. The principles and practice of medicine, designed for the use of practitioners and students of medicine. accompanied often with a short expiratory grunt; the alje nasidilate with each inspiration; herpes is usually present on the lips or nose;the eyes are bright, the expression is anxious, and there is a frequent shortcough which makes the patient wince and hold his side. The expectora-tion is blood-tinged and extremely tenacious. The temperature may be104° or 105°. The pulse is full and bounding and the pulse-respirationratio much disturbed. Examination of the lung shows the physical signso
. The principles and practice of medicine, designed for the use of practitioners and students of medicine. accompanied often with a short expiratory grunt; the alje nasidilate with each inspiration; herpes is usually present on the lips or nose;the eyes are bright, the expression is anxious, and there is a frequent shortcough which makes the patient wince and hold his side. The expectora-tion is blood-tinged and extremely tenacious. The temperature may be104° or 105°. The pulse is full and bounding and the pulse-respirationratio much disturbed. Examination of the lung shows the physical signsof consolidation—^blowing breathing and fine rales. After persisting forfrom seven to ten days the crisis occurs, and with a fall in the temperaturethe patient passes from the condition of extreme distress and anxiety to oneof comparative comfort. 116 SPECIFIC INFECTIOUS DISEASES. Special Features. —The fever rises rapidly^, and the height may be104° or 105° within twelve hours. Having reached the fastiginm, it is Jan. 40 11 i2 is u IS 16 R«sp. Pnlse190 Temp109 96Temp, Resp,Stools 3ay ofiscase. BLACK, temperature; red, pulse; blue, respiration. Chart IX.—Fever, pulse, and respirations in lobar pneumonia. remarkably constant. Often the two-hour temperature chart will not showior two days more than a degree of variation. In children and in cases LOBAR PNEUMONIA. 117 without chill the rise is more gradual. In old persons and in drunkardsthe temperature range is lower than in children and in healthy individuals;indeed, one occasionally meets with an afebrile pneumonia. The Crisis.—After the fever has persisted for from five to nine or tendays there is an abrupt drop, known as the crisis, which is perhaps themost characteristic feature of lobar pneumonia. The day of the crisis isvariable. It is very uncommon before the third day, and rare after thetwelfth. I have twice seen it as early as the third day. From the time ofHippocrates it has been thought to be more frequent
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