Bleeding and purging are generally proper at the beginning of this disease; but if the patient’s spittle is pretty thick, or well concocted, neither of them are necessary. It will be sufficient to assist the expectoration by some of the sharp medicines recommended for that purpose in the pleurisy, as the solution of gum ammoniac with oxymel of squills, &c. Blistering plasters have generally a good effect, and ought to be applied pretty early. If the patient does not spit, he must be bled according as his strength will permit, and have a gentle purge administered. Afterwards his body may be kept open by clysters, and the expectoration promoted, by taking every four hours two table-spoonfuls of the solution mentioned above. When an inflammation of the breast does not yield to bleeding, blistering, and other evacuations, it commonly ends in a suppuration, which is more or less dangerous, according to the part where it is situated. When this happens in the pleura, it sometimes breaks outwardly, and the matter is discharged by the wound. When the suppuration happens within the substance or body of the lungs, the matter may be discharged by expectoration; but if the matter floats in the cavity of the breast, between the pleura and the lungs, it can only be discharged by an incision made betwixt the ribs. If the patient’s strength does not return after the inflammation is to all appearance removed; if his pulse continues quick though soft, his breathing difficult and oppressed; if he has cold shiverings at times, his cheeks flushed, his lips dry; and if he complains of thirst, and want of appetite, there is reason to fear a suppuration, and that a phthisis or consumption of the lungs will ensue. We shall therefore next proceed to consider the proper treatment of that disease. CHAP. XVIII. OF CONSUMPTIONS. A consumption is a wasting or decay of the whole body from an ulcer, tubercles, or concretions of the lungs, an empyema, a nervous atrophy, or a cachexy. Dr. Arbuthnot observes, that in his time consumptions made up above one-tenth part of the bills of mortality in and about London. There is reason to believe they have rather increased since, and we know from experience, that they are not less fatal in some other towns of England than in London. Young persons, between the age of fifteen and thirty, of a slender make, long neck, high shoulders, and flat breasts, are most liable to this disease. Consumptions prevail more in England than in any other part of the world, owing perhaps to the great use of animal food and malt liquors, the general application to sedentary employments, and the great quantity of pit-coal which is there burnt; to which we may add the perpetual changes in the atmosphere, or variableness of the weather.