Page:Cyclopaedia, Chambers - Supplement, Volume 2.djvu/699

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The common coltsfoot ftands generally recommended as a very great medicine in coughs, and all disorders of the breaft and lungs. It is alfo fometimes ufed externally in inflamma- tions.

TUSSIS, the Cough. Medical writers define a Cough to be a difcuflbry and elifory motion of the breaft, by means of which nature attempts to throw off fomewhat that is offeniive to her.

Phyficians diftinguifh Coughs into the idiopatic and the fymp- tomatic ; the firft is truly pectoral ; the other only affects the breaft, by means of the cbnfent of parts. Of the fymptoma- tic, or, as fome exprefs themfelves, the confenfual Coughs, fome have a catarrhal difpofirion, and have a coryza for their origin or attendant, or, more ftridtly fpeaking, a gravedo ; fometimes a bronchus, hoarfenefs, and inflammation of the ton- fils ; others are called hypochondriacal, which fometimes arife from diforders of the ftomach, and are therefore called dry ftomachic coughs ; and fometimes from fchirrofities of the liver, whence they are common to people in cachexies, and in hectics and dropfies.

A Cough, which rifes from internal caufes, is to be carefully difiinguifhed from one that rifes from external. The dry and the moift Cough, that is, thofe in which matter is fpit up, and thofe in which nothing is evacuated, differ alfo greatly, as well in regard to their fymptoms, as to the perfons they attack. The dry Cough is always more tedious in cure than the moift, and more eafily returns. The ftomachic Cough, which is owing to confent of parts, is known by the quantity and thicknefs of the matter that is fpit up, which is always moft frequent after meals, and gives a tendency toward a reaching to vomit. This moift ftomachic Cough differs in this manner, in all particulars, from the dry cough of the fame name and origin with it, as mentioned before.

The hypochondriac Cough is abundantly difiinguifhed from the other kinds, by its drynefs, and by its vehement violence, for it always leaves a hoarfenefs behind it; this always is moft violent after eating, and after drinking large draughts of cold liquors, or afcending fteep places. As alfo by its bearing very well a cold and humid air, and not being exafperated by it, as the pectoral Coughs are ; and finally, by a fenfation of a con* cuffion of the diaphragm, when the effects in coughing are violent. Junker's Confp. Med. p. 5 14. The common habitual dry Cough is diftmguifhed from the other kinds by its remarkable drynefs ; and the common moift habitual Cough by its abundant quantity of matter difcharged, , and by its appearing pulpy and greenifti, and not famous, or; ftreaked with blood, and continuing in the fame degree ufually. for aconfulerabletime. In this habitual Cough there is no wafting of the flefli, nor is there that violent exacerbation on the taking of opiates, which is always found in the phthifical Coughs, to which all opiates feem the greateft enemies. This Cough alfo always receives great benefit from purging medi- cines, but the phthifical Cough none at all : But both thefe differ greatly, according to the age and temperament of the body of the perfon afflicted with them.

Perfons fubjeel to Coughs. The fimple idiopathic Cough, arifing from internal caufes, whether it be of the moift or dry kind, is almoft peculiar to young people, and thofe of plethoric ha- bits. The catarrhal fymptomatic Cough, which arifes from external accidents, is common to perfons of all ftates and ages; but is more frequent among old men than among others. The perfons moft fubjedt to the common dry Cough are young people of a florid conftitution and dry habit of body; and men of the middle or more advanced ages are fometimes alfo afflicted with it, from fuppreffions of the hemorrhoidal difcharges, or from omiflions of habitual bleedings ; as are alfo people who are badly conformed, gibbofe or crooked, and fuch as are afflicted with the evil, or have calculi in the bronchia, or nodes of a fchirrous nature in the lungs; and fi- nally, fuch as have been ill-treated in the fmall-pox, or have had the itch, or any other violent cutaneous eruption ft ruck in upon them. People moft fubject to a common moift Cough arc thofe of a phlegmatic habit, fuch as are apt to cool their neck and breaft in autumn in damp cold air in evenings ; fuch as have omitted their habitual bleedings, and fuch as have drank too freely of fpirituous liquors, or taken too much of acids. The idiopathic pectoral Cough arifes from a congeftion of humours in the breaft ; and the hypochondriac Cough is ei- ther owing to a fault in the ftomach, or to a fchirrofity in the liver. Junker's Confp. Med. p. 515.

Prognojlics in Coughs. The fimple idiopathic pectoral Cough very frequently goes off of itfelf, without the afliftance of medicines, or with no farther affiftance to nature than bleed- ing, judicioufly managed ; but though thus gentle while recent, yet when it is become habitual, and fixed upon a perfon, it is very obftinate ; and though at firft it is far from a confump- tive Cough, yet there is no certainty but that it may, at fome time or other, occafion ulcerations in the lungs. A dry Cough in young people is much to be feared, when of long ftanding, for it not unfrequently degenerates into a fpitting of blood, or into a confumption : This kind fometimes alfo changes into what authors call the ferine Cough, which is fo violent, that perfons afflicted with it are fcarce able to recover them- fclves after a fit of it. In general, any Cough that feizc*

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a perfon in the Spring, is much eafier cured than one that attacks in Autumn. Periodic Coughs^ that have been long ufed to return upon people at certain times* are always to be fufpected of danger, if they leave them fuddenly, and no na- tural or artificial evacuation is made In their place ; for they too often bring on faults in digeftion, and fometimes fuffoca- tive catarrhs, and paralytic diforders : A moift habitual Cough 9 when it fuddenly changes into a dry one, is alfo a bad pro- gnoftic. A violent dry hypochondriac Cough, that frequently remits and recurs again* and is ufually worft in the night, gives great reafon to fufpedt a fchirrofity in the liver ; and the more regularly it returns at ftated times, the more certain is the de- fect of this or fome other of the vifcera ; fo that the prognoftic is very fatal and very certain from it. Junker^ Confp."Med. p. 518. Method of Cure. In cafe of a moift pectoral Cough^ it is pro- per firft: to give a purge, not violent, but yet moderately ftrongi to derive the matter from the breaft ; and the catarrhal matter muft then be prepared for evacuation ; when it is fim~ ply mucous, the common refolvent and difcutient catarrhal medicines are to be depended upon ; fuch are decoctions of the roots of pimpernel and iris, with the leaves of hyffop, hore- hound, fcabious, and fpeedwell ; with thefe are to be given the attenuant gums, as ammoniacum* benjamin, and fao-a- penum, with the warm carminative feeds. When the matter is too tough and vifcous, the bufinefs then is, on the con- trary, to incraffate and reduce it to a foft pulpofe body. This is effected by liquorice-root or juice, with gum arabic, figs, ftarch, together with all the ftilphureous medicines. If, on the contrary, the matter is thin and acrimonious, and irritates violently* then the cure is to be effected by fuch things as ob- tund and fweeten it; of this kind are emulfions of almonds, and the cold feeds, with barley-water, water-gruel, the muci- lages of quince, and fleawort feeds, and the like; and to thefe are to be added occafionally, fperma ceti, and oil of fweet al- monds : When the Cough is habitual, laxatives are to be given after thefe, or hi the intermediate times, during the taking them ; and if the Cough returns, when the matter of it is no longer the caufe, it is to be quieted by gentle opiates, fuch as the ftorax pill ; and finally, corroborants are to be given to reftore the due tone of the lungs. In the dry Cough the gentleft purges only can properly have place, and nothing is fo proper as to begin with fmall dofes of rhubarb ; after this, to difcufs the fhgnating blood about the breaft, decoctions of the pectoral herbs are to be taken in large quantities, fuch are coltsfoot, fcabious, maiden-hair, and the like. While the patient is taking thefe, he ftiould fre- quently wafti his feet in warm water ; and finally, the cure is to be compleated by fuch corroborants as reftore the due tone of the lungs ; of this kind, Stahl's tonico-nervine mixture is a very excellent medicine.

In the hypochondriacal Cough, as there is generally a fault in the liver, the Cough can never be cured, unlefs that defect can be removed. The Cough is therefore to be judged, in this cafe, only a fymptom of the difeafe, and the method of treatment mult be the fame as in the infarctions of the liver* See the article Hepatjs InfarBus.

When this obftruction is removed, the Cough, occafinned by it, goes off of itfelf. In cafes where the hypochondriac Ciugh depends on a fault in the ftomach, the firtt confident ion to be had, is, whether it be dry or moift ; when it is dry, we may conclude that the fault is not fo much in the ftomach, as in the parts about it ; and hence the motion of the congeftions of blood toward the vena porta are to be regarded. The moift ftomachic Cough always brings the breaft into con- fent, and is hence often called a Jhmachico-peBoral Cough; fof the mucous matter which lies in the fauces, and is daily eva- cuated rather by hawking than coughing, probably afcends up the cefophagus, and caufes a flight Cough in the day-time; but in the night, when that excretion ceafes, it is eafy for fome little humidity to flip down the afpera arteria ; and this will be again thrown up by coughing in the morning. In the cure of this, there muft be firft given fome gentle purges ; af- ter thefe, fuch medicines as refolve vifcofities in their firft for- mation ; in which intention the roots of elecampane and pim- pernel, with that of florentine orrice, are of great effect ; and in the food it will be proper to eat large quantities of ginger, pepper, and the other fpices ; and at night, going to bed, drink a fmall glafs of brandy. When the difeafe begins to mitigate, the eflence of amber is a medicine that will do the greateft fervice.

Bleedings in Coughs in general, when the conftitution is ple- thoric, and they are done at proper times, are of great fervice in breaking the force of the difeafe; nay, in cafes of a true phthifis, bleeding often greatly retards, and keeps off the bad fymptoms. It is to be obferved, however, in all thefe cafes, that, when the conftitution will bear it, the quantity taken away fhould be larger, for otherwife they only invite a larger afflux of blood to the breaft, and fo increafe inftead of miti- gating the force of the difeafe.

Bleeding is always more ncceffary in a dry Cough than in a moift one, unlefs the fuppreffion of fome natural haemorrhage, or the omiffion of the habitual bleedings, have been the occa- fion of it. Bleeding is alio the more neceffary in Coughs* as

they