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time, induced a severe cough He has sed many medicines, with the natur os,hicli heris unacquainted. And he has neverreas'ed any considerable relies rom them. Infusi rosarum uncias duas; Mucilagini gummi Arabici, Θ up implicis inguArum unciam unam. Mior hyossos uncias tres M. Capiat emunciam tertia quaque hora. June Io. The mixture sit eassit on his stomach ut he has had frequent returns of the lood expectoration to a considerable extent, and hecis stili very much disti essed illi cough. viis pulse beat an hundred strokes in the minute; ut it sat present 1ieither hard nor fuit an his
heli is regular. Continuetur sura, et
Pu eris salis nitri, Pu eris gummi Arabici, utriusque semi- drachmam M. Capiat do in vespere
June 7. The mixture sit easit oti his stomacho ut e complain os avi rigbeen assected illi ripes rom the pow
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Intermittatur pulvis salis nitri. Continuetur mistura, cum infuso rosarum, ut antea. Jul 1 He has alien non of the mixture for sontes lay past andine stili continues Dee froni the blood expectoration: but hecis affected illi much cough, whichis particulari severe during the night; and e complain also os aliis in his breas and other paris of the trunk of hisbo ly. Pulse ninely-Dur beli regular.
Intermittaturi sura; et Mucilogini gummi Arabici, Drusi plicis,singulorum unciam unam. Tincturae thebaicae drachmas duas. Aquis uncias quatuor M. Capiat unciam unam omni nocte hora somni.
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OBSERVAT 1ON delisere. Di 8. That this patient is subjected o distase, sevident even froni thymost sight attentionto his applarance. In his emaciated habit, we have evident indication o soni causegivin exhaustionis the generat system and fron his mode of respiration, herecan he litti doubi in fixin this cause tome in the breast although, at the fame time, the description gi ven by the patient,ould seem to lead to a different supposition. For, accordinito his account, he was Dfect d, bout a forinight efore e cameunderisu care, With a severe vomitinios blbod his might heres ore lead to a suspicion, that the cause of the affectionwas ather in the stomach than in thelung or, in ther Wor is that he principat par of the assection to hichie u
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stinctions. The are apta include under the ille of vomiting, almos ever preternatura disicharge by the mouili Andrinthis case there is particulari room for deception, heia, by the actionis vomiting, the expectoratio of lood is promoted.
That the blood with ou present patient is in reality disicharge frona the reast, is evident fro the mixture stili appearing in vilia is pit, froni the lungs by cough
Thespresumption here re is that the supposition o ou patient, a to his disia charginiblood by vomiting, is a mistahe,
especiali when, conside that Haemate-mesis is but a rare assection, and ver generali occurs ni as a sympto os other complaints. I would here then consider
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tom peculia tocit, o characteristical oscit. On the contrary, it is an universa con- comitant of haemoptysis and it must, indeed, e a constant sympioni o every dis eas where alter is lodged in the breast It is tot observed, o ever, that thecough occurring in Haemoptysis ahes placei ver different states. Sometimes hereis meret a stior tickling cough, without an severity and this is tot consideredas proceedin Domis other cause hanfroin the irritation whicli the blood occasion in the air-vesicles This perhaps is the most common state of the cough and hence, in some of the est definitions itis characteris ed by the ille o Tussicula. Where the hsemoptysis is illi his state of the cough, i may be consideresa the effect itheris a peculia determination to the lungs, oris a genera plethori habit. An the haemorrhag occurriniis to eviewed alway a being of the active hind, that is, a dependi niupo the actio ofth blood-vesset themselves bella augmented and tu in rupture noti a VP A a ture
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iure procee ling rom ther causes, and a consequent dis charge of blood meret fromthe ordinar impetus of the circulation. In cases of suci active haemorrhagy be-sides the state of the ough, the assectionis also distinguis ed by the mark of apte thori habit particulari by a flushing of the countenance, and a generat 1 ΤΟ - 1 in state os complexion; by a sense of weight and oppremon an particularly, hy what a b calle a haemorrhagicaldisposition that is, a tenderic to the evacuation o blood by other paris, s wel ashy the esset of the lungs. At suci ap-
teast, antin in the instance efore iis, and the cough is here remarhable both forfrequenc an severity. dis charge of lood a talae placector the lungs, in consequence of passive haemorrhagy, as et a froni that of the active hi nil And amoniother cause inducinia rupture of vesseis violent coughis to e justi enumerate i. It CCUrs,
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there re, as a question os orne import- ance, hether the haemorrhag with our present patient e of this o the formerkin Anda must wn that froni thestate of the cough, together illi the pre sent condition of his habit, Pam dispossed
have formeri been the case, as of the passessive hind. It is triae indeed that bessides dyspnoea, hicli a b considere fas a consequence of the air-vessiclesieinifille twith other matter, his patient complainsalso Calain at his breast; hicli is per-haps to e viewcd as ne of the strong- est mark of increasse faction, o what is callet haemorrhagi effort, ivin riserio increassed disicharge. But it is tot ob1er-Ved that patia, as et a Cough, is os dis ferent in is and it is no improbabie, that the pati here occurriniis meret theconsequence of oppression and of generaluneasinesse particulari as it is no re-marhed that it is attended illi ny senseo heat, hicli is an almost constant con- omitant of that peculia increased action. a a But
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But although, froin these considerations, would vie the haemorrhag as a present of the passive inii, et I would notinfer haesit has alway been si for, stombeginning in a disserent state, it ma havegi ven ris to a debilitatesconditionis thevesseis, and may have even been the origin os sonae fixe cause producing the congli. O this there is solo presiimptionfroin the continuance of the affection, and froni the extent of the haemorrhagyieingi uch a to ive the appearance of vomit-ing et when me conside the cause of the affection, a far a that is obvious, ema perhaps conclude that froni the be- ginniniit as of the fame nature a at
But an inquir respecting the originalstate of this patient' diseasi is no per-haps immateriai, a the realmen is un- questionabi to e accommodate to his present condition. An respecting this there is another questionis greate consequence laimin attention that is, he- the we an conside him a subjecte to Phthi-
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Phthisis Pulmonalis, 3 no have for- meri had occasion to potnt out three different causes ivin origin t Phthisis.
These were, Catarrh, Tubercle, and Haemorrhagy. Wheneuer, heres ore, H EmOp-tysis exists, there is reason to dread Phthisis pulmonalis as a consequence and in diseas whicli akescit progress si imperceptibly, ver symptoto giving any
indication oscit is particularly to e attende icio. In the case efore us, there are sonae particulars hicli favour the suppositiono a phthisis and it a b imagined,
that it is in consequence of ulceration orvomica originatin froin his cause, that the cough is supporte for socioni time, and with fuch severity. The state os expectoration ais may be considere Das i vinissem countenance to this supposition. For there is here room for supposing that the ello viscid matter expectorate sis of purulent nature. It mustiei ned that
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pus and mucus I is ellanown however, that both the particular mentionedas descriptive of the matte in the presentinstance, the ellownes and the viscidity, are stricti properties of mucus. The lat-
terris even more a propert of mucus thano purulent matter an here sonae atteast of the mos common mark of pusare anting, particulari a fetid melland aste. I ould the conside thismar of a phthisica affection to emanting and froni the circumstance of the viscid mucus alone, e may perhaps explain the severit and frequency of the
It is farther o b observed that other charaeteristic mark of phthisis are also wanting. Though his reathin be a se fected, et it is no observe tot particulari laborious heri e lies on itherside The patia of the reast isto fixedio an particular pol an although his pulset qui ch, et it is not with thos regula accessons hicli distinguissi the hecti sever Besides, even the circumstance Of