PATHOLOGY. 2G7 
this affedtion difficult, as we are fometimes deterred by 
that caufe from purfuing the blood-letting when the in¬ 
flammatory fymptoms indicate its employment. In this 
event we mull fubdue the inflammation by thofe means 
which are lead: likely to bring on effufion. 
Catarrhus, however, as has been noticed in the hiftory 
of the fecond variety, fometimes occurs in robuft habits, 
and occafions violent fymptoms. The flage of excite¬ 
ment in thefe cafes is not of very long continuance; it 
foon terminates in irremediable debility. The flrort 
fpace of time that is allotted for the employment of an- 
tiphlogiftic meafures fltould not, therefore, be allowed to 
pafs without an attempt to make a decided impreffion on 
the difeafe. With this view, blood-letting fltould be 
holdly employed. From twenty to thirty ounces of 
blood may be taken from the arm in fevere cafes, at the 
firft blood-letting. It is difficult, however, to diredl the 
precife quantity of blood. If the patient be of a ftrong 
habit, and the pulmonary fymptoms urgent, and the fe¬ 
brile excitement confiderable,we fhould allow it to flow till 
the pulfe becomes weak, or the pulmonary fymptoms are 
relieved. There are few cafes which yield to one blood-let¬ 
ting. The propriety of its repetition fhould be determined 
by the degree of benefit obtained, the date of the fymptoms, 
and the ltrength of the patient. Several blood-lettings 
are fometimes required. When the difeafe attacks chil¬ 
dren, general blood-letting fhould be employed as far as 
the ftrength will admit. In young children we cannot 
always obtain blood from the arm, but we may generally 
fucceed in taking it from the jugular vein. This prac¬ 
tice, indeed, is attended with forne advantage, as the 
blood is taken from a vefiel which pours its contents in¬ 
to the thorax. For the moll part, however, children do 
not bear the lofs of blood well; but in an attack which 
is menacing life there is no alternative: we mull adopt 
powerful meafures, for without them the difeafe will al- 
moft certainly prove fatal; but fuch is its dangerous 
charadlei^ that even by them its progrefs is often not 
arrefted. When bronchitis is complicated with chronic 
difeafe of the trachea, blood letting to any great extent 
cannot be always employed ; for, if ulceration of the 
trachea have come on, the ftrength is often fo much ex- 
liaufted by it, that the lofs of any confiderable quantity 
of blood is not admiffible. Even if relief be obtained by 
thefe means, it can only be temporary, unlefs the ulcer¬ 
ation can be removed. Bronchitis arifing from the irri¬ 
tation of external tumours requires venefedfion ; but this 
remedy cannot give efteblual relief, unlefs the caufe pro¬ 
ducing the inflammation can be taken away. 
Vomiting is fometimes productive of relief. Several 
writers have fpoken very lv.ghly of the ufe of emetics in 
the fecond variety. The aqueous folution of tartarized 
antimony is in general, perhaps, the bell remedy for pro¬ 
ducing it, although in young children it is not fo fafe as 
ipecacuanha, which, in them, fliould be confequently 
preferred. Independently of the adlion of the former as 
an emetic, it feldom fails to excite diaphorefis, which if 
general, and not too profufe, nor brought out by heating 
meafures, is ufually beneficial. But the good effedts of 
antimonials are not confined to thofe cafes in which we 
wifh to produce vomiting. In every variety of acute ca¬ 
tarrh, when there is much fever prefent, the greateft ad¬ 
vantage is derived from the fteady ufe of antimonials. 
They are indeed the mod valuable of all medicines; for 
they not only, by exciting naufea and opening the pores 
of the fkin, confiderably leffen the febrile excitement, 
but, by their adlion on the exhalant vefiels of the lungs, 
they promote expectoration, and thus leffen the inflam¬ 
mation of the mucous membrane. They may be given 
in combination with faline draughts and nitrate of potafs. 
In the advanced ftage, when the inflammation is nearly 
fubdued, and the bronchia are clogged, ipecacuanha 
combined with fquills is often of great fervice ; but in 
all cafes of this difeafe, as long as the excitement is con- 
Vol. XIX. No. 1302. 
fiderable, if antimonial remedies be excepted, no expec¬ 
torants are fo ufeful as mucilaginous mixtures. 
In every variety of bronchitis, we fltould keep the body 
lax ; and, in the commencement of the difeafe, fhould 
adminifter an adlive purgative, fo as to clear the alimen¬ 
tary canal, and fliould afterwards fo employ it as to keep 
up a due adlion of the bowels. Opium is prejudicial as 
long as there is much fever; but, when that declines, 
and irritability of the fyftem and air-paffages Hill prevails, 
it not unfrequently allays the cough, and calms the pa¬ 
tient. But opiates mull be employed with great caution, 
efpecially in the fecond variety ; for when the fecretion 
is copious, and the ftrength much reduced, they inter¬ 
rupt, for a time, the efforts to expedlorate, and may thus 
prove fatal. In combination with fmall dofes of calomel, 
opium may fometimes be exhibited at an earlier period 
of the difeafe. When conjoined, thefe remedies not only 
diminifh the cough and aflill expectoration, but feem 
likewife to regulate the fecretions throughout the fyf¬ 
tem. Diuretics have been advifed by fome writers of au¬ 
thority ; and, when the difpofition to effufion fiiow's it- 
felf, the milder kinds may be of confiderable fervice. 
Local blood-letting fhould be ufed under the fame re- 
ftridfions as in other inflammations. Blifters are pro¬ 
ductive of great benefit after the excitement has been 
confiderably relieved by blood-letting. But when ca¬ 
tarrh occurs in phlegmatic habits, and affumes the form 
of peripneumonia notha, bliftering may then be employed 
from the commencement, and is one of the remedies to 
be chiefly relied on in the cure of that variety. If the 
difeafe be obftinate, we fhould not be content with a 
fmall blifter to the chell; one of fufficient fize to cover 
the whole of its anterior part fliould be applied ; and, if 
the fymptoms do not readily yield, the difcharge from 
the bliftered part fliould be fupported, or a fucceffion oj| 
blifters employed. ” 
The tepid bath often relieves this as well as other in¬ 
ternal inflammations, by removing the tenfion of the 
furface, and exciting diaphorefis. Local fomentations 
and cataplafms may be alfo ufed : they bring a larger 
quantity of blood into the vefiels of the integuments co¬ 
vering the thorax, and encourage a more copious effufion 
of blood from the leech-bites. When the difeafe be¬ 
comes chronic, thofe remedies are to be had recourfe to 
which we have mentioned when treating of chronic ca¬ 
tarrh. See p. 183 of this article. 
The diffedlions of catarrhal fubjedls manifeft morbid 
appearances in the following order: Rednefs of the 
bronchial membrane'; w'ant of elafticity in the lungs ; 
mucous, fanguineous, or purulent, exhalation; ulcera¬ 
tion of the bronchias ; a rednefs or other morbid ap¬ 
pearance of the fubftance of the lungs, fhowing the exig¬ 
ence of pneumonia and bronchitis. 
Dropfy and a variety of dyfpeptic ailments are fome¬ 
times aflociated with Catarrhus; the dropfy as a con- 
fequence, the dyfpepfia a caufe, of the pulmonary'dif¬ 
eafe. Of the dyfpeptic bronchitis we have fpoken under 
Dyfpepfia ; and the latter does not require a diftindt 
treatment. The fame remark is applicable to the ca¬ 
tarrhus attending meafles and other exanthems. 
2. Catarrhus epidemicus, the epidemic catarrh, or in¬ 
fluenza : attack fudden ; great heavinefs over the eyes; 
fever ftrikingly depreffive; epidemic. 
For an excellent Chronological Table of the bell 
writers upon the fubjedl, from the Cronica Meteorologica' 
Tufcana of 1323, by Targioni Tozzetti, to Saillant’s 
Tableau des Epidemies catarrhales, fee Cullen’s Synop- 
fis, in loco. It appears, from what can be gathered from 
thefe fources, that the influenza was a calarrh which was 
no otherwife diftinguiffied from the firft fpecies than by its 
feverity and its being contagious. Dogs and horfes are 
fubjedl to a violent and frequently fatal variety of this 
difeafe ; in molt inftances highly contagious or epidemic. 
This, among ourfelves, is vulgarly known by the name 
3 Z of 
