ADDITIONS TO THE REVISED EDITION OF 1880. 261 



9. P. 178. 



This remark of the author is not to be understood as meaning 

 that a pneumonia, once begun, must go through all the stages of 

 engorgement, of red and of gray hepatization. Indeed, the inflam- 

 mation may resolve itself at a very early period of its course. The 

 editor of the last German edition has already reported certain cases 

 of abortive pneumonia. Instances have been repeatedly observed 

 in which there was fever, with or without pain in the chest, and the 

 nature of which would have been obscure but for a faintly audible 

 crepitation, accompanied sometimes by a circumscribed tympanitic 

 resonance, and a little blood-stained sputum, showing the engorge- 

 ment period of pneumonia, which, however, instead of passing on 

 into that of hepatization, abated and subsided. 



To these abortive pneumonias are allied the migratory pneu- 

 monias described by Wiegand and Waldenburg. In these cases 

 the physical signs of engorgement (crepitus and tympanitic reso- 

 nance) with fever arise fitfully, here and there, in the lungs, but 

 often promptly subside and never go on into hepatization. Thus 

 the disorder continues for several weeks, and Waldenburg per- 

 ceives a strong analogy between this form of pneumonia and ery- 

 sipelas migrans. We must remember that the ordinary course of 

 a pneumonia is a wandering one, or rather a steadily-marching one, 

 and likewise in this respect, therefore, may be likened to erysipelas. 



10. P. 190. 



Believing as we do that in a pneumonia, just as in a typhus, the 

 chief danger consists in the paralyzing effect upon the vital func- 

 tions (particularly those of the heart) which is produced by a per- 

 sistent high temperature, treatment by systematic cold bathing, such 

 as has been used in typhus, has now been applied in pneumonia. 

 Although one might be disposed a priori to dread ill effects, by 

 driving back the blood upon the inner organs, yet the numer- 

 ous trials which have been made of cold bathing by Liebermeis- 

 ter and Jurgensen have dissipated such fears. Indeed, both ob- 

 servers have obtained better results in point of mortality by the 

 bath than by the ordinary treatment. Cold baths are always suit- 

 able in high fever, and are not contraindicated by an asthenic 

 condition ; but Jurgensen earnestly urges that a stimulant of red 

 wine be given both before and after the bath, to insure a vigor- 

 ous reaction of the heart ; and if the heart be weak, port, madeira, 

 or champagne. 



