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Page:Mrs Beeton's Book of Household Management.djvu/2053

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into prominent notice. Appendicitis is more commonly met with in children and young adults.

Causes.—Since the lumen of the appendix is small it may readily become blocked by a faecal concretion or by a foreign body, cherry stone, etc. These, by pressure on the walls of the appendix, and by stopping the exit of the mucus secreted in its interior, set up inflammation.

Over-eating, constipation and indigestion, and a sudden chill, are common factors in its causation.

Symptoms.—Pain in the abdomen, more especially in the lower part on the right side. This pain is often accompanied by nausea and sickness. The tongue is furred, the temperature is often raised, and there is no constipation.

Treatment.—The patient should be put to bed and hot flannels applied to the painful side. The diet should be entirely fluid. Medical assistance must be obtained at once, since some cases, happily the minority, progress very rapidly, and early surgical treatment is essential for the safety of the patient.

Asthma, from a word signifying "to gasp for breath," is a nervous disease, depending upon contraction of the circular muscular fibres surrounding the bronchial tubes. Occasionally it is connected with, and dependent upon, original malformation of the heart, or an unnatural conformation of the chest, in which case it usually makes its first appearance in childhood; otherwise it is most frequently met with about the middle period of life.

Syptoms.—Asthma, whether connected with malformation or not, is a hurried, oppressed and noisy state of the breathing, coming on in paroxysms, and leaving the patient comparatively well in the intervals; although in some cases there may be observed wheezing and a more confined dilation of the chest than is natural in inspiration. In a typical asthmatic attack, the patient wakes up in the small hours of the morning with a sensation of suffocation; the difficulty of breathing continues, and a terrible struggle begins. He sits up in bed, or gets up and goes to the window, where he stands struggling for breath. The wheezing is attended with successional coughing, and at length the expectoration of some viscid phlegm gives him great relief; he breathes for a while, and after a little more coughing and expectoration the paroxysm ends. A peculiar state of the atmosphere is an exciting cause; damp, foggy weather will induce it in some, a north-east wind in others; some asthmatics are liable to attacks while spending the night in a large town; others enjoy freedom from attacks while similarly circumstanced. A single indigestible meal, particularly a hearty supper, is another exciting cause.

Treatment.—Avoid everything likely to set up an attack, particularly, the articles of diet. During the attack, if there is reason that the stomach is at fault, an emetic of 20 grains of pow-