184 
PATHOLOGY, 
Every practitioner muft have ohferved the almoft con- 
ftant derangement of the excretions of the bowels, under 
any acute difeafe in children, but more efpecially under 
tbofe affefting the lungs ; and the relief obtained, even 
in refpeCt to the original diforder, by regulating the al- 
vine difcharges. It is important, therefore, when the 
difeafe affumes an inflammatory type, to keep up a con- 
ftant free (fate of the bowels from the fir ft, by the repeated 
ufe of laxatives, efpecially of thofe which contain a por¬ 
tion of calomel. According to the ftate of aCtual con- 
ftipation, or of mere derangement of the excretions, the 
purgatives will be ufed more actively at intervals, or more 
conftantly in fmaller dofes. 
Of all other remedies, emetics appear to be among the 
moft ufeful in this difeafe ; for they not only determine 
the fluids to the furface, and ftill more effectually relieve 
the lungs by promoting its fecretions, but they alfo tend 
to interrupt the recurrence of the fpafmodic affeCtions. 
As a fecondary expedient, with a view to obviate or re¬ 
move inflammatory determination to the lungs, when it 
occurs in this difeafe, the application of blifters is often 
beneficially reforted to. They do not, however, appear 
to aCt fo beneficially in the relief of the pain and dyfpnoea 
attending this difeafe, as in ordinary cafes of catarrh; and 
ought not to be relied on, where the inflammatory con- 
geftion in the lungs is confiderable. They are moft be¬ 
neficial, when this inflammatory condition has been al¬ 
ready partly fubdued by the more aCtive evacuations. 
The medicines generally in ufe in thefe complaints are 
the fame as in the common forms of bronchitis ; viz. di¬ 
gitalis, colchicum, &c. The alkalies, foda and potaflt, 
have alio great influence on this complaint. To allay 
the nervous excitation, conium and hyofciamus may be 
advantageoufly prescribed ; the warm bath Should be ufed 
occasionally, and reft absolutely enjoined ; for, whether 
we view' the mere Symptom of dyfpncea, or extend our 
refearches to the probable caufe of its occurrence, we 
Shall find ample reafon to induce us to keep the lungs 
in as tranquil a ftate of action as poffible. It is in this 
way indeed that bleeding in all pulmonary difeafes muft 
be principally ufeful ; viz. that the diminished quantity 
of blood in the fyfteni calls for lei’s activity in the refpir- 
ing powers. 
Thefe rules apply, however, only to Severe cafes. In the 
ufual mild forms, a regulated diet, pure air, and medi¬ 
cines of an aperient nature, with an occafional emetic, 
will accomplish all that is required in the firft ltage of the 
diforder. 
In the after Stages', when the operation of the conta¬ 
gion may be fuppofed to have ceafed, and the convulsive 
cough to be continued through the influence of habit, a 
different indication arifes, and different remedies are to 
be employed. That the power of habit contributes to keep 
up the difeafe, after the influence of contagion has de¬ 
clined, is to be inferred from the circumftance that the 
fymptoms have disappeared, like other nervous Symp¬ 
toms, in confequence of the impreflion of terror, or other 
Strong emotions of the mind ; which agents cannot be 
fuppofed to have the power either of correcting or ex¬ 
pelling a morbific matter from the conftitution, but 
which are evidently Suited to change the ftate and ha¬ 
bits of the nervous fyftem ; or, at all events, of inducing 
a change in the merely habitualdiforderof the fecernents. 
With this view, the inhalation of tar vapour may be re¬ 
forted to with advantage. Some authors have advifed a 
variety of tonics ; but their mode of aftion is obfcure, 
and general experience has not confirmed the original 
accounts of their efficacy. A Stimulant more congenial 
to the bronchial membrane is country air. Indeed 
change of air has been very generally deemed the moft 
effectual remedy in the advanced ftages of the difeafe. 
And fo Strong has this impreflion been made upon the 
public, that it has been generally believed, that any 
change of air, even from a better to a v/orfe, is beneficial. 
This, however, Seems improbable; and the fact perhaps 
is as Dr. Watt has Stated it : “It no doubt frequently 
happens,” fays that writer, “ that a child is better on 
being taken from one place to another, even when the 
air in the latter place.is fuppofed to be worfe than the 
former. Here, however, I fnould be difpofed to attribute 
the good effeCts, not to coming into a more impure at- 
mofphere, but to the child’s being abroad , any atmol- 
phere being better than confinement to the houfe.” This 
advice is not of courfe meant to apply to any but cafes 
in which the inflammatory tendency of the cough is per¬ 
fectly fubdued. 
But we muft not forget to mention, that a refpeCtable 
author has oppofed the notion that change of air is al¬ 
ways beneficial to patients of whooping-cough. Dr. Ro- 
bertfon has Seen Some lamentable instances to the con¬ 
trary. He thinks the removal Should be but a Short dif- 
tance from home, “and the new abode Should be choferi 
in every thing refembiing the former one,” avoiding ele¬ 
vated and expofed Situations, as well as thofe that are 
too low and damp, or within the range of exhalations 
from Stagnant waters or flooded meadows. Inland Situ¬ 
ations are preferable to the coalts. The advantages of 
change of air, he thinks, may Sometimes be obtained by 
change of rooms and habits, at home. Upon the whole 
we are of opinion, that, as a general meafure, change of 
air, or, at any rate, being much in the air, is advisable ; 
but, like other good rules, it is liable to fotne exceptions. 
Dr. Archer, an American phyfician, advifes to relieve 
the whooping-cough by vaccination. This, of courfe, 
can be reforted to only under particular circumstances. 
Dr. A. fays, “ I have vaccined fix or eight patients that 
had the whooping-cough, and in every cafe it has fuc- 
ceeded in curing this moft diftreffing difeafe. The 
whooping-cough does not come to its height in lefs than 
fix weeks from its commencement; and then, when a 
favourable termination is expefted, the declenfion of the 
difeafe is gradual, and it does not terminate in lefs than 
fix weeks more. To arreft this afflicting diforder in its 
progrefs, I would recommend vaccination in the fecond 
or third week of the whooping-cough, i. e. when the 
fymptoms of the whooping-cough are fully afcertained, 
then to vaccinate. Should the convulfive cough be vio¬ 
lent, I Should immediately vaccinate ; being well allured 
that the diftreffing fymptoms of the whooping cough are 
checked by vaccine diS'eafe. The termination of the vac¬ 
cine difeafe will be the termination of the whooping- 
cough.” 
Genus II. Tdyfrnaa, [from Sw;, bad, and mice, to 
breathe.] Anhelation. ‘Permanent difficulty of breath¬ 
ing, with a fenfe of weight on the cheft. 
Dyfpnoea is produced by fo great a variety of caufes, 
and from its very nature is fo evidently fymptomatic, as 
in faff Parr and the belt fyftematic writers have always 
considered it, that we Shall refer our readers to the origi¬ 
nal maladies which give rife to its varieties for the necef- 
fary details concerning it. 
It may be pradtically ufeful, however, to remark, that 
an unremitting difficulty of breathing is common to fome 
old perfons, in whom its long continuance, and the ab- 
fence of other fymptoms, forbid us to fuppole any orga¬ 
nic change in the Structure of the lungs or contiguous 
vifeera, or indeed any merely mechanical obstruction, to 
have occurred. It differs but in a flight degree (as far 
as our own opportunities of Seeing it have extended) from 
afthma: the point of difference between the two com¬ 
plaints is merely the regular and continuous diforder of 
refpiration in the former difeafe, as antagonized to the 
paroxyfms or exacerbations of the latter. There are two 
lpecies. 
i. Dyfpncea chronica, or Short breath : breathing uni¬ 
formly Short and heavy, moftly accompanied with a 
cough. There are five varieties. 
a. D. 
