Epidemics. 245 



instances ; it is very rarely albuminous, and if so it is transient 

 and small in quantity, but enough to be able to say it is 

 decidedly appreciable to other eyes than the initiated. 

 Being annoyed at the ill-success and progressive weakness, 

 and slight but continued wasting, the patient returns to his 

 old medical adviser ; fortunately he has taken a recent cold,, 

 and much mucous rale and bronchial roughness is perceived 

 in the upper part of the chest, but the expectoration is frothy 

 and not very tenacious. 



He gets better, and now he has been trying one and 

 another for six months ; his bronchitis is ended, but he 

 evidently continues wasting, and assures his medical 

 attendant that he brings up more phlegm than ever, and 

 every morning he fancies he will be choked from the diffi- 

 culty of its rising ; and for the first time complains of the 

 soreness of his sides, but usually the right side most; for this 

 congestion is far more frequent in the right than the left 

 lung. The patient is now examined towards the base of the 

 lungs on the sides, behind, and anteriorly. As a rule, 

 the side and anterior portion of the lower half of the lung is 

 affected ; and now there is a noisy, crackling crepitation 

 over the affected part, but for the extent of surface no great 

 amount of fever or heat exists generally, unless there is a 

 very irritable heart, when there is usually more fever than 

 with a quiet heart. The expectoration is not rusty nor 

 streaked with blood, but it is becoming more finely frothy 

 and tenacious. Soon suspicious signs of dulness in one or 

 both lungs appear in the upper part, and it is not long before 

 patches one, two, or more are found, where the respiration 

 is not quite equal, rather more noisy, and yet no true 

 crepitation nor mucous rale. It is the sound of air running 

 over hard and non-elastic surfaces ; tubercle is rapidly 

 depositing, and in a few months it runs through softening 



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