INFLAMMATIONS. 49 



from the first, moist, and the matter spit up various, both in 

 consistence and colour, and frequently it is streaked with blood. 



CCCXXXIX. The pain attending this disease is, in dif- 

 ferent cases, felt in different parts of the thorax, but most fre- 

 quently in one side. It has been said to affect the right side 

 more frequently than the left ; but this is not certain ; while, 

 on the other hand, it is certain that the left side has been very 

 often affected. The pain is felt sometimes as if it were under 

 the sternum, sometimes in the back between the shoulders ; 

 and when in the sides, its place has been higher or lower, more 

 forward or backward: but the place of all others most fre- 

 quently affected is about the sixth or seventh rib, near the mid- 

 dle of its length, or a little more forward. The pain is often 

 severe and pungent ; but sometimes more dull and obtuse, with 

 a sense of weight rather than of pain. It is most especially se- 

 vere and pungent when occupying the last place mentioned. For 

 the most part, it continues fixed in one place ; but sometimes 

 shoots from the side to the scapula on the one hand, or to the 

 sternum and clavicle on the other, 



CCCXL. The varying state of symptoms now mentioned 

 does not always ascertain precisely the seat of the disease. To 

 me it seems probable that the disease is always seated, or at 

 least begins in some part of the pleura : taking that membrane 

 in its greatest extent, as now commonly understood, that is, as 

 covering not only the internal surface of the cavity of the tho- 

 rax, but also as forming the mediastinum, and as extended over 

 the pericardium, and over the whole surface of the lungs. 



CCCXLI. There is, therefore, little foundation for distin- 

 guishing this disease by different appellations taken from the 

 part which may be supposed to be chiefly affected. The term 

 Pleurisy might with propriety be applied to every case of the 

 disease ; and has been very improperly limited to that inflam- 

 mation which begins in, and chiefly affects the pleura costalis. 

 I have no doubt that such a case does truly occur, but at the 

 same time I apprehend it to be a rare occurrence ; and that the 

 disease much more frequently begins in, and chiefly affects the 

 pleura investing the lungs, producing all the symptoms sup- 

 posed to belong to what has been called the Pleuritis vera. 



CCCXLI I. Some physicians have imagined that there is a 



VOL. II. D 



