22 Thoracic complaints amongst Natives. 



by a large number of *post-mortem examinations at the Jail and Dis- 

 pensary. We make it a rule, therefore, to examine the condition of 

 the chest, in all cases of chronic diarrhoea, dysentery, the so called 

 remittent, but frequently hectic fever, and in continued fevers in the 

 cold season. The patients often make no complaints of chest disease 

 themselves, their attention being concentrated on the symptomatic 

 fevers or diarrhoeas, or failure of strength. It is necessary to question 

 them closely, to watch the general symptoms of lung affections, and 

 generally to resort to auscultation, before coming to a conclusion as 

 to their real complaints. Within twelve months, we have met with 

 every form of pulmonary disease, except the malignant ones, and 

 many of the diseases of the heart. Tubercular phthisis, we have 

 had an abundance of, as the detailed autopsies forwarded every month, 

 show. 



In the cold season, Pneumonia and Broncho-pneumonia, were preva- 

 lent, the patient complained mostly of continued fever ; he made light 

 of the little dyspnoea and cough that accompanied his complaint, 

 and as the pleura was not generally involved, there was little or no 

 pain to draw his attention to the chest. We found careful ausculta- 

 tion of great use here in directing the mode of treatment. This con- 

 sisted in bleeding in the early stage when the patient's strength al- 

 lowed : calomel carried to ptyalism, if necessary, and large doses of tar- 

 tar emetic. Some of the patients took 15 or 20 grains of it daily, for 

 two or three days, without any inconvenience whatever. When the com- 

 plaint had passed into the third stage, or the bronchial tubes were 

 loaded with secretions, of course a stimulating plan was adopted, and 

 carbonate of ammonia was found most useful. 



Asthenic-pneumonia, I have frequently met with among the weak and 

 the old ; in these cases, diarrhoea, dysentery, or perhaps some form of 

 standing sore, and great prostration, were the principal symptoms : a 

 very careful inspection would show, that there was some dyspnoea from 

 the slight dilatation of the alse nasi, and some heaving of the chest, 

 the breath had a foetid smell, but not amounting to that produced by 

 ordinary gangrene ; auscultation was here of considerable assistance. 

 In the post-mortem examinations, we found consolidation of parts of 

 the lungle, but the color was darker (sometimes approaching to brown 

 or muddy color,) than the consolidation of asthenic-pneumonia, while 



