250 
G. W. BUCKNER. 
but the local expression of a general state, and only exception¬ 
ally proceeding beyond hyperamia and simple exudation. 
Etiology. 
Individual Predisposition. No age is exempt from pneu¬ 
monia, but the disease is most common during the active 
stage of life. Depressed vitality, overcrowding in bad, ill 
ventilated stables, renders the patient more prone to its at¬ 
tack. A plethoric state also favors attack. Cold seasons, 
great variation of temperature, rough, cold winds bring 
about pneumonia and account for its epidemic form. An 
epidemic of influenza is most likely to be followed by pneu¬ 
monia. 
Pathologists also state that the bacilli pneumonocci is a 
most fruitful cause, but as this theory has not been substan¬ 
tiated as being the cause, 1 will just say that it is a point wor¬ 
thy of investigation. 
Pathology and Morbid Anatomy .—The morbid anatomy of 
pneumonia consists of an acute hypermia of the affected lung, 
resulting in an exudation into the alveoli and forming a film 
upon the pleural surface. This film coagulates and fixes the 
lung in an immovable state of expansion or hepatization. 
Here all the severity of the disease is manifested, and with its 
attainment the disease proper is at an end. 
The local consequences of the disease do not thus termin¬ 
ate, however, with the first consequences of extravenous influ¬ 
ence. Coagulation of the exuded product, a chain of second¬ 
ary phenomena commences, partly chemical and partly vital, 
attending their liquifaction and reabsorption. Thus, after a 
usually very short time the malady is ushered in abruptly 
with rigors, rapidly mounting and maintaining high tempera¬ 
ture. In the second to fifth day the local signs present them¬ 
selves. On the seventh to the tenth day the temperature usu¬ 
ally falls, but the local lesions have yet to be removed. Pneu¬ 
monia is thus artificially divided into three stages: 
The first stage begins with the rigors and ends with the 
appearance of definite signs of consolidation. It may be 
termed the stage of initial fever with pulmonary engorgement. 
If death should occur at this stage, the affected lung is found 
