after their full growth: women from fifteen to three-andthirty; men two or three years later. In Great Britain, a spitting of blood generally occurs to those predisposed to it, in the spring, or beginning of summer, when the weather suddenly changes from cold to excessive hot; and when the heat is supposed to rarify the blood, before the solids are proportionably relaxed from the contracted state they acquire during the cold of winter. When a spitting of blood happens to a person who has actually lost brothers or sisters, or other near relations, by the pulmonary consumption, as that circumstance gives reason to suspect a family taint or predisposition, the case will, on that account, be more dangerous.

Violent exercise may occasion the rupture of blood-vessels in the lungs, even in those who have no hereditary disposition to such an accident; it ought therefore to be carefully avoided by all who have. Violent exercise, in the spring, is more dangerous than in other seasons; and, when taken at the top of high mountains, by those who do not usually reside there, it has been considered as more dangerous than in valleys. The sudden diminution of the weight of the atmosphere, co-operating with the exercise, renders the vessels more apt to break. Of all things the most pernicious to people predisposed to a spitting of blood, is, playing upon wind-instruments. Previous to the spitting of blood, some perceive an uneasiness in the chest, an oppression on the breath, and a saltish taste in the spittle; but these symptoms are not con

stant.

Nothing can be more insidious than the approaches of this disease sometimes are. The substance of the lungs, which is so full of blood-vessels, is not supplied so liberally with nerves; the lungs, therefore, may be materially affected, before danger is indicated by acute pain. And it sometimes happens, that people of the make above described are, in the bloom of life, and generally in the spring of the year, seized with a slight cough, which gradually increases, without pain, soreness in the breast, dif

ficulty of respiration, or spitting of blood. A slow fever supervenes every night, which remits every morning, with sweats. These symptoms augment daily; and, in spite of early attention, and what is thought the best advice, the unsuspecting victims gradually sink into their graves.

Those who by their make, or by the disease having in former instances appeared in their family, are predisposed to this complaint, ought to be peculiarly attentive in the article of diet. A spare and cooling regimen is the best. They should avoid violent exercise, and every other exciting cause; and use the precaution of loosing blood in the spring. If their circumstances permit, they ought to pass the cold months in a mild climate; but, if they are obliged to remain during the winter in Great Britain, let them wear flannel next the skin, and use every other precaution against catching colds.

The fourth cause above enumerated is, tubercles in the lungs.

The moist, foggy, and changeable weather, which prevails in Great Britain, renders its inhabitants more liable, than those of milder and more uniform climates, to catarrhs, rheumatisms, pleurisies, and other diseases proceeding from obstructed perspiration. The same cause subjects the inhabitants of Great Britain to obstructions of the glands, scrofulous complaints, and tubercles in the substance of the lungs. The scrofulous disease is more frequent than is generally imagined. For one person in whom it appears by swellings in the glands below the chin, and other external marks, may have the internal glands affected by it. This is well known to those who are accustomed to open dead bodies. On examining the bodies of such as have died of the pulmonary consumption, besides the open ulcers in the lungs, many little hard tumours or tubercles are generally found; some, with matter; others, on being cut open, discover a little blueish spot, of the size of a small lead shot. Here the suppuration, or formation of matter, is just going to begin;

and in some the tubercle is perfectly hard, and the colour whittish, throughout its whole substance. Tubercles may remain for a considerable time in the lungs, in this indolent state, without much inconveniency: but, when excited to inflammation by frequent catarrhs, or other irritating causes, matter is formed, they break, and produce an ulcer. Care and attention may prevent tubercles from inflammation, or may prevent that from terminating in the formation of matter; but when matter is actually formed, and the tubercle has become an abscess, no remedy can stop its progress. It must go on till it bursts. If this happens near any of the large air-vessels, immediate suffocation may ensue; but for the most part, the matter is coughed up.

From the circumstances above enumerated of the delicate texture, constant motion, and numerous blood-vessels of the lungs, it is natural to imagine, that a breach of this nature in their substance will be still more difficult to heal than a wound from an external cause. So unquestionably it is; yet there are many instances of even this kind of breach being repaired; the matter expectorated diminishing in quantity every day, and the ulcer gradually healing; not, surely, by the power of medicine, but by the constant disposition and tendency which exists in nature, by inscrutable means of her own, to restore health to the human body.

It may be proper to observe, that those persons whose formation of body renders them most liable to a spitting of blood, have also a greater predisposition than others to tubercles in the lungs. The disease, called the spasmodic asthma, has been reckoned among the causes of the pulmonary consumption. It would require a much greater degree of confidence in a man's own judgment, than I have in mine, to assert, that this complaint has no tendency to produce tubercles in the lungs : but I may say, with truth, that I have often known the spasmodic asthma, in the most violent degree, attended with the most alarming symptoms, continue to harass the patients for a long

period of time, and at length suddenly disappear, without ever returning; the persons who have been thus afflicted, enjoying perfect health for many years after. It is not probable that tubercles were formed in any of these cases; and it is certain they were not in some, whose bodies were opened after their deaths, which happened from other distempers, the asthma having disappeared several years before.

Certain eruptions of the skin, attended with fever, particularly the small-pox, and still oftener the measles, leave after them a foundation for the pulmonary consumption. From whichever of the causes above enumerated this disease takes its origin, when once an ulcer, attended with a hectic fever, is formed in the lungs, the case is, in the highest degree, dangerous. When it ends fatally, the symptoms are, a quick pulse, and a sensation of cold, while the patient's skin, to the feeling of every other person, is hot; irregular shiverings, a severe cough, expectoration of matter streaked with blood, morning sweats, a circumscribed spot of a crimson colour on the cheeks, heat of the palms of the hands, excessive emaciation, crooking of the nails, swelling of the legs, giddiness, delirium, soon followed by death.

These symptoms do not appear in every case. Although the emaciation is greater in this disease than in any other, yet the appetite frequently remains strong and unimpaired to the last; and although delirium sometimes comes before death, yet in many cases the senses seem perfect and entire; except in one particular, that in spite of all the foregoing symptoms, the patient often entertains the fullest hopes of recovery to the last moment.

Would to heaven it were as easy to point out the cure, as to describe the symptoms of a disease of such a formidable nature, and against which the powers of medicine have been directed with such bad success, that there is reason to fear, its fatal termination has been oftener accelerated than retarded by the means employed to remove it! To particularize the drugs which have been long in

use, and have been honoured with the highest encomiums for their great efficacy in healing inward bruises, ulcers of the lungs, and confirmed consumptions, would in many instances be pointing out what ought to be shunned as pernicious, and in others what ought to be neglected as futile.

Salt water, and some of the mineral springs, which are unquestionably beneficial in scrofulous and other distempers, have been found hurtful, or at least inefficacious, in the consumption; there is no sufficient reason to depend on a course of these, or any medicine at present known, for preventing or dissolving tubercles in the lungs. Mercury, which has been found so powerful in disposing other ulcers to heal, has no good effect on ulcers of that organ;-though some physicians imagine it may be of service in the beginning to dissolve tubercles, before they begin to suppurate; but as there is no absolute evidence, during life, of indolent tubercles being formed, there can be none that mercury cures them.

Various kinds of gums, with the natural and artificial balsams, were long supposed to promote the healing of external wounds and ulcers, and on that account were made the basis of a vast variety of ointments and plasters. It was afterwards imagined, that the same remedies, administered internally, would have the same effect on internal ulcers; and of course many of those gums and balsams were prescribed in various forms for the pulmonary consumption. The reasoning on which this practice was established, however, seems a little shallow, and is far from being conclusive; for although it were granted, that these balsams contributed to the cure of wounds, when applied directly to the part, it does not follow that they could carry their healing powers, unimpaired, from the stomach to the lungs, through the whole process of digestion. But more accurate surgery having made it manifest, that the granulations which spring up to supply the loss of substance in external wounds, and the healing or skinning over of all kinds of sores, proceeds from no