The change in her cough is no material change in the state of her
disease. I have had & have a precisely similar case. It is a nervous
affair & is not durable. Opiates quiet it for a little but their effects do
not last, and as it is troublesome only in the daytime Opiates are not
convenient not to say that they may otherwise do more harm in quieting
the Convulsive ticking cough, than good. What I find most useful
is what we do to cure hiccup viz. occupying their attention. The
Lady whom I have just now with such a cough has it stopped for
several hours by her being surprised with her sister fainting.
But this must be left to your discretion judging of your patients
state of mind or what it will bear. It may sometimes be relieved
by a Lozenge which dissolves slowly like pomfret cake. Otherwise
this symptoms requires no change in our measures -- I hope
the little looseness you mention is stopped but if such a symptom
with pains of the Stomach & bowels should return, nothing can be
depended on but Opiates which you will employ however no
more than is absolutely necessary.