614 PRACTICE OF PHYSIC. 



other febrile symptom ; although I believe this happens in the 

 case of partial affections only, or when a more general affection 

 is yet but in a slight degree. In both cases, however, and 

 more especially when the disease is considerably advanced, some 

 degree of fever is generally present : and I apprehend it to be 

 in such case, that the persons affected are more than usually 

 sensible to cold, and complain of the coldness of the air when 

 that is not perceived by other persons. 



MDCCIV. The hydrothorax sometimes appears alone, with- 

 out any other species of dropsy being present at the same time : 

 and in this case the disease, for the most part, is a partial af- 

 fection, as being either of one side of the thorax only, or being 

 a collection of hydatides in one part of the chest. The hydro- 

 thorax, however, is very often a part of more universal dropsy, 

 and when at the same time there is water in all the three prin- 

 cipal cavities, and in the cellular texture of a great part of the 

 body. I have met with several instances in which such uni- 

 versal dropsy began first by an effusion into the thorax. The 

 hydrothorax, however, more frequently comes on from an anas- 

 area gradually increasing ; and, as I have said above, the 

 general diathesis seems often to affect the thorax sooner than it 

 does either the head or the abdomen. 



MDCCV. This disease seldom admits of a cure, or even of 

 alleviation, from remedies. It commonly proceeds to give more 

 and more difficulty of breathing, till the action of the lungs be 

 entirely interrupted by the quantity of water effused ; and the 

 fatal event frequently happens more suddenly than was expect- 

 ed. In many of the instances of a fatal hydrothorax, I have 

 remarked a spitting of blood to come on several days before the 

 patient died. 



MDCCVI. The cause of hydrothorax is often manifestly 

 one or other of the general causes of dropsy pointed out above : 

 but what it is that determines these general causes to act more 

 especially in the thorax, and particularly what it is that pro- 

 duces the partial collections that occur there, I do not find to 

 be easily ascertained. 



MDCCVI I. From what has been said above, it will be 

 evident, that the cure of hydrothorax must be very much the 



