LUXATION. 



LUNGS, DISEASES OF THK. 



-i 



Both plan, have been adopted; and 

 the rMlto * not appear to diftr materially. 



A great improvement has taken place in the class of persons ap- 

 Minted a* attendants, or. according to the old phraseology, keeptn. 

 That all such parson* should posse** benevolence and intelligence is 

 ssssnlisl to the enVctiv* working of a humane and enlightened system ; 

 and they should be liberally paid. The proportion of attendants to 

 patirau in the different English public asylums varies from one to ten, 

 to on* to twenty ; the former does not seem too much, and U far less 

 that in all well-managed private asylums. No ward, however 

 , should have IMS than two attendant*, in order that it should 

 be left without one ; this is enforced by the rules of several 

 asylum* ; and is most essential wherever a night attendance U adopted. 

 In some asylums this iHtinhmt U endeavoured to be effected by 

 making the day attendant, undertake night duty in turns ; but this is 

 taxing their physic*! powers too severely, even when they are released 

 from doty for half the succeeding dsy. 



l.fX ATli 'V. the Ume between two new moons. [Moos.] 



LUXE. Ll'Xl'LE. the figure formed on a sphere or on a plane 

 by two are* of circles which inclose a space. [HrroTin 

 Smmc.] 



Lt'XETTE, in fortification, is a work simiUr to a ravelin, or demi- 

 lune, but generally of smaller dimensions. Such works bare been 

 placed in the retired angles between the ditches of a bastion and of the 

 collateral ravelin, but they are now usually considered as advanced 

 works, and are placed in front of those just mentioned. 



The form of a lunette is the same as that of the redoubt Y in the 

 plan at the end of the article FORTIFICATION ; and its positions may be 

 understood by conceiving such works to be placed be} ond the glacis s s 

 on lines p****"g through r and z, x and R, and produced. Each lunette 

 is protected in front by a ditch beyond which is a covered- way , as usual. 



The best disposition for a series of such works is that in which they 

 are alternately more and less advanced beyond the fortress ; since then 

 they afford one another a reciprocal defence by the crossing fires which 

 may be kept up from the nearest face* of every salient and retired 

 lunette. And should the besiegers succeed in carrying their approaches 

 up the glacis of the Utter, the artillery on the flanks of the two more 

 salient and collateral lunettes would effectually prevent them from 

 forming a battery on its crest to breach the work. The o)>eratioiis 

 against any one retired lunette must consequently be postponed till the 

 two collateral lunettes are taken ; whereas had all been equally advanced 

 beyond the fortress, the three might have been breached and assaulted 

 at the aame time. 



To give the more advanced lunettes, which ore generally those placed 

 beyond the ravelins, all the advantages of which they are susceptible. 

 the magistral lines of their faces should coincide with the sides of an 

 equilateral triangle whose base is a line joining the faces of the two 

 collateral bastion* at pointa about twenty or thirty yards from their 

 banked angle* ; for thus the earthen parapets at the salient angles of 

 the lunette will not be eatily destroyed by rain, and the ditches b. f,,re 

 the face* of the work can be defended by two or more pieces of artillery 

 conveniently placed on the faces of the bastions. The ditches of the 

 retired lunette* should in like manner be defended by artillery placed 

 on the face* of the collateral ravelins ; and the magistral lines of their 

 face* abould consequently be directed towards such ravelins. 



In a front of fortification of the ordinary extent (360 yards) this rule 

 for placing the advanced lunette, will permit the ditch and covered-way 

 of the Utter to be defended by a fire of musketry from the retired 

 place* of arms L L f KOHTIKICATION], and from the covered-way Iwfurc 

 the bastions ; and. that such fire may graze the bottom of the ditch of 

 the lunette, this ditch ought to be in an inclined pUne nearly coinciding 

 with the slope of the glacis s s. Should the ditch so formed be too 

 hallow to fulfil its end, which is that of being an obstacle to the 

 enemy in his attempt to assault the lunette, it would I* necessary to 

 make it deeper; and that it might not thus become a trench in which 

 the enemy would be covered from the fire of the defenders, it should 

 communicate with water, by which it might be filled previously to the 

 expected assault. 



The rampart of a lunette differs in no respect from that of other 

 works; it should have the same relief, or height above the natural 

 ground, a* U given to the ravelin* ; since, as in the Utter work, the fire 

 vf artillery should be capable of being directed against the trenches of 

 the enemy at the foot of the glacis, over the heads of the defenders on 

 the banquette of the covered-way. It* escarp should be revcted with 

 brick or stone, in order that the enemy may be compelled to form a 

 breach in it by artillery, or by a mine, previously to making an assault ; 

 IT at le**t that the attack by escalade might be a process of difficulty 

 and danger. The terreplrin, or ground in the interior, should be high 

 enough at the gorge to prevent an enemy from entering there 

 scaling-ladder* ; this part should be further protected by a loop holed 

 wall, or a line of palisade* ; it should b* wen and defended from some 

 collateral work, and an open caponnicre, or a subterranean gallery, for 

 communication, abould lead from the gorge of each lunette to the place 

 of arm* in its rear. The advanced covered-way should pas* in front of 

 all the lunette*, and it might tern inate at the two extremities on inac- 

 enable ground, or in the general coverod-way of the place. 



Advanced lunette, about a fortress form strong port* for artillery, 

 by which an enemy is compelled to commence hi* approach** at a 



greater distance than would otherwise be necessary. The Irngth of 

 their faces may bo from sixty to seventy yards, and that of their flanks 

 from fifteen to twenty. It is considered that a well-disposed series of 

 the** works would prolong tin- f a place alwut ten or twelve 



days. But they are only proper for fortresses of thu first magnitude, 

 since they would require a largo garrison; and the troops on being 

 compelled to retire, might not find sufficient room in a small place, 



l.l'XCS, IHSKASKS OK THK. The highly organised structure of 

 the lungs and the incessant exercise of their important function, 

 frequently under noxious circumstances, render these organs )* 

 the most liable to disease of any in the body. Exposure to damp and 

 o-ld, sudden atmospherical changes and transitions of temperature, 

 want of proper nourishment, inattention to personal cleanliness, and 

 some of the mechanical employments in which the confined and heated 

 atmosphere of workshops i< impregnated with minute particles of 

 foreign substances, such as steel, wool, Ac., may be considered as 

 amongst the chief exciting causes of this extensively prevailing class of 

 /Kjyunn The subject may be conveniently divided into those 

 affections which are acute and rapid in their progress, and those in 

 which their course is slower and the changes of structure more 

 gradually effected. 



In inflammation of the lungi (pneumonia peripiieumonia) the air- 

 cells and parenchymatous structure of the organ are the seat of the 

 disease. This affection is generally preceded in a greater or less degree 

 by shivering and such other febrile symptoms as commonly usher in 

 any febrile attack. Soon afterwards pain and a ferae of oppression are 

 felt in the chest, with hurried respiration and a short dry cough. The 

 pain is sometimes severe, sometimes it is described as of a dull and 

 obscure kind and deeply seated. If the pleura, or investing membrane 

 of the lungs, participate in the affection, it is generally severe. At first 

 there is little expectoration, but this increases in the progress of the 

 disease, and the sputa acquire a reddish or rusty colour from the 

 admixture of small quantities of blood. They also possess an unusual 

 viscidity and tenacity, sometimes to such a degree that the \ - -< 1 into 

 which they are received may be inverted without their falling out; 

 they also contain numerous minute bubbles of air, which are prevented 

 from escaping by the consistence of the secretion. 



If the disease continue unchecked, the difficulty of breathing 

 becomes much greater, and the respirations, which in the natural state 

 are about 20 in a minute, increase in frequency to about 40 or 60. 

 Sometimes there is little cough throughout tin- ili-. :-!-. but most 

 commonly it increases as the disease advances, and the sputa becomes 

 more deeply tinged with blood. The features subsequently assume a 

 livid appearance : the breathing gets more oppressed ; expectoration is 

 effected with difficulty; the powers of life fail, and the pat in.' 

 from the lungs being no longer able to carry on their function. 



When a favourable change takes place in the course of the disease, 

 either s]>ontaueously, or from judicious medical treatment, it is g, ; 

 attended by perspiration, the expectoration loses its rusty colour and 

 unusual tenacity, the urine becomes turbid, and sometimes there is 

 diarrhoea. Andral and other authors are of opinion that improvement 

 is most likely to take place at certain times critical days. The 

 diagnosis of this disease bos received most important assistance from 

 auscultation, and in many instances it has been detected by its aid, 

 where formerly it would have been overlooked. The assistance 

 afforded by the auscultatory signs will perhaps be better understood if 

 we defer them until we have spoken of the changes of structure in the 

 lungs occasioned by inflammation. 



In the early stage of pneumonia the inflamed part acquires an 

 unnatural density and heaviness from the unusual accumulation of 

 blood in it, and if a portion of lung so circumstanced be examined 

 after death, pressure with the finger on its surface leaves an indenta- 

 tion which is not filled up, as would immediately !>< the case in a 

 healthy state of the part. When it is cut into, a bloody frothy fluid 

 exudes freely from it, and the Bin-faces present a deep Mood-n-d 

 and if a porti' n the lingi-r and thumb a crackling 



noise is heard indicating the prcaence of air. In a m< 1 state, 



the lung is found -'II more dense, and does not crepitate when 

 squeezed, showing that air i.s no longer admitted. As in tlii- e,,n,Iition 

 it somewhat resembles liver, it has been termed the stage of htpatiia- 

 tion. When the disease has proceeded still further, suppuration may 

 Iw found to hove taken place. Pus is then . (fused 



throughout the structure of the diseased part, by which it dull red is 

 changed to a yellow or straw colour, and the mass is rendered soft, an,! 

 easily broken. Suppuration in the form of abscess very rarely occurs 

 as a consequence of pneumonia. I.nennec U of opinion that 

 in- <t probably takes place before the change can have proceeded to 

 that eat- nt. 



A tuciillator;/ f>if/iit. In that stage of the di.-e.iM- in which there is 

 only an ac< umulation of blood in the part, and whilst air is still 

 admitted, the respiratory murmur is heard on examining the chest 

 with the car or stethoscope, but it is attended with a crackling sound 

 which resembles that produced by rubbing a portion of hair l 

 r and thumb near the car, or by throwing salt into th 

 this is commonly called erepitons rattle or rhoiiclniM, crepitous r. 

 tion or rrtiiitati'jH. A clear sound is also heard on percussing the 

 : 



If the discos* has proceeded to thu Ugo of bepataation, the lung 



