Pharmacologia / Fourth American, from the Seventh London Edition

by John Ayrton Paris

It not unfrequently occurs in persons either debilitated by age or disease, that the exhalant vessels of the lungs lose their tone, and pour out a larger quantity of fluid than is necessary for the lubrication of these organs; this is particularly observable in the disease called humoral asthma, and in the catarrh of old persons: if this excess be restrained by strengthening the tone of the system generally, or by astringing these vessels in particular, the expectoration of the remainder will be rendered much more easy. According to my experience, sulphate of zinc displays considerable powers in moderating this effusion of fluid, and it appears to produce this effect by increasing the tone of the exhalant vessels of the lungs; several medicines also, which are included in the former division of this classification, may, by stimulating these organs, not only promote the exhalation when it is too scanty, but repress it when it is too abundant.

b. By increasing the power of the Absorbents.

In some cases, the mucous inundation may not depend upon any fault in the exhalants, but upon a torpid state of the pulmonary absorbents: our remedy for this evil is to be found amongst that class of medicines which have the power of promoting absorption, as small doses of some mercurial preparation, Digitalis, and perhaps Nicotiana, &c.

c. By determining to the skin by a gentle diaphoresis.

It is evident that an increase of the cutaneous exhalation is generally attended with a relative diminution in the other serous excretions of body; this is so obvious with respect to our urinary discharge, that every person must have noticed the variation of its quantity at different seasons of the year: in like manner the exhalation from the lungs, although less capable of becoming an object of observation, is not less affected by the state of the cutaneous discharge; hence medicines capable of promoting it, are calculated to diminish the quantity of serous exhalation from the lungs; and it is upon this principle, that well regulated doses of the compound powder of Ipecacuan], frequently furnish the oppressed asthmatic with a valuable resource.

d. By exciting serous discharges from the bowels.

Upon the principle announced in the preceding section, the operation of a saline cathartic may relieve the pulmonary organs when loaded with a preternatural accumulation of fluid, and consequently assist expectoration. On the contrary, if the exhalation be deficient, this class of remedies may increase pulmonary irritation, and check expectoration, a fact which coincides with the concurrent testimony of many able practitioners.

III. Of Medicines which operate mechanically.

a. By imparting vigour to the respiratory muscles, engaged in the act of expectorating.

It must be admitted that, to a certain extent, expectoration is a voluntary operation, connected with the action of a variety of muscles, which in a state of extreme debility are not easily excited into action: every practitioner must have noticed this fact during the treatment of the coughs of exhausted patients, and have witnessed the distress necessarily arising from it; in this condition, the exhibition of a stimulant may so far renew the exhausted excitability of these organs, as to enable them to undergo the necessary exertions.