PATHOLOGY. 189 
obftruflions. Diaphoretics are of much ufe in the ear¬ 
lier ftages of afthma ; but, when the malady is of long 
Handing, their utility is often doubtful. Whenever they 
are employed, gentle perforation, not fweating, fliould 
be elicited. Stimulating ludorifics are for the moll part 
improper. The pulv. ipecac, comp, will be found a ufe- 
ful diaphoretic in afthma. It is generally allowed to be a 
very innocent form of exhibiting opium ; and the ufe of 
this article is often called for by the deranged Hate of the 
nerves, as much as the aftion of the fkin is required to 
be promoted by its diaphoretic property. The inhalation 
of fteam ariling from various herbs, as hemlock, ftramo- 
nium, &c. appears to be rather hurtful. Indeed from 
what has been before faid of the caufe of afthma, it is 
evident, that heat and moifture conveyed into the lungs 
is by no means likely to cure an afthma. A regular ufe 
of oxygen between the paroxyfms, and when inflamma¬ 
tory tendency exifts, will be found more ufefu). 
2. Afthma humidum, humoral afthma. Under this 
term fome phyficians have comprehended the anafarca of 
the lungs j but we defignate by it that fpecies or variety 
of fhortnefs of breath or wheezing, which is accompanied 
with a conllant cough, and expectoration of mucus, and 
which is diftinguilhed from phthifisand catarrh by being 
unattended with fever. It is diftinguilhed fromadropfy 
of the cheft, by the abfence of a numbnefs of the arms, 
and (after the ceflation of a temporary aggravation of the 
fliort-breathing from accidental caufes) by the patient 
being able to bear the horizontal pollute. It is the pi- 
luitous afthma of fome writers. It generally begins un¬ 
der the form of the firft fpecies, or convullive afthma $ 
and, like it, is liable to accidental aggravations from 
changes of the weather, and the other exciting caufes 
before mentioned. In regard to its therapeutical treat¬ 
ment, we Ihould adminiller emetics anti expeflorants 
joined with artherand other antifpafmodics. Bliftersand 
ilfues are more ferviceable here than in the convulfive 
afthma; but the employment of diuretics is more parti¬ 
cularly indicated; fuch as fquill, acetated kali, and di¬ 
gitalis. Ten or fifteen drops of the tinClure of foxglove, 
or one grain or a grain and a half of the powdered leaves, 
joined with a fourth part of opium, Ihould be given at a 
dofe, and repeated twice in twelve or fourteen hours, 
until the fhortnefs of the breath is relieved by a flow of 
urine, or until fuch an eft'efl is produced on the pulfe, 
the head, or the bowels, as fliall make it neceflary to fuf- 
pend the ufe of the medicine. Decoflions of feneka or 
dulcamara (fee Practical Synopfis of the Materia Medica, 
vol. i. p. 152, 233.) may be prefcribed in place of the 
digitalis, where this laft fliall be found to difagree. The 
patient fliould be direfled to wear flannel next his Ikin, 
and to keep his feet warm and dry. 
It is worthy of remark, that afthma is often prolonged 
by the habitual ill-aflion of the refpiratory mufcles, their 
nerves, or the bronchial exhalants, when the general 
health is otherwife tolerably good, and the patient free 
from the external agents which firft: caufed the malady. 
When the difeafe affumes this form, the paroxyfm js lia¬ 
ble to be brought on by mental emotion, or any extraor¬ 
dinary impulfe on the nervous fyllem. As the aftion of 
mufcles in general, by frequent repetition, produces in 
them a great mobility, orpronenefs to contradl, fo thole 
of the glottis and chelt equally obey this law. It is to 
the mufcles therefore that Dr. Bree referred the feat of 
this afthma from habit. Others deem it a want of energy 
in the nerves; and this feems a very probable account of 
it in fome cafes. 
The complaint is to be cured by tliofe meafures likely 
to break the aflociated chain of morbid adlions; as, em¬ 
ployment of an interefting kind when the paroxyfm is 
flightly threatened ; a complete change of air and occu¬ 
pation, a ufe of ftimulants of higher order than is admif- 
fible in the preceding forms of afthma, tolerably good 
jiving, and aflive exercife. But galvanifm is a remedy 
of the firft importance. Dr. W. Philip having ufed this 
meafure with great fuccefs, we quote his account of its 
adminiftration. 
“ I have employed galvanifm in many cafes of habit¬ 
ual afthma, and almoft uniformly with relief; and have 
found the aftedlion of the breathing as readily relieved 
when it appeared as a primary difeafe, as when it fuc- 
ceeded to indigeftion. The time, during which the galva¬ 
nifm was applied before the patient faid that his breathing 
was eafy, has varied from five minutes to a quarter of an 
hour. I fpeak of its application in as great a degree as 
the patient could bear without complaint. For this ef¬ 
fect I latterly found from eight to fixteen four-inch plates 
of zinc and copper, the fluid employed being one part of 
muriatic acid, and a hundred and twenty of water, fuf- 
ficient. Some require more than fixteen plates, and a few 
cannot bear fo many as eight; for the fenfibility of dif¬ 
ferent individuals to galvanifm is very different. It is 
curious, and not eafily accounted for, that a conliderable 
power, that perhaps of twenty-five or thirty plates, is 
often neceflary, on firll applying the galvanifm, in order 
to excite any fenfation ; yet, after the fenfation is once 
excited, the patient fhall not, perhaps, particularly at 
firft, be able to bear more than fix or eight plates. The 
ftronger the fenfation excited, the more fpeedy in gene¬ 
ral is the relief. I have known the breathing inftantly 
relieved by a very ftrong power. It has generally been 
made a rule to begin with a very weak one, and increafe 
it gradually at the patient’s requeft, by moving one .of 
the wires from one divifion of the trough to another, 
and moving it back again when he complained of the 
fenfation being too ftrong. It is convenient for this pur- 
pofe to charge with the fluid about thirty plates. 
“ The galvanifm was applied in the following manner. 
Two thin plates of metal, about two or three inches in 
diameter, dipped in water, were applied, one to the nape 
of the neck, the other to the lower part of the epigaf- 
tric region. The wires, from the different ends of the 
trough, were brought into contact with thefe plates, and, 
as obferved above, as great a galvanic power maintained 
as the patient could bear without complaint. In this 
way the galvanic influence was fent through the lungs, as 
much as poflible, in the direction of their nerves. It is 
proper, conftantly to move the wires Upon the metal 
plates, particularly the negative wire, otherwife the cu¬ 
ticle is injured in the places on which they reft. The 
relief feemed much the fame, whether the pofitive wire 
was applied to the nape of the neck, or the pit of the llo- 
macln The negative wire generally excites the ftrongefl 
fenfation. Some patients thought thatthe relief was molt 
fpeedy, when it was applied to the epigaftric region. 
The galvanifm was difcontinued as foon as the patient 
faid that his breathing was eafy. In the firft cafes in 
which I ufed it, I fometimes prolonged its application 
for a quarter of an hour or twenty minutes after the pa¬ 
tient faid he was perfeflly relieved, in the hope of pre¬ 
venting the early recurrence of the dyfpnoea ; but I did 
not find that it had this eft'efl-. It is remarkable, that, 
in feveral who had laboured under opprefled breathing 
for from ten to twenty years, it gave relief quite as rea¬ 
dily as in more recent cafes; which proves, that this ha¬ 
bitual difficulty of breathing, even in the moll protrafled 
cafes, is not (always) afcribabie to any change having 
taken place in the more evident mechanifin of the lungs.” 
Philip on Indigeftion, p. 372. 
Genus IV. EphiaUes, [Gr. a leaper, becaufe it was 
thought a demon ‘'leaped” upon the bread.] Incubus, 
or Nightmare. Generic characters—Sighing fuffocative 
anhelation, with intercepted utterance, and a fenie of 
fome external fubftance prefling heavily on the chelt: tran- 
fitory. This genus has two Ipecies, both of which are 
fomewhat allied to epilepfy. 
1. F.phialtes vigilantium: produced during wakeful- 
nefs 5 
