INFLAMMATIONS. 55 



A delirium coming on during a pneumonic inflammation, is 

 constantly a symptom denoting much danger ; " either as aris- 

 ing from the violence of the fever, or in consequence of the 

 ready return of the blood from the head to the right ventricle 

 of the heart being impeded, or from the phlogistic diathesis 

 acting on the brain. It is not certainly and absolutely danger- 

 ous, but must always alarm." 



CCCLIII. When the termination of this disease proves 

 fatal, it is on one or other of the days of the first week, from the 

 third to the seventh. This is the most common case ; but, in a 

 few instances, death has happened at a later period of the 

 disease. 



When the disease is violent, but admitting of resolution, this 

 also happens frequently in the course of the first week ; but, in 

 a more moderate state of the disease, the resolution is often de- 

 layed to the second week. 



The disease, on some of the days from the third to the 

 seventh, generally suffers a remission ; which, however, may be 

 often fallacious, as the disease does sometimes return again 

 with as much violence as before, and then with great danger. 



" There is a very curious fact, which I think has been clearly 

 delivered only by Dr. Cleghorn, and repeated by Dr. Font, 

 viz. that whatever be the management of peripneumony and 

 pleurisy, about the end of the third or beginning of the fourth 

 day a very considerable remission of all the symptoms happens, 

 which may in different cases take place any time between the third 

 and seventh day. The by-standers are on account of this remis- 

 sion easy as to the event : but it is as constant, that the day after 

 the remission, sooner or later the disease returns with a remark- 

 able exacerbation, and is very often incurable. I would explain 

 this on the principle, that this remission occurs when the effu- 

 sion takes place to a considerable degree, the first effect of which 

 will be to relieve the distention which had taken place in the 

 membrane, and therefore to produce a seeming remission in the 

 symptoms. I regret extremely that Dr. Cleghorn has not been 

 more explicit with regard to this subject ; for I can see the prob- 

 ability of the explanation as to the pain, but would wish to be 

 told, whether it holds equally so with regard to the anxiety and 

 dyspnoea ; for I must own, that for want of my attention being 



