48 PRACTICE OF PHYSIC. 



tions are of any importance, or can be distinctly marked, is 

 uncertain. 



" I thought proper to take this general view, in some mea- 

 sure theoretical, of the possible seats of pulmonic inflamma- 

 tions ; but now I add that our distinctions of diseases are not 

 to be taken from such theoretical considerations of their inter- 

 nal seat. Such distinctions cannot be admitted in Nosology, 

 where we must found them upon a concourse of symptoms." 



CCCXXXV. Pneumonic inflammation, however various in 

 its seat, seems to me to be always known and distinguished by 

 the following symptoms : Pyrexia, difficult breathing, cough, 

 and pain in some part of the thorax. But these symptoms are, 

 on different occasions, variously modified. 



CCCXXXVI. The disease almost always comes on with a 

 cold stage, and is accompanied with the other symptoms of py- 

 rexia ; though, in a few instances, the pulse may not be more 

 frequent nor the heat of the body increased beyond what is na- 

 tural. Sometimes the pyrexia is from the beginning accom- 

 panied with other symptoms ; but frequently it is formed for 

 some hours before the other symptoms become considerable, 

 and particularly before the pain be felt. For the most part, 

 the pulse is frequent, full, strong, hard, and quick ; but, in a 

 few instances, especially in the advanced state of the disease, 

 the pulse is weak and soft, and at the same time irregular. 



CCCXXXVII. The difficulty of breathing is^always pres- 

 ent, and most considerable in inspiration; both because the 

 lungs do not easily admit of a full dilatation, and because the 

 dilatation aggravates the pain attending the disease. The diffi- 

 culty of breathing is also greater when the patient is in one 

 posture of his body rather than another. It is generally greater 

 when he lies upon the side affected ; but sometimes the con- 

 trary happens. Very often the patient cannot lie easy upon 

 either side, finding ease only when lying on his back ; and some- 

 times he cannot breathe easily, except when in somewhat of an 

 erect posture. 



CCCXXXVIII. A cough always attends this disease ; but, 

 in different cases, is more or less urgent and painful. It is 

 sometimes dry, that is, without any expectoration, especially in 

 the beginning of the disease ; but more commonly it is, even 



