PIvEURO-PNEUMONIA. BRONCHO-PNEUMONIA. 

 BRONCHO-PLEURO- PNEUMONIA. 



Though we often meet with typical forms of bronchitis, pneumo- 

 nia and pleurisy, it is much more common to find them combined 

 more or less with each other. Thus combined inflammation of 

 the bronchial tubes and pulmonary substance is frequent ; inflam- 

 mation affecting both the lung and its investing pleural membrane 

 is no less common ; and cases are seen in which all three struc- 

 tures are involved. These conditions are to be recognized by the 

 presence of the symptoms of both the coexisting maladies, but 

 particularly by the indications furnished by touch, auscultation 

 and percussion. The predominance of one disease over another 

 will decide the nature of the treatment which will be adapted to 

 the peculiar character of each case whether mainly bronchitic, 

 pneumonic or pleuritic. It is these mixed cases that test the 

 ability and judgment of the practitioner, as he must carefully in- 

 dividualize each case, ascertain the different parts affected, the 

 grade of the inflammatory action, the nature of the attendant 

 fever, the presence or absence of epizootic influence, etc., and 

 having all these conditions in view, must apply remedial measures 

 accordingly. 



It must be evident that particular directions cannot be supplied 

 for all of these cases. General principles only can be inculcated 

 and their adaptation to the varied phases of different cases left 

 to the judgment of the student. 



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