metimes it is spasmodic and irritating and particularly so
when it is associated with affections of the larynx, or with asthma,
involving irritation of the branches or the filaments of the
pneumogastric nerve.

When the chronic follows the acute form of the disease, or follows
inflammation of the lungs, the expectoration may be profuse from the
first, and of a yellowish color and tenacious character. When the
disease arises from other causes, the expectoration is generally slight
at first, and the cough dry or hacking. This may continue some time
before much expectoration occurs. The expectorated matter is at first
whitish, opaque, and tenacious, mixed sometimes with a frothy mucus,
requiring considerable coughing to loosen it and throw it off. As the
disease progresses, it becomes thicker, more sticky, of a yellowish or
greenish color, mixed with pus, and sometimes streaked with blood. In
the latter stages, it becomes profuse and fetid, and severe hemorrhage
may occur. Sometimes the cough and expectoration disappear when the
weather becomes warm, to appear again with the return of winter, which
has gained for it the appellation of _winter cough_. The sufferers feel
as if something was bound tightly round them, rendering inhalation
difficult. Soreness throughout the chest is often a persistent symptom,
especially when the cough is dry and hard. Behind the breast-bone there
is experienced a sense of uneasiness, in some cases amounting to pain,
more or less severe.

As the disease progresses, the loss of strength is more and more marked,
the patient can no longer follow his usual employment, his spirits are
depressed, and he gradually sinks, or tubercular matter is deposited in
the lungs, and consumption is developed.

TREATMENT. Thorough attention to hygiene, with the avoidance of the
causes concerned in the production and perpetuation of the disease, is
necessary. The patient must be protected from the vicissitudes of the
weather by plenty of clothing; flannel should be worn next to the skin,
with a pad of flannel or buckskin over the chest, and the feet should be
kept warm and dry. Exercise in the open air is essential. When the
weather is so cold as to excite coughing, something should be worn over
the mouth, as a thin cloth, handkerchief, muffler, or anything which
will modify the temperature of the atmosphere before it comes into
contact with the mucous lining of the lungs. Good ventilation of
sleeping-rooms is a