256 PRACTICE OF PHYSIC. 



is felt in one side, sometimes very constantly, and so as to pre- 

 vent the person from lying easily upon that side ; but at other 

 times, the pain is felt only upon a full inspiration, or upon 

 coughing. Even when no pain is felt, it generally happens, that 

 phthisical persons cannot lie easily on some one of their sides, 

 without having their difficulty of breathing increased, and their 

 cough excited. 



DCCCXCV. The phthisis begins and sometimes proceeds to 

 its fatal issue, in the manner described from DCCCLXXXIX. 

 to DCCCXCV., without any appearance of haemoptysis. Such 

 cases are indeed rare ; but it is very common for the disease to 

 advance far, and even to an evident purulency and hectic state, 

 without any appearance of blood in the spitting : so that it may 

 be affirmed, the disease is frequently not founded in haemoptysis. 

 At the same time, we must allow, not only that it sometimes 

 begins with an haemoptysis, as is said in DCCCLXIV., but 

 further, that it seldom happens, that in the progress of the dis- 

 ease more or less of an haemoptysis does not appear. Some de- 

 gree of blood-spitting does indeed appear sometimes in the state 

 mentioned DCCCLXXXIX. DCCCXCIIL, but more com- 

 monly in the more advanced stages of the disease only, and 

 particularly upon the first appearance of purulency. However 

 this may be, it is seldom, in the phthisis from tubercles, that 

 the haemoptysis is considerable, or requires any remedies dif- 

 ferent from those which are otherwise necessary for the state of 

 the tubercles. 



DCCCXCVI. I have now described a succession of symp- 

 toms which, in different cases, occupy more or less time. In 

 this climate they very often take up some years, the symptoms 

 appearing especially in the winter and spring, commonly be- 

 coming easier, and sometimes almost disappearing during the 

 summer ; but returning again in winter, they at length, after 

 two or three years, prove fatal, towards the end of spring or be- 

 ginning of summer. 



DCCCXCVII. In this disease, the prognosis is for the most 

 part unfavourable. Of those affected with it, the greater number 

 die ; but there are also many of them who recover entirely, af- 

 ter having been in very unpromising circumstances. What are, 

 however, the circumstances more certainly determining to a 



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