INTUMESCENTI^E. 613 



awaked with a sense of anxiety and difficult breathing, and with a 

 violent palpitation of the heart. These feelings immediately re- 

 quire an erect posture ; and very often the difficulty of breath- 

 ing continues to require and to prevent sleep for a great part of 

 the night. This symptom I have frequently found attending 

 the disease; but I have also met with several instances in which 

 this symptom did not appear. I must remark further, that I 

 have not found this symptom attending the empyema, or any 

 other disease of the thorax ; and therefore, when it attends a 

 difficulty of breathing, accompanied with any the smallest 

 symptom of dropsy, I have had no doubt in concluding the 

 presence of water in the chest, and have always had my judg- 

 ment confirmed by the symptoms which afterwards appeared. 



MDCCII. The hydrothorax often occurs with very few, or 

 almost none, of the symptoms above mentioned ; and is not, 

 therefore, very , certainly discovered till sorm others appear. 

 The most decisive symptom is a fluctuation of water in the 

 chest, perceived by the patient himself, or by the physician, 

 upon certain motions of the body. How far the method pro- 

 posed by Auenbrugger will apply to ascertain the presence of 

 water and the quantity of it in the chest, I have not had occa- 

 sion or opportunity to observe. 



It has been said, that in this disease some tumour appears 

 upon the sides or upon the back ; but I have not met with any 

 instance of this. In one instance of the disease, I found one 

 side of the thorax considerably enlarged, the ribs standing out 

 farther on that side than upon the other. 



A numbness and a degree of palsy in one or both arms, has 

 been frequently observed to attend a hydrothorax. 



Soon after this disease has made some progress, the pulse 

 commonly becomes irregular, and frequently intermitting : but 

 this happens in so many other diseases of the breast, that, un- 

 less when it is attended with some other of the above-mentioned 

 symptoms, it cannot be"considered as denoting the hydrothorax. 



MDCCIII. This disease, as other dropsies, is commonly at- 

 tended with thirst and a scarcity of urine, to be explained in 

 the same manner as in the case of anasarca (MDCL'XXIIL). 

 The hydrothorax, however, is sometimes without thirst, or any 



