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O/a

PERIPN!UMONY.

are f"'eral kinds of rhis difeafe. For it may

arife from a violent inHammation of [he lungs,

a very

lizy denf< blood obll,utling vcry many of the pulmonic

aDd broDchial ¡ncries : or from an obfiruélion of

lhe

lungs

a htavy, vifcid, pituitous matter ; which is called a

fpurious or

bafhrd

peripneumony : or [rom a thin, accid

deftu x.ion

tbe lungs ; and [hen

is a c¡ (arrha] perip.

neumony.

The fymptoms

cammon

aIl, are, a

load

at the brean,

a fhon diflicult breuhing. and more or I<fs of a fever.

But in a true peripneumony,

[heTe

is a more teorive paio

chan in the pleurify;

befides,

it is racher more

obture

and

preOing than aeute. and

(hooes

as [ar as the back and fea–

pulz. But rhe difficulty of breathing i. greater, as well

as' (he

anxietyand

expeéloratioo, whereby a

variega,

ted fpiule is

brought up.

which layas

\VeTe

dcep :

for in rhis diCeaCe the vefiels of rhe lungs themfelves,

whereby lhe

blood circulates

from one "entriele of che

heart

the o,her. are affetled; being lluff<d and obllrutl·

td with

lhick

blood,

which is

apt

ro gro\V more vifcid

and folid. Wherefore it i. the more dangerous and raral.

eCpecially iC it attacks old perCons, and if bleeding is not

timely admioifl red. Boerhaave f. ys, the pulfe is fofr.

flender, and in

every

feofe unequal : and H lJxham, lhat

if the pulCe is hardly Celt before bleeding. it \ViII aCter·

wards beat very·llrongly.

In the cure, great regard mufl he had to the different

lIages of this difeafe, ond rhe different Cymptoms thar ato

tend it. Bleeding is illdifpenCably necelfary at the begin–

ning of a fevc.!re infhmmation of

lhe

lu ngs;

bUl

ir,

after

,he Cecond or third bleeding. the parient hegins to Cpit a

well concotled matter, freely tinged wi,h blood, you

rnuH forbear

lO repeal

it,

otherwire

che patient \ViII be

\Ve,kened . and a f." , 1 fuppreffion of rhe expetloration

wilJ

enfue.

BUl

he brings up a confidcrabJe quantity

of /lorid, thin, fpumous blocd, by fpitting; rhen bleed a·

gaín, quiee the cough with dtacodium, and give proper

acids preuy (reely. \Virh

rofl

coC\ling

incralrdms.

thin, gleety, dark-coloured matter is

expedorated,

ir is

generaJlya mark of

grl!'3ter

maJignity, and that the bJood

is in • putrefying dilfolving (ta'e, and wilJ not

h.ar

a large

lof."f blood.

G enen lJy the more violent lhe rigor or horror is at the

anark. lhe more violent the fu ccel!ding fc\-er will be,

which \ViII in fome meafure guide

llS

in drtlwing oCbload_

the Cymptoms are not rdiev.-d by rho :idl blading, af·

ter eight. ten, or twelve hours, let

r~pc¡.o ted;

{oontr, iCthey bec?me:

ag~r

..vatcd .

Ifrl le ((vl!r, anxiety,

oppre:ffion, and difli<.uhy of bre2thing, inCrt!2fe, bJe;:ed

gaio, efpeci.dly ir it 3!

'PC.HS

ve;:ry firm and dC'nfe, ur co–

ve:re:d OYer with a thit.:k ycllowifh

cO.

or buer.

I1 ow~

ever. it dOt"s not appear lotnetimes till

t11t::

fecond or thil d

bJeeding.

thou~h

the fymptoms indicare a very

h;rilJ

in–

flammation. T'his often happcns rrom the bJood nOl '-P0l}(–

¡og out in a ful l !lream.

'T'nis

appearance (Ir the blood ,

wilh 3 lirm nrooJ: pulfe. will war..aot (he t:lking away

more, liJl the brcathing bt:comes free and c;'Iry.

the cr,,{famentum is of a very loofe leXtUre, ancf

n.ot

cov.red \Vit" a buff coat, and the pulf<!

blccdiDg

fill"S,

flune rs, or gro\Vs more weak and rmall . it is time to

deGll. A hluiO, film on the blood. ",ith a kind of a

cor,

greenilh jelly undcrnealh, while the Cruor ¡tfelr is livid,

loofe and [oft, with a turbid, reddifh. or green ferum,

is a fign of a \'ery lax craCis

the blood, and great acri·

mony, which .....ill nOl bear great quantilies- tO be drawn

off. I f the blood is very Horid, ,hin and loofe, with

Jiltle or no ferum arter Clanding for fome time, ít gene–

rally argues a confiderable ad.ance tO a pUlrid and very

acrid (late.

A flrong, throbbing, thick puJre, always indicates far–

ther bleeding

at leaH

tiJl

the patient bl eathes more eafi....

ly, or a (ree expedoratioo oflaud2ble maller is obtaioed.

often h. ppcns. that the pulfe at the very beginning

feems obfcure and opprelfed. irregular. Ouggilh, and

Come–

times intermitting. with weaknefs an.d oppreffion. But

this

does

DOt

arife from lhe dered, bUI from lhe

too

great quaOlity of blood; for the blood·,..lfels being

0 -

ver~loaded

and dinended, cannOl

:\(t

with fufllcie nt vi·

gour. This i. Cucceeded \Vith a dreadful Irain of Cymp–

lOOlS,

2nd even de3th ¡lfelf, ir nOI prevented with fuffi ..

cient bleedi ng.

In fome very violent peripneumonies , aD immediate

and excefTive weaknefs comes

00,

with an inexpreffible

anxiety and oppleffion of the brean; a very rmall, weak,

trembling pulfe, coldnefs of lhe extremilies, with c1am–

rny. coJdifh,

parti~I

fweats, the eyes flaring, fixed and

infiamed, 'rhe f.o< blo.ted anil almoll livid. This has

foon beeo rollowed wi th a (lupor. delirium , and fometimes

with a complete paraplegia.

Some kinds of peripneumonies \ViII not bear Jarge bleed–

ing. eCpecially the epldeOlic or m.

lign.OI

. The pulCe

and llrength of theCe parients have Cunk ro a furpriGng

degree; and the d,feale has turned imo a

fort.or

a nervous

rever, with great tremors, fu bfuhus lendinum, profufe

fweats, or an atrabiliou5 diarrhCEJ. with a bJack tongue.

coma, or delirium; though at lhe beginning the pulfe

feemed tO be Cull and throbhing, .nd the pain, cough,

and oppreilion fo

\'ery

urgt"nt, as

indicate bleediog pret–

ry llrongly. In rhefe caCes the blood was feldom buffy

tO any confiderable degree, but commoDly very florid, of

a very Joofe and fott 'confiflence, or very dark-colou red,

and coated with .a thin and blll ifll or greenilh film, undee

which was a fOrl greenifh jelly, anJ a dark livid cruor

at lhe bonom. Somelimes the coat was much thicker

and

more

tOugh, but of a pale red colour. refembJing the

cornelian (lone, or a díiute jeJly or red curr3nts . ' Vhcn

the hlood is thus diffoh'ed, abnain from fanher bleeding,

efpeci..

lIy

ir lhe puBe or p:ttient becomcs more Janguid af..

t( r it. Ihuugh rhe opprcflion, 103d, or even pain, may

fefm tO require it.

When the fizy coar on the blood js exceffively tough,

and extremcly ycllow, or or a palc red colour, it threatens

danger; ror the intlammatory leotor will fcarcdy mix

widl

Jn~

dílllents. Sometimes, arter repeatcd blceding ,

the cra{1.tOleOlum has rcarce been a fixth pan of the vo–

lume of rhe hlood. and YCt as Culid as a piece of lI<fh.

T his is

generally

mon al.

' Vhen lhe pcripncumollic fymptoms continue (or foue

or f:ve: (Iays or more, we may juHl y fear an abfcefs, or a

monilic.tion; and linlc advaotage is to be expetled fror.>

fartller