Sedatives of every kind arc essentially necessary. A class of medicines, which we have styled iniirritants, which we shall soon notice, and which consists of those diluents and demulcents which sooth and sheath the irritations of the nervous system, or inflamed membranes, are highly useful in these active inflammations. The other sedatives employed with advantage in such cases are nitre and camphor. The utility of the former is generally acknowledged, except in inflammations of the bladder, where large doses are supposed to produce some additional irritation. The latter is not so generally-employed, as it is thought to prove occasionally stimulant, and by some practitioners to be useless. In small doses, however, we have repeatedly found it an advantageous medicine, particularly in those cases where nitre seems to produce too great an irritation. Some of the narcotics promise to be useful in such cases, particularly the hemlock, and the digitalis; but they have not been often employed and of their advantages we cannot speak from experience.

Cold, as a privation of heat, has been considered as an active remedy of inflammation, and employed very freely of late, in one species, the gout. (See Arthritis.) In general, however, it is a doubtful and uncertain remedy. When temporarily employed, it is followed by' increased action, and will of course exasperate the disease; when continued it occasions torpor, and may produce or hasten gangrene. In external phlegmons it is of use in the early periods, and will sometimes contribute to their resolution; but in internal phlegmasiae it is generally a dangerous remedy.

It may be questioned, however, whether, when we avoid cold, we should freely indulge a higher temperature. The reason for employing heat has been to promote perspiration, and consequently to relieve internal accumulations; but we have found reason to doubt whether the discharge from the skin, brought on by high temperatures, is truly salutary. In general it appears otherwise; and the warm diaphoretics, of which warm air and warm fluids are the principal, appear to injure more by increasing the circulation, than they relieve by the discharge they produce from the surface. When then we would avoid cold, we would not indulge heat. The temperature of the room should be moderate, and scarcely exceed 62°; the drinks tepid, somewhat about the heat of new milk, a degree peculiarly soothing to the irritated nerves. See Inirritantia.

As cold applications are admitted in phlegmons, it may be considered that they would be equally beneficial where the cold air is applied to the part, as in pneumonia and sore throat. In the latter, cold applications are sometimes useful; and nitre or sal prunellae held in the mouth has been said to relieve the inflammatory angina. The lungs are, however, more irritable; and though great heat is injurious, extreme cold is equally so; nor can we sink the temperature of the room or of the drinks far below the degrees stated, though perhaps they may be somewhat diminished with advantage. Of this, however, the feelings of the patient are the proper criteria.

Phrenitis and pneumonia are perhaps the only inflammations which form an exception to the general rule, respecting the utility of a recumbent posture. In the former the erect position is highly advantageous, and it has been supposed equally useful in the latter; but the subject will be resumed when we speak separately of each.

Inflammations, as the habit is less inflammatory, and the circulation less actively excited, require these remedies in a less degree and diminished power. When we approach that low state in which inflammation proceeds from atony, with a very slight, if any, increased circulation, we must be cautious in all the evacuations. Great inconvenience has arisen from a want of caution in professors and lecturers, who generally remark, in every inflammation, that, should the patient be young and plethoric, some blood may be taken. Many epidemic pneumonias and cynanches occur in which this evacuation would be fatal in forty-eight hours. In the Breslaw epidemic, though attended with topical inflammation from atony, so debilitating was the cause as at once to take off rheumatic pains. The practitioner must consequently attend with care to the reigning epidemic; to the state of the pulse; to the countenance, and all the circumstances" which indicate debility; and he must be particularly cautious not to mistake a pulse throbbing from irritation for a hard inflammatory one. The countenance often furnishes a very certain index: if the features are sunk, the eyes staring, the expression lost, whatever are the other symptoms, bleeding must be avoided. The warmer diaphoretics must be preferred also to the nauseating or relaxing ones; and cathartics, particularly the purgatives, carefully avoided. In the more asthenic inflammations of this kind, we must soon have recourse to bark, and the warmest cordials; nor will blisters, as we have had occasion to remark, be always safe. Many modifications of these directions will occur under the separate diseases.

External inflammation is more within the reach of the sight and touch; and to this the former directions are only applicable, when attended with general fever. If not in the vicinity of any large vessel, or in a situation peculiarly inconvenient, we are seldom anxious about its resolution, but suffer it to proceed to suppuration. If it arises from wounds or bruises, the remedies styled dis-cutient are useful: these are warm and astringent appli-tions, capable of exciting the torpid action of the vessels, and restoring the tone destroyed by the blow. If these do not succeed, and the accumulation is followed by increased action from behind, the vessels are depleted by topical bleeding, and our discutients applied with increased power, or more frequently repeated. In all such cases, practice gives the firmest support to theory, for emollients are constantly forbidden where resolution is attempted. The use of the preparations of lead rests on some uncertainty. This metal is an apparent exception to the general tonic powers of metallic substances: it seems to render the nerves torpid, and the muscular fibres less