54 PRACTICE OF PHYSIC. 



the frequency of the pulse, of the heat of the body, and of 

 other febrile symptoms. 



CCCLII. The prognostics in this disease are formed from 

 observing the state of the principal symptoms. 



A violent pyrexia is always dangerous ; " because the more 

 violent the circulation, the more readily will an effusion be pro- 

 duced/' 



The danger, however, is chiefly denoted by the difficulty of 

 breathing. When the patient can lie on one side only ; when 

 he can lie on neither side, but upon his back only ; when he 

 cannot breathe with tolerable ease, except the trunk of his body 

 be erect ; when, even in this posture, the breathing is very dif- 

 ficult, and attended with a turgescence and flushing of the face, 

 together with partial sweats about the head and neck, and an 

 irregular pulse; these circumstances mark the difficulty of 

 breathing in progressive degrees, and consequently, in propor- 

 tion, the danger of the disease. 



A frequent violent cough, aggravating the pain, is always 

 the symptom of an obstinate disease. 



As I apprehend that the disease is hardly ever resolved, 

 without some expectoration, so a dry cough must be always an 

 unfavourable symptom. 



As the expectoration formerly described marks that the dis- 

 ease is proceeding to a resolution, so an expectoration, which 

 has not the conditions there mentioned, must denote at least a 

 doubtful state of the disease ; but the marks taken from the 

 colour of the matter are for the most part fallacious. " I have 

 often seen the patient recover after expectorating bloody, some- 

 times purulent greenish matter." 



An acute pain, very much interrupting inspiration, is always 

 the mark of a violent disease ; though not of one more danger- 

 ous than an obtuse pain, attended with very difficult respira- 

 tion. 



When the pains, which at first had affected one side only, 

 have afterwards spread into the other ; or when, leaving the 

 side first affected, they entirely pass into the other, these are 

 always marks of an increasing, and therefore of a dangerous 

 disease. 



