3. _Vomica._ An abscess in the lungs is sometimes produced after peripneumony, the cough and shortness of breath continue in less degree, with difficulty in lying on the well side, and with sensitive irritated fever, as explained in the preceding article.
The occasional increase of fever, with hard pulse and sizy blood, in these patients, is probably owing to the inflammation of the walls of the vomica; as it is attended with difficulty of breathing, and requires venesection. Mr. B----, a child about seven years old, lived about five weeks in this situation, with a pulse from 150 to 170 in a minute, without sweats, or diarrhoea, or sediment in his water, except mucus occasionally; and took sufficient nourishment during the whole time. The blood taken was always covered with a strong cupped size, and on his death three or four pints of matter were found in one side of the chest; which had probably, but lately, been effused from a vomica. This child was frequently induced to swing, both in a reciprocating and in a rotatory swing, without any apparent absorption of matter; in both these swings he expressed pleasure, and did not appear to be vertiginous.
M. M. Repeated emetics. Digitalis? Perseverance in rotatory swinging. See Class II. 1. 6. 7.
Mr. I. had laboured some months under a vomica after a peripneumony, he was at length taken with a catarrh, which was in some degree endemic in March 1795, which occasioned him to sneeze much, during which a copious hæmorrhage from the lungs occurred, and he spit up at the same time half a pint of very fetid matter, and recovered. Hence errhines may be occasionally used with advantage.
4. _Empyema._ When the matter from an abscess in the lungs finds its way into the cavity of the chest, it is called an empyema. A servant man, after a violent peripneumony, was seized with symptoms of empyema, and it was determined, after some time, to perform the operation; this was explained to him, and the usual means were employed by his friends to encourage him, "by advising him not to be afraid." By which good advice he conceived so much fear, that he ran away early next morning, and returned in about a week quite well. Did the great fear promote the absorption of the matter, like the sickness occasioned by digitalis? Fear renders the external skin pale; by this continued decrease of the action of the absorbents of the skin might not those of the lungs be excited into greater activity? and thus produce increased pulmonary absorption by reverse sympathy, as it produces pale urine, and even stools, by direct sympathy?