to fufpeft a congefted ftate of 
the capillaries of the mucous membrane, we rnuft peril ft 
in low regimen, the life of Digitalis, Colchicum, &c. as 
we (hall mention when fpeaking of catarrh; but, when 
the complaint prefents much irritation or relaxation of 
the fecernent veffels, more ftimulating medicines are 
ufeful. In having recourfe to thefe, however, we muft 
be careful not to ltimulate too fuddenly or too much, 
as we have to deal with a ftate of parts much difpofed to 
refume inflammatory aftion. It is therefore advifable to 
'pegin with the mildeft of this clafs. The powder of the 
bulbs of the Scilla maritima is often ferviceable in chronic 
cough. Dr. Haitings exhibited this powder in conjunc¬ 
tion with ammoniacum, as diredted in the compound 
i'quill-pill of the London Pharmocopceia ; and in old 
people of phlegmatic habits, when there is not much 
fever, he found it very ufeful. 
Witli the fame view Dr. Haftings has exhibited Cin¬ 
chona chiefly in thofe inftances that fucceed to acute 
bronchitis, where the debility brought on by the acute 
attack is very confiderable. In fuch cafes, if the dyfp- 
ncea be not increafed, the benefits arifing from its exhi¬ 
bition are fometimes very apparent. The profufe perfpi- 
rations and other difcharges are not only reftrained by 
this remedy, but it occafionally appears to alter the fe- 
cretion from the mucous membrane of the lungs, and 
thus brings about a more healthy condition of that mem¬ 
brane, by invigorating its blood-veflels and reftoring 
their natural tone. In thefe cafes it may be combined 
with diluted fulphuric acid, which alfo tends to reftrain 
the colliquative fweats that fo often accompany this dif- 
eafe. 
The ufe of mercury in fome varieties of chronic bron¬ 
chitis greatly aflifts the operation of other remedies; but 
it muft be given in fuch a way as to produce the leaft 
poflible debility of the fyftem. We have before noticed 
the efficacy of this medicine in bronchitis arifing from 
gaftric and fibrous difturbance. But there are cafes in 
which it is advantageous in chronic bronchitis uncom¬ 
bined with any difeafe in the abdomen. Thefe fometimes 
occur after meafles, when the fnrillnefs of the voice in¬ 
dicates confiderable affedtion of the mucous membrane 
lining the trachea. Indeed the great advantage we de¬ 
rive from calomel in croup would lead us to adopt it 
very conftantly in fimple inflammation of the bronchial 
membrane. But the debility produced by this difeafe, 
when of a chronic nature, forbids the ufe of a remedy fo 
debilitating. 
In the latter ftages of chronic bronchitis, where the 
quantity of matter expe&orated is very large, and the 
cough very troublefome, there is no remedy fo powerful 
in allaying the uncomfortable irritation about the glottis 
as opium. But, valuable as this remedy is, it is not 
always free from inconvenience or danger, and confe- 
quently other remedies of this clafs have been propofed 
as fubftitutes for it. Dr. Duncan has ftrongly recom¬ 
mended la&ucarium when opium cannot be given. He 
fays, “Of all the medicines which I have employed for 
alleviating cough in phthifis, and indeed as a fedative in 
many other difeafes, next to opium, I have found no 
article fo beneficial as that fubftance which fome have 
lately denominated lettuce-opium, and which I term 
tu&ucarium." 
When inflammation is not apparent, inhalation of tar- 
water may be a gentle ftimulus of fome avail in altering 
the morbid aftion of the veffels. The ftritleft attention 
ihould be paid to the due performance of the digeftive 
and excretory functions. The clothing muft of courfe 
vajy according to the feafqn and fituation. The patient 
fiiould endeavour to obtain moderate but not opprtfiave 
warmth. In this climate, flannel next the Ikin during 
the fpring and winter months, by (lightly ftimulating its 
veffels, fuftains the circulation on the furface, and thus 
tends to relieve chronic inflammatory difeafes of the 
pulmonic fyftem. When the difeafe has feveral times 
returned, and is eafily brought on by viciffitudes of tem¬ 
perature, a removal to a wanner and more Heady climate 
is proper. Under thefe circumftances a pure and dry air 
fnould be felefled, as a hot fituation conjoined with 
moifture is always to be avoided. The lea-air during 
the fummer-months, in thole who live in an inland fitu¬ 
ation in this country, fometimes invigorates the confti- 
tution, and reftores the tone of the veffels on the bron¬ 
chial furface, fo as to prevent a return of the difeafe-, 
where former attacks have left a fufceptibility to inflam¬ 
matory adlion. 
The two following varieties are given on the authority 
of Dr. Good ; but their feparate exiftence, affumed on 
the different appearance of the fluid difcharged, does not 
feem fupported by practical writers. They are, 
y. B. acrida; the difcharge thin, frothy, and faline; 
for the molt part excreted with difficulty. It is in mo ft 
inftances an atonic affeftion of the lungs or of other or¬ 
gans that affociate in their adlion. Sometimes an atten¬ 
dant upon the gouty; more frequently upon inebriates 
labouring under a difeafed liver, to whom it is peculiarly 
troublefome in the morning. 
B. periodica ; recurring at Hated periods: partly 
reftrainable; difcharge thin, but not acrid. Moftly 
common to perfons of a nervous or hypochondriacal tem¬ 
perament. 
2. Bex ficca, or dry cough; i.e. unaccompanied with 
expe&oration. Three varieties. 
«. B. ingenerata ; from irritation produced locally, as 
a fcirrhous or calculous affeftion of the lungs. See Bo¬ 
re] li, obf. 6. arid Zacut. obf. 95. 
( 3 . B. extranea ; from irritating materials inhaled from 
without, as minute particles of glafs, lime-ftone, and 
fimilar bodies; and common feo glafs-cutters, hewers of 
free-ftone or fand-ftone, workers of metals, and other 
mechanics. 
In manufadluring towns, the preparers of yellow 
leather, and thofe employed in fome parts of the china 
manufactory, are often fubject to fevere attacks of this 
kind. They are expofed during fome parts of the procefs 
to inhale an air loaded with dull, which produces inflam¬ 
mation of the bronchial membrane of a chronic and pe¬ 
culiar nature. Dyfpncea is generally the primary fymp- 
tom, which is often neglected for many months. If the 
occupation, under thefe circumftances, be continued, 
the difeafe is aggravated. The patientis not unfrequent- 
ly feized with harmoptyfis, which is occafionally very 
profufe, and is accompanied with a great increafe of 
dyfpncea, and fevere cough. The pulfe too becomes ac¬ 
celerated, and is generally hard and ftrong. The furface 
is hot, the tongue white, and there is confiderable thirft : 
occafionally bluenefs of the lips and general lividity of 
the countenance alfo appear. It often happens that we 
can arreft the haemorrhage by blood-letting and aft rim- 
gents; but in moll: cafes of this delcription, the haemop- 
tyfis is followed by very untoward fymptoms. Whether 
haemoptyfis have come on or not, if the bronchia be ftill 
fubjeded to irritation, the cough increafes, and is atten¬ 
ded (for it is by no means true that extraneous fubllan- 
ces always produce a dry cough,) with a copious expec¬ 
toration of thick mucus, which is mixed with pus-like 
matter, and fometimes ftreaked with blood. “The pa¬ 
tient complains of an uncomfortable tightnefs acrofs the 
cheft, and the dyfpncea does not abate. He lofes flefii, 
the pulfe becomes quicker, the tongue continues loaded, 
and there is confiderable thirft. In by far the greater 
proportion of thefe cafes, if the occupation be relinquifh- 
ed, thefe fymptoms, by an appropriate treatment, difap- 
pear, and the patient is reftored to health. In others the 
termination 
