REPORTS OF CASES. 
507 
Auscultation and percussion. — Nothing abnormal on the 
right side, on the lett side absence of vesicular murmur, 
opposite the whole anterior and medium parts of the lung ; 
dull sound to percussion of those parts; but the most atten- 
ti\ e auscultation does not reveal the presence of crepitating 
rale (rale crepitant humide). - 
Diagnosis doubtful , but probably right pneumonia. That 
was a mistake, and I confess that such an error should not 
have been committed. I will explain it by saving that I was 
in a hurry, that I neglected to explore the heart (there are 
two modes of exploring the chest, one used for respiratory 
organs and the other for cardiac diseases. I will have an op¬ 
portunity in the near future to be more explicit on the sub¬ 
ject). The color of the mucous membranes, the absence of 
crepitating rale and the very high temperature were, it is true, 
negative symptoms; but, on the other hand, the frequent 
breathing, the absence of respiratory murmur and the cough 
lead me to think that it might be pneumonia. I insist on these 
points because I am of opinion that the confession of an error, 
or of failure in treatment, is as producive of good results to 
confreres as anything else. 
Treatment. —Antifebrine, y 2 ounce doses every 6 hours. 
August 18th.—The next morning my patient is much 
worse. Pulse 90, very small; respiration 20; temp. 106*4°. 
Refuses all food; great prostration; chest is again explored 
for pulmonary disease. Dull sound at percussion, of a very 
large surface of the lung, even larger than the day before, no 
crepitating rale and no vesicular murmur. I am rather 
puzzled and can form no opinion yet of the case; I begin to 
believe that there is no disease of the lungs. A large and 
strong sinapism is applied to belly and chest and the patient 
is left alone till 5 p* m. At 5 p. m. that day she begins to per¬ 
spire profusely, such perspiration that I have never seen any¬ 
thing like it before or since ; the perspiration is falling to the 
ground as if the patient had been dipped in water. Not much 
importance was attached to the fact as I attributed it to the 
sinapism. The patient has eaten nothing since noon the day 
before. 
