Epidemics. 241 



species of acute congestion and morbid nutrition sets in, 

 which altogether, interferes with the local integrity of the 

 part, and gives us all the results known as acute inflammation, 

 with certain alteration of structure in the part affected. 



Now, it is to the former condition of passive congestion, 

 without much alteration of structure, saving in capillary 

 dilatation, that attention is chiefly directed. 



It is, then, this state, that in our day exists so long without 

 running into all the sequelae of true inflammation, that is 

 so often witnessed, and in no organ so frequently as that of 

 the lungs, in which, through sounds, the various changes 

 can be traced from month to month and day to day if re- 

 quired. 



Let brief mention be here made of chronic congestion of 

 the lungs, so common since 1849, and which is so frequently 

 confounded with consolidation of the lungs from pneumonia, 

 and with extensive tubercular deposit ; and which, under 

 change of air, to the delight of the physician, and sometimes 

 to his great astonishment, and to the advantage of the 

 patient, frequently ends in most perfect recovery, especially 

 if, for two or three years in succession, a change of air for 

 two months is insisted upon, for fear, through sameness of 

 atmosphere and duties, the system should become enfeebled, 

 and as a result a relapse should occur. 



Upon the whole, this affection does not appear to have 

 obtained that share of careful attention which its importance 

 appears to deserve.* It is very common, but mostly ends 

 in phthisiss pulmonalis, or a very lingering type of pleuro- 

 pneumonia. The indications of the latter rarely set in 

 before six to twelve months have passed over, and the fatal 



* Since this was first written great attention has been paid to chronic 

 pneumonia, and different forms of consolidation of the lungs, beside that 

 of tuberculosis pure and simple ; but it will do no harm to record 

 matters as they have presented themselves in the order of personal 

 observation. 



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