any considerable efficacy, and have observed them to be sometimes hurtful by their heating too much. Some other antispasmodics which might be supposed powerful, such as musk, have not been properly tried. The vitriolic ether has been found to give relief, but its effects are not lasting.

1397. As in other spasmodic affections, so in this, the most certain and powerful antispasmodic is opium. I have often found it effectual, and generally safe; and, if there have arisen doubts with respect to its safety, I believe they have arisen from not distinguishing between certain plethoric and inflammatory cases of dyspnoea, improperly named Asthma, and the genuine spasmodic asthma we treat of here.

1398. As in many cases this disease depends upon a predisposition which cannot be corrected by our art, so in such cases the patient can only escape the disease by avoiding the occasional or exciting causes, which I have endeavoured to point out above. It is, however, difficult to give any general rules here, as different asthmatics have their different idiosyncrasies with respect to externals. Thus, one asthmatic finds himself easiest living in the midst of a great city, while another cannot breathe but in the free air of the country. In the latter case, however, most asthmatics bear the air of a low ground, if tolerably free and dry, better than that of the mountain.

1399. In diet, also, there is some difference to be made with respect to different asthmatics. None of them bear a large or full meal, or any food that is of slow and difficult solution in the stomach; but many of them bear animal food of the lighter kinds, and in moderate quantity. The use of vegetables which readily prove flatulent, is always very hurtful. In recent asthma, and especially in the young and plethoric, a spare, light, and cool diet is proper, and commonly necessary; but, after the disease has continued for years, asthmatics commonly bear, and even require a tolerably full diet, though in all cases a very full diet is very hurtful.

1400. In drinking, water, or cool watery liquors, is the only safe and fit drink for asthmatics; and all liquors ready to ferment and become flatulent, are hurtful to them. Few asthmatics can bear any kind of strong drink; and any excess in such is always very hurtful to them. As asthmatics are commonly hurt by taking warm or tepid drink; so, both upon that account, and upon account of the liquors weakening the nerves of the stomach, neither tea nor coffee is proper in this disease.

1401. Asthmatics commonly bear no bodily motion easily but that of the most gentle kind. Riding, however, on horseback, or going in a carriage, and especially sailing, are very often useful to asthmatics.

CHAP. VII.

OF THE CHINCOUGH OR HOOPING-COUGH.

1402. THIS disease is commonly epidemic, and manifestly contagious. It seems to proceed from a contagion of a specific nature, and of a singular quality. It does not, like most other contagions, necessarily produce a fever; nor does it, like most others, occasion any eruption, or produce otherwise any evident change in the state of the human fluids. It has, in common with the catarrhal contagion, and with that of the measles, a peculiar determination to the lungs; but with particular effects there, very different from those of the other two; as will appear from the history of this disease now to be delivered.

1403. This contagion, like several others, affects persons but once in the course of their lives; and therefore, necessarily, children are most commonly the subjects of this disease: but there are many instances of it occurring in persons considerably advanced in life; though it is probable, that the further that persons are advanced in life, they are the less liable to be affected with this contagion.

1404. The disease commonly comes on with

the ordinary symptoms of a catarrh arising from cold; and often, for many days, keeps entirely to that appearance; and I have had instances of a disease, which, though evidently arising from the chincough contagion, never put on any other form than that of a common catarrh.

This, however, seldom happens; for, generally in the second, and at farthest in the third week after the attack, the disease puts on its peculiar and characteristic symptom, a convulsive cough. This is a cough in which the exspiratory motions ресиliar to coughing are made with more frequency, rapidity, and violence, than usual. As these circumstances, however, in different instances of coughing, are in very different degrees; so no exact limits can be put to determine when the cough can be strictly said to be convulsive; and it is therefore especially by another circumstance that the chincough is distinguished from every other form of cough. This circumstance is, when many exspiratory motions have been convulsively made, and thereby the air is in great quantity thrown out of the lungs, a full inspiration is necessarily and suddenly made; which, by the air rushing in through the glottis with unusual velocity, gives a peculiar sound. This sound is somewhat different in different cases, but is in general called a Hoop, and from it the whole of the disease is called the Hooping Cough. When this sonorous inspiration has happened, the convulsive coughing is again

renewed, and continues in the same manner as be fore, till a quantity of mucus is thrown up from the lungs, or the contents of the stomach are thrown up by vomiting. Either of these evacuations commonly puts an end to the coughing, and the patient remains free from it for some time after. Sometimes it is only after several alternate fits of coughing and hooping that expectoration or vomiting takes place; but it is commonly after the second coughing that these happen, and put an end to the fit.

1405. When the disease, in this manner, has taken its proper form. it generally continues for a long time after, and generally from one month to three; but sometimes much longer, and that with very various circumstances.

1406. The fits of coughing return at various intervals, rarely observing any exact period. They happen frequently in the course of the day, and more frequently still in the course of the night. The patient has commonly some warning of their coming on; and, to avoid that violent and painful concussion which the coughing gives to the whole body, he clings fast to any thing that is near to him, or demands to be held fast by any person that he can come at.

When the fit is over, the patient sometimes breathes fast, and seems fatigued for a little after: