1-i ^METHODS OF ELUCIDATING DISEASE. 



(1) That simple numerical increase in the number of the re- 

 si)irations is capable of production by various means, and is 

 generally in direct proportion to acceleration of the circula- 

 tion. That the respirations are increased in number to pro- 

 vide for the aeration of a larger amount of blood which by in- 

 creased circulation is being passed through the lungs, and is 

 thus not necessarily indicative of disease. (2) That oppressed 

 or difficult breathing — dyspnoea — is a marked symptom of 

 many diseases because resulting from various causes. That 

 difficulty of breathing, although characteristic of serious struc- 

 tural' changes in the cavity of the thorax from inflammatory 

 or other causes, is not a sign of chest disease alone. That it 

 may occur as a symptom, merely from the pain induced in the 

 performance of the respiratory acts, as well as from the results 

 of inflammatory action, causing obliteration of the air-cells or 

 adhesions of the otherwise movable portions of the organs of 

 the thorax ; also that in numerous instances it has a direct 

 relation with conditions interfering with the due performance 

 of the natural activities of the nervous centres which regulate 

 the respiratory act. (3) That the forms of respiration recog- 

 nised by the terms abdominal breathing and thoracic breath- 

 ing are accomplished respectively by the muscles and struc- 

 tures of the opposite cavity, those of the other being, from 

 disease in connection with them, held in abeyance. (4) That 

 the so-called irregular breathing, i.e. where there is a want of 

 harmony between the inspiratory and expiratory acts, and 

 which occasionally terminates by becoming spasmodic in the 

 expiratory act, is well seen, and largely diagnostic of that 

 form of disease of the lung-tissue ordinarily recognised under 

 the name of ' broken-wind.' (5) That snoring, or stertorous 

 breathing, depending on a relaxed or paralyzed condition of 

 the soft palate, when encountered is usually indicative of 

 cerebral mischief of a serious character, and procursive of dis- 

 solution. 



In addition to peculiarities connected with the act of re- 

 spiration properly so called, and deserving of notice, there is 

 the occurrence of special phenomena or sounds included under 

 the term ' coughing.' A cough is generally attendant on some 

 irritation of the lower or upper air-passages, and is the in- 

 voluntary effort to get rid of the irritation ; the sound is pro- 



