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mercury affords a good example: although inactive in its fluid form, it is highly active in the form of vapour; it is thus that the workmen employed in gilding, silvering looking-glasses, constructing barometers, &c., experience such dreadful effects, for the metal assumes an elastic form at the ordinary temperature of the atmosphere, as Mr. Faraday has proved by a series of conclusive experiments. The operation of inhalation, moreover, enables us to bring various bodies into immediate contact with organs exposing a great extent of mucous surface, through which innumerable capillaries spread out their ramifications, and to which all remedies in any other state of aggregation are necessarily inaccessible. THIS OBSERVATION APPLIES MORE PARTICULARLY TO THE LUNGS AND THEIR AIR-PASSAGES."

Dr. Paris describes the two forms of administration, viz. dry fumes and watery vapours; and, in reference to the form, says:

"I shall only observe, in this place, that the profession do not attach sufficient importance to it; not only is a certain amount of moisture in the air essential to healthy respiration, but it would appear, when in too dry a state, to act as an irritant to the bronchial tubes. In states of congestion, nothing is more calculated to soothe their mucous membrane than the inhalation of steam; to which may be added such medicines as appear appropriate to each particular case."

Such evidence from such a source cannot fail to convince the sceptic and encourage the invalid in the use of means, the value of which is acknowledged in these unequivocal terms by one who made the philosophy of therapeutics the study of his lifetime, and whose work from which I quote is universally admitted to be the standard authority on the subject.

It is now an undeniable fact, that the inhalation of pure æther and chloroform so acts upon the sensorium and whole nervous system, as to render the patient insensible to the pain of the severest surgical operation; and this discovery may, as Dr. Scudamore has well observed, be cited as a full answer to those who distrust the effective power of a medicine acting through the medium of the lungs. It will surely no longer

be disputed by any, that certain medicines may exert a powerful agency when so administered, and produce effects distinct from those which ensue when they are received into the stomach.

In a treatise published in the year 1817, by Sir Alexander Crichton, M.D., this able physician says, in allusion to the ordinary mode of treatment :

"That pulmonary consumption cannot be cured by medicines which act through the medium of the stomach, the whole history of our art proves to us. Their efficacy in alleviating for a time particular symptoms, such as cough, febrile heat, and colliquative sweat, &c., is not denied. Their assistance, when combined with a judicious and suitable diet, is admitted; but it seems a strange hope and strange conduct to pretend to cure an ulcer on the lungs, whether scrofulous, or phlegmonous, or of whatever kind it may be, by internal remedies alone, while it is acknowledged that ulcers on other parts of the body require a local application independently of all internal treatment.

"Judicious applications to an ulcer, whether arising from a vice in the constitution or local injuiry, are equally necessary for its speedy healing. In exterior ulcers, arising from constitutional causes, such as a scrofulous disposition, no one trusts to internal remedies alone; but in ulcerated lungs, in which, for various reasons, local applications are more necessary, they are almost totally neglected. How incongruous this is, all analogy demonstrates."

On the influence of inhaled medicines, and the knowledge of the profession in regard to this mode of treatment, the doctor observes:

"The medicines which can be brought into immediate contact with the diseased parts are both powerful and numerous: but as yet we are in the infancy of this art. Our knowledge of the volatilized substances capable of being inhaled and of doing good in pulmonary complaints is still very limited. The conditions which ought to guide the choice of those which we are acquainted with, and the restrictions which retard their administration, are far from being settled, merely from the want of accumulated experience."

Sir Alexander Crichton, it must be remembered, wrote this sentence some forty years ago, and prior to the adoption

of chlorine, iodine, and other important remedies; happily this "want of accumulated experience" is supplied, and the hope may now be reasonably cherished, from the rapid advances which pharmaceutical chemistry has recently made, that pulmonary consumption will shortly be admitted, not by a few individuals, but the whole body of the profession, to be as much under the control of the art of medicine as is any other formidable disease.

Sir D. J. Corrigan, M.D., the learned and respected member of the "Medical Education and Registration Council," &c. &c., observes that he feels justified in coming to the conclusion that "medicated inhalations exert a most powerful influence over diseased action; and that, as it is only in this form we can administer remedies to act locally upon diseased tissues in the lungs, the exhibition of remedies in this manner merits the closest attention and most diligent inquiry."

Medicated Inhalations are now largely employed in America, in which country my work has been republished by Dr. Green, and, as I am informed, with a great amount of success. Among other eminent physicians who have adopted this treatment may be mentioned Dr. Coxe of New York, who, in an excellent treatise on 'Diseases of the Respiratory Organs,' remarks:

"I have found medicated inhalations peculiarly applicable in many complaints of the larynx, trachea, bronchi, and lungs; and the value and efficacy really belonging to this remedial measure may, to a certain extent, be estimated from the fact, that in every case in which I have employed it, not only was the disease of many years' duration, but the long continued trial of the various remedies generally recommended, and upon whose curative powers the most experienced of our profession almost solely depend, had proved entirely ineffectual."

Dr. Coxe states that

"The first case in which I used inhalations was upon myself, and it may not be amiss to state, that for years I had given a fair and ample trial to all the remedies which were suggested by many of the most experienced American and French physicians, without

being able to effect more than an alleviation of some of the most distressing symptoms attendant upon a chronic disease of the larynx. Even this alleviation could only be finally accomplished by abandoning the practice of my profession, and calling into requisition the advantages of sea-voyages, a long residence in warm climates, in conjunction with such other means as were considered appropriate."

Dr. Coxe adds, by regularly pursuing a course of treatment (inhalation), that he succeeded in completely curing himself, and that he is, at the period of his writing, in the enjoyment of excellent health, and enabled to attend to the duties of an active life.

Dr. Coxe relates several cases of asthma, bronchitis, and consumption, which were cured by inhalations; among the latter is included a physician of extensive experience, now practising at New York. Dr. Coxe concludes by saying:

"The fact of the curative powers of medicated inhalations I now consider well established, and those who, labouring under any diseases of the respiratory organs, are generally made to depend upon the uncertain effects of sea-voyages and change of climate, however inconvenient such measures may be, for a probable restoration to health after a long-continued, though most frequently inefficacious, treatment, have certainly a right to require from their medical advisers that the efficacy of medical inhalation should be faithfully and fully tried in their cases."

Dr. Rush of Philadelphia, in his work on 'Diseases of the Chest,' observes, in reference to inhalation, that

"Too much cannot be said in favour of this simple system of conveying remedies. I have frequently seen patients snatched from the jaws of death by it. Whether all the beneficial effects, that may be justly considered possible to result from the use of the inhaler, either as a preventive or curative agent, will be realised, must be determined by future observation; but it is to be hoped that the general want of success which attends the present mode of treating pulmonic disease, will induce medical men to give a fair and full trial to a remedial measure, which appears so well calculated to effect a great amount of good.”


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Sir John Forbes, M.D., Physician to Her Majesty's Household, and late editor of the British and Foreign Medical Review,' makes the following judicious remarks upon the efficacy of inhalations in asthmatic affections:

"We are disposed to look to this class of remedies with considerable hopes of success. Legitimate reasoning and strong analogy, at least, are in their favour; and it cannot now be denied that a good deal of direct experiment can also be brought to testify in behalf of some of them. The most common, if not the general cause of asthma, is, as we have seen, permanent alteration of the mucous membrane of the bronchi, frequently characterised by obvious signs and symptoms, sometimes only inferred from the morbid sensibility of the part to external influences. Although we know that similar affections of other parts are curable by general means, still we find that, when we are enabled to combine with these applications that act directly upon the seat of the disease, the result is frequently much more speedy and certain. This is the case in diseases of the external skin, of the stomach and bowels, and in various local affections of the mucous outlets of the body. We are well aware that applications of this kind are frequently very injurious, in place of being beneficial; but this is an argument against their improper use only. Every physician must have witnessed the extraordinary and instantaneous benefit afforded by local applications to the urethra, the throat, the eye, in cases which had been for weeks or months unrelieved by general treatment. In the dry catarrh [bronchitis] we have a morbid state of the mucous membrane very analogous to some of the affections now alluded to; and although, as in these, the injudicious or improper use of local applications is likely to increase irritation in place of allaying it, it does not certainly seem unreasonable, à priori, to expect that due care in adapting the particular remedy to the individual case might be followed by results equally happy. The history of asthma affords ample proof that the return of the paroxysms is very much influenced by the direct applications made accidentally to the bronchial membrane."

In every stage and form of ASTHMATIC and BRONCHIAL DISEASE inhalation, when properly directed, affords certain and prompt relief, and in the great majority of cases so alters the condition of the mucous membrane, and overcomes the

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