PATHOLOGY. 2G5 
eluding not only what is commonly underftood by Ca¬ 
tarrh, but the cough ot‘ old age, (which he'admits is 
without febriie aftion,) croup, dyfentery, phthifis, cyf- 
tirrhcea, leucorrhcea, gonorrhoea, and one or two others. 
This is the wideft acceptation of' the term: the narrow¬ 
ed is that of the old pathologifts, who thus diftinguiflied 
between three feparate terms which are now regarded by 
many writers as fynonymous : 
Si fluit ad peffus, dicatur rheurna Catarrhns, 
Ad fauces, Bronchus; ad nares, efto Coryza. 
In the prefent fyftem, the following are the Generic 
characters—Inflammation of the mucous membranes of 
the fauces, often extending to the bronchia and frontal 
fmufes ; infar&ion of the noftrils ; fneezing, and for the 
moil part a mucous expectoration or difeharge from the 
nofe. There are two fpedes. 
i.Catarrhus communis, common catarrh, or cold in the 
head ; in which the fever is flight, and the mucous dif¬ 
eharge confiderable. 
Of thofe flight inflammatory affeCtions of the branchiae 
which are familiarly termed colds , and which fpontane- 
ottfly amend, we have already fpoken of under Bex 
humida, p. 181. There are two remarkable varieties in 
adute catarrh. 
The firfl, which commonly appears during fudden 
changes of fhe weather, generally attacks old people, 
and thofe of phlegmatic habits. This difeafe often 
deceives by the apparent mildnefs of its attack. 
The febrile fymptoms are for the mod part not fevere 
at firfl, when compared with thofe which ufually 
attend pneumonia. The patient does not complain of 
any fixed pain in the cheft, but of confiderable uneafinefs 
and fenfe of flraitnefs there. He is affeCted with oppref- 
fion about the pnecordia, and the countenance is expref- 
iive of anguifh. To thefe fymptoms are added laflitude 
over the whole body, and a general fenfe of weight and 
tenfion over the bread. The refpiration is quick and la¬ 
borious. By degrees, from the accumulation of the fe- 
cretions, the air-cells are more and more filled up, and a 
wheezing noife comes on. Hoarfenefs, though not con- 
ftantly, very frequently attends. The patient cannot 
take a deep infpiration with the accuftomed freedom ; 
and the attempt to do fo often brings on confiderable 
cough, or increafes the pain, if any exifts. Early in the 
difeafe, the dyfpnoea is not aggravated by lying down, 
and no inconvenience arifes from turning on either 
fide; but, as it advances, the refpiration is more free 
in the ereCt pofture. In addition to this conftant dyfp- 
ncea, there are cafes in which the patient is fubjeCt three 
or four times in the day to an aggravation of the diffi¬ 
culty in breathing; a fudden conftri&ion acrofs the 
thorax is complained of, which fometimes, extending to 
the larynx, prevails to fo great a degree as to prevent 
the voice from being articulate. In a flrort time, how¬ 
ever, fuch exacerbations remit, and the complaint re¬ 
lumes its continued form. 
A cough is one of the firfl: fymptoms, and from the 
commencement is ufually accompanied with flight ex¬ 
pectoration ; though in fome cafes, in the firfl ftage, 
there is an unnatural drynefs of the parts. The expec¬ 
toration is always fcanty early in the difeafe, and does 
not at all relieve the cough : but in a few days, if the 
diforder begin to fubfide, a copious fecretion takes place 
from the inflamed membrane, and a large quantity of 
thick vifeid opaque mucus is fpit up : after which the 
violence of the cough is ufually diminiflied. The cough 
more frequently in this than in pneumonia excites vo¬ 
miting : this ufually relieves the bronchia of very confi¬ 
derable portions of denfe white mucus, which are fome¬ 
times moulded into the fliape of their ramifications. 
The patient is frequently feized with fits of coughing, 
which aggravate the dyfpncea ; and, after their violence „ 
lias fubflded, he is left almoft breathlefs, with a painful 
I'enfation of flraitnefs acrofs the cheft. The urgency of 
thefe fymptoms, however, gradually abates if another fit 
of coughing do not difturb the refpiration. Yet the 
dyfpncea, in many cafes of this difeafe, is by no means 
proportional to the cough ; the latter being often flight 
when the former is very fevere. The cough and dyfp¬ 
ncea are generally relieved by a copious expectoration, 
and more efpecially in thofe who are in the decline of 
life, and have been frequently the fubject of catarrhal 
affeCtions. 
In almoft every inftance the cough is accompanied 
with intolerable pain acrofs the forehead, which may be 
fympathetic, or it may be an aCtual extenfion of the in¬ 
flammation. In many cafes drowfinefs and vertigo at¬ 
tend. The tongue is often dry, and the whole mouth 
feels clammy from vifeid mucus. The ftomach refufe.s 
all fuftenance, and the third is urgent. The urine is 
fometimes red and-turbid, depofiting no fediment; and 
fometimes it is fcarcely changed from the natural ftate. 
The frequency of the pulfe in the commencement 
of the difeafe is often not much increafed; but during 
its progrefs fome fulnefs and hardnefs are perceptible, 
though, in the more ordinary examples, fulnefs is 
more charafteriftic of this affeCtion than hardnefs ; 
and in thofe whole conftitutions are impaired by hard 
drinking, wdio are frequently attacked with this diforder, 
the ftrength of the pulfe is often rather diminiflied than 
increafed. The temperature of the body is feldom much 
raifed, although the face is often fluflied, and evening 
paroxyfms of heat and reftleffnefs come on. The furface 
is generally dry, unlefs aCted upon by diaphoretic reme¬ 
dies. The blood drawn is, for the moil parr, buffed. 
The duration of this difeafe is uncertain. It is often 
difficult indeed to determine the precife time of its com¬ 
mencement, fo infidious is the attack. In fome cafes it 
terminates in a few days, whilft in others it runs on to a 
much longer period. In the more violent cafes, when the 
remedies employed do not check the progrefs of the 
fymptoms, the pulfe towards the feventii or eighth day 
becomes very quick and much weaker; occafional per- 
fpirations breakout, the nails and lips aft'ume a flightly 
livid hue, and the countenance is diftreffed, anxious, 
and pallid, with fomewhat of a purple tinge. In faCt, 
every fymptom befpeaks obftruCtion in the air-paflages. 
Soon afterwards the extremities grow cold, and the pa¬ 
tient dies from fuffocation. 
In cafes of a lefs dangerous nature than above alluded 
to, the more diftreffing fymptoms begin in fix or feven 
days to fubfide. The dyfpnoea becomes lefs urgent, the 
cough is relieved, and a copious expectoration of a thick 
white matter takes place. But the recovery is always 
flow', the expectoration continuing for fome time, and ge¬ 
nerally preventing the patient from recovering his ftrength 
for feveral weeks. Moreover, in this ftate of the difeafe 
the bronchial membrane is particularly liable to be af- 
feCted by atmofpheric changes; and thus, not unfrequent- 
ly, a chronic affeCtion of a very obftinate nature occurs. 
If, however, the weather be favourable, after the worff 
fymptoms have been removed, the difeafe often gradually 
dilappears ; but not without leaving the mucous mem¬ 
brane much difpofed to take on inflammatory aftion, 
which will almoft inevitably occur when the exciting 
caufes again operate in any confiderable degree. 
Inflammation of the bronchia, when it takes place in 
the ltrong and plethoric, ufually produces fymptoms of 
much greater feverity. The pulfe, the furface, and the 
tongue, all ufually indicate violent reaction ; but the 
countenance is often peculiarly pallid. The progrefs of 
this variety of catarrh is more rapid than that of the one 
before fpoken of. Even in this, however, there is rarely 
a fixed pain in any part of the cheft, but a diftreffing 
fenfe of Jlraitnefs is conftantly felt. The breathing is 
hurried and laborious, the patient only experiencing to¬ 
lerable eafe in an ereCt pofture. A cough almoft con¬ 
ftantly attends, but it feldom bears any proportion to 
the dyfpncea; the former being often trifling when the 
/ latter 
