IDS DISEASES OF THE PARENCHYMA OF THE LUNG. 



(Physical exploration, as we have repeatedly stated, never gives infor- 

 mation as to the quality of the condensation of a lung, or of effusion 

 into the pleura.) If, on the other hand, we have had opportunity to 

 observe the progress of the malady from its commencement, the dis- 

 tinction between the two is, as a rule, easy : as the occurrence oi 

 double symmetrical condensation and the tardy lateral extension of the 

 narrow condensed stripes indicate collapse of the lung and catarrha* 

 pneumonia ; while, on the other hand, a condensation at first confined 

 to one side, and, afterward, spreading over the whole of one of the 

 pulmonary lobes, denotes croupous inflammation of the lung. 



The progress of catarrhal pneumonia is sometimes, although not 

 often, a very acute one. The disease may prove fatal in a few days, 

 especially if it attack feeble children. In such an event the counte- 

 nance, previously red, becomes pale and livid. The lips assume a 

 bluish hue ; the eyes grow dull and lustreless ; the restlessness gives 

 place to apathy, and to a continually augmenting somnolence. Owing 

 to the serious disturbance of respiration, the pernicious effects of 

 incomplete oxygenation and overcharge of the blood with carbonic 

 acid soon become apparent. It is also rare for a rapid resolution to 

 occur hi catarrhal pneumonia, and, even when it does take place, the 

 sudden decline of the fever so characteristic of croupous pneumonia 

 is scarcely ever seen; so that, in doubtful cases, the termination 

 of the attack by a lysis or a crisis may decide the question as 

 to the distinction between catarrhal and croupous pneumonia. 

 It is much more common for catarrhal pneumonia to take on a 

 subacute, and even chronic course. This is especially true of those 

 cases which set in upon a whooping-cough or chronic catarrhal bron- 

 chitis. Here, as a rule, not only does the consolidation form slowly 

 and gradually, but it continues stationary with great persistence often 

 for many weeks. The child becomes extremely emaciated, until death 

 finally ensues with the symptoms above given ; or, perhaps, after hope 

 has almost ceased, resolution of the infiltration and complete recovery 

 follow. 



Tubercular infiltration, abscess, and induration of the lungs following 

 catarrhal pneumonia, present the same symptoms as when they appear 

 as sequelae of croupous inflammation of the lung. 



TREATMENT. It is easy to understand that if, in the course of 

 capillary bronchitis, the disease extend from the mucous membrane of 

 the bronchi into the air-cells, producing catarrhal pneumonia, the same 

 general directions already given will apply for the treatment of this 

 disease. This is especially the case with regard to local and general 

 blood-letting. According to the recent experience of Bartels and 

 Zievissen, the latter never proves of service, and often does con- 



