PI^EURO-PNEUMONIA. BRONCHO-PNEUMONIA. 

 BRONCHO-PLEURO-PNEUMONIA. 



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

 nia andi 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 afiEecting 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 must 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 hav- 

 ing all these conditions in view must apply remedial measures ac- 

 cordingly. 



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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