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Entered according to the Act of Congress, in the year 1854,

BY MARSHALL CALKINS, M, D., ' In the Clerk's Office of the District Court of Massachusetts.


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One object which Dr. Newton had in the preparation of this work, was to supply the increasing demand in the New School of Medicine, for a scientific treatise upon the Pathology, Diagnosis and Treatment of Thoracic Diseases ; and another was to make public the results of his own study and investigation into General and Special Pathology, and the means of Physical Diagnosis. Many new remedies, though in general use among the physicians of the New School, yet not in common use by the whole profession, are substituted for those upon which dependence has chiefly been placed for the removal of inflammatory diseases. That they are much more efficient, and at the same time less injurious to the constitution, a thorough trial will demonstrate. During nine years, Dr. Newton had given special attention to the study of thoracic diseases, and their treatment, and hence he could reasonably claim ample qualification to execute the task which he commenced. He had formed the plan for the whole work and had written all the general principles of pathology and diagnosis, and also, a particular description of several of the more important diseases of the thorax. Dr. Newton's writing ends on the two hundred and twenty-sixth page, at which place the writing of the Completing Author commences. In the completion of the work, the pathology, diagnosis and prognosis, have been chiefly derived from the best medical authorities of the age; and yet, such alterations have been made as investigation seemed to suggest. The treatment recommended, is substantially that of New School Authors, with such modifications as have seemed necessary, and of practical utility. Being a student of Dr. Newton in 1847 and 1848, and having been since that time associated with him in the practice and teaching of medicine during a limited period, good opportunities have been afforded for learning his peculiar views of the pathology and treatment of disease. From many other medical gentlemen of extensive experience much valuable information has been derived, to whom the Completing Author would here express his thanks for the interest which they have manifested in the work, and for their many voluntary contributions to the treatment of disease. In conclusion he would simply say, that he has used every possible effort to make the work valuable for the profession, to which it is now offered, with the hope that it may be the means of alleviating human suffering, and of the advancement of sound medical education.

Worcester, July 1854.




Part I. General Considerations, 18

Division I. Pathology, 18

CHAP. I. Fever, discussion of its nature, 19

6 II. Inflammation, theories of; its nature; author's views, 20434

66 III. Congestion, active and passive, 34–35

66 IV. Serous Effusion, pathology of, 35

V. The Reparative Process; discussion of its nature, 37–45

VI. The Red Corpuscles ; description of, 45—50

6 VII. The Formation of Pus; its kinds, chemical and microscopic char-

acter, 50-55

VIII. Ulceration, 55

" IX. Mortification ; sphacelus, gangrene, 57

X. Lymphatic Swellings, 58

XI. Tubercles; their pathology and microscopic character, 59—69

4 XII. Carcinoma; forms of; chemical and microscopic character, 69–77

" XIII. Melanosis; various forms of, 77–80

XIV. Non Malignant Tumors, encysted, hydatids, vascular, 80–82

Division II. Diagnosis : definition, 83

CHAP. I. Symptoms ; divisions of, rational, constitutional, physical signs, 83–85

" II. Topographical terms; regions of thorax and abdomen, 85-87

“ III. Position of patient for physical exploration, 87

• IV. Succussion ; Hippocratic, 89

“ V. Palpation, 89

VI. Inspection, 90

6 VII. Mensuration, 91

VIII. Percussion; sounds of; cracked pot sound; mediate and imme-

diate, 91-92

Pleximeters; directions for their use, 93—95

" Its range of application and utility, 96

6 IX. Auscultation, 97

Sec. I. Mode of application, mediate and immediate, 97

Stethoscopes; kinds of; manner of using, 98-103

Sec. II. Healthy sounds of respiration ; (a) tubular; (b) vesicular,


Varieties of healthy sound, 108

Sec. III. Diseased sounds of respiration ; (a) bronchial ; (b) cavern-

ous; (c) amphoric, 110–112

Varieties of diseased sounds, 115

Sec. IV. Rales; the dry, 116–120

" humid, 120-124

66 V. Adventitious Sounds, 124

• VI. Sounds of the Voice, bronchophony, pectoriloquy, ego-

phony, 126-129

CHAP. VIII. Pulmonary Apoplexy, 211

Pathology, 212

Diagnosis, 214

Prognosis ; Treatment, 215

4 IX. Pulmonary Gangrene,

Pathology, 216

Diagnosis, 217

Prognosis; Treatment, 219

66 X. Pulmonary Edema,

Pathology, 220

Diagnosis, 221

Prognosis; Treatment, 222

« XI. Pleuritis, 222

Sec. I. Primary Sthenic Pleuritis,

Pathology, 223

Diagnosis, 230

Prognosis, 237

Treatment, 238

" II. Asthenic Pleuritis, 244

“ III. Chronic Pleuritis, 244

Pathology, 245

Diagnosis, 246

Prognosis, 247

Treatment, 248

L'aracentesis Thoracis, 249–252

Description of Operation, 253–257

Treatment to prevent its necessity, 257—259

IV. Latent Pleuritis, 259–260

6 V. Secondary and Complicated Pleuritis, 261-263

66 VI. Pleuritis of Children, 261-265

66 XII. Pneumothorax,

Pathology, 265

Diagnosis, 266

Prognosis, 269

Treatment, 270

4 XIII. Hydrothorax,

Pathology, 272

Diagnosis, 273

Prognosis, 274

Treatment, 275

“ XIV. Empyema,

Diagnosis, 280

Prognosis; Treatment, 281

66 Pulsating; Treatment, 282–283

66 XV. Phthisis; definition of, 283

Sec. I. Tubercles ; History of their pathology, 284

Pathological characters; causes of, 286—289

Location ; law of their deposition, 290—292

Forms of; Progress of ; Softening of, 293–295

Effects upon the lungs; Cavities; Adhesions,


" II. General course of Phthisis, and General Symptoms, 300

Tuberculous Cachexia, 301

Stages of Phthisis, 301

(a) first stage; Diagnosis, General and Special

Symptoms, 301-305

(b) second stage; Diagnosis, General and Spec-

cial Symptoms, 305-308

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