56 PRACTICE OF PHYSIC. 



properly directed to this, and of so large an experience, I have 

 not myself clearly and distinctly observed this." 11 



Sometimes the disease disappears on the second or third day, 

 while an erysipelas makes its appearance on some external part ; 

 and, if this continue fixed, the pneumonic inflammation does not 

 recur. 



CCCLIV. Pneumonia, like other inflammations, often ends 

 in suppuration or gangrene. 



CCCLV. When a pneumonia, with symptoms neither very 

 violent nor very slight, has continued for many days, it is to be 

 feared it will end in a suppuration. This, however, is not to be 

 determined precisely by the number of days : for, not only after 

 the fourth, but even after the tenth day, there have been ex- 

 amples of a pneumonia ending by a resolution ; and, if the dis- 

 ease has suffered some intermission, and again recurred, there 

 may be instances of a resolution happening at a much later 

 period from the beginning of the disease than that just now 

 mentioned. 



CCCLVI. But, if a moderate disease, in spite of proper 

 remedies employed, be protracted to the fourteenth day without 

 any considerable remission, a suppuration is pretty certainly to 

 be expected ; and it will be still more certain if no signs of re- 

 solution have appeared, or if an expectoration which had ap- 

 peared shall have again ceased, and the difficulty of breathing 

 has continued or increased, while the other symptoms have 

 rather abated. 



CCCLVII. That in a pneumonia the effusion is made, 

 which may lay the foundation of a suppuration, we conclude 

 from the difficulty of breathing becoming greater when the pa- 

 tient is in a horizontal posture, or when he can lie more easily 

 upon the affected side. 



CCCLVIII. That, in such cases, a suppuration has ac- 

 tually begun, may be concluded from the patient's being fre- 

 quently affected with slight cold shiverings, and with a sense of 

 cold felt sometimes in one and sometimes in another part of the 

 body. We form the same conclusion also from the state of the 

 pulse, which is commonly less frequent and softer, but some- 

 times quicker and fuller than before. 



CCCLIX. That a suppuration is already formed, may be 



