COLD APPLICATIONS VS. COUNTER-IRRITATION. 
729 
The increase of temperature that we notice in the patient 
has been set down to increased metabolism, while other and 
later writers believe there is a thermic center in the corpus 
striatum, and that this has been so influenced by adverse sur¬ 
roundings that it has lost its inhibitor} 7 power over the sys 
tern. But whatever may be the correct cause of the rise in 
temperature, we will pass it by for the present by merely not¬ 
ing that it is there, and is symbolical by its rise or fall of the 
intensity of the internal trouble. 
The dryness of the skin is due to the increase of tempera¬ 
ture and the loss of the nerve control over the pseudoriferous 
glands. 
These are some of the most striking changes we notice in 
pneumonia, with some of the physiological reasons for their 
existence. 
The physical symptoms of pneumonia we are all familar 
with ; on percussion we have a dullness that invariably affects 
the lower part of the lung and extends upwards, the distance 
being only governed by the extent of the disease. Over this 
dull spot there is also a loss of respiratory murmur. The 
question may here present itself as to why the lower part of 
the lung should be the first part affected? The answer is 
simply the law of gravitation. I mention this here because I 
think it shows us that some of the laws that affect diseased 
parts are the same as those which govern the universe, and in 
our treatment of this disease certain laws, although they may 
appear to be purely mechanical, exert the same influence on 
the system as they do in nature and should not be overlooked. 
Farther on I may have reason to refer to this again. 
In following up a case of pneumonia we find that it usually 
extends over from two to three weeks, and that this period 
is divided into certain well defined stages. The first or initial 
stage occurs with the rigors or shiverings. In this stage 
there is high temperature and considerable congestion of the 
lungs, which is not pronounced enough, however, to be appar¬ 
ent on percussion. If this shivering has its desired effect of 
rousing the system, the congestions are dispelled and the 
trouble is at an end, and it is only when this is not the case 
