OF THE PRACTICE OF MEDICINE. BY RICHARD BRIGHT, M.D. AND THOMAS ADDISON, M.D. PHYSICIANS TO GUY'S HOSPITAL, AND LECTURERS ON THE PRACTICE OF MEDICINE. PART II. LONDON: LONGMAN, REES, ORME, BROWN, GREEN, AND LONGMAN, PATERNOSTER-ROW. INTRODUCTION. IN offering a second part of their work to the public, the Authors feel it incumbent upon them to apologise for having in some degree deviated from their expressed intention of avoiding the introduction of theoretical discussions; but it has been found almost impossible to adhere rigidly to this determination, more particularly when treating on the subject of inflammation. It may likewise be thought by some of their readers, that the observations they have made on the stethoscopic signs in the diseases of the chest, to which the present part is chiefly devoted, have been less explicit than might be expected in a purely elementary work; but the Authors have judged it better, that the student should make himself master of the minutia and the technicalities of this most important branch of medical acquirement, by practice at the bed-side, and by the perusal of some of the many excellent and elaborate works in which it has been fully illustrated; while at the same time they hope that in the present fasciculus no essential stethoscopic indication has been omitted. essentially in a diseased function of a part only of the organic nervous system, so do we think it probable that a febrile state consists essentially in an universal disorder of that system of a different kind: as the general phenomena of inflammation are the same, whether induced by a local injury, by cold, or by venereal poison, so are the general phenomena of a febrile state the same, whether occasioned by a local injury, by miasmata, or by a contagion: as the progress, effects, and mode of treatment of inflammation vary accordingly as it is produced by violence or by venereal poison, so are the progress, effects, and mode of treatment of a febrile state varied accordingly as it is induced by local violence, by miasmata, or by a contagion. INFLAMMATION. WHEN any part of the body presents the phenomena of pain, redness, heat, and swelling, it is said to be affected with Inflammation; such inflammation, when extensive or severe, being usually attended with a febrile state of the system at large, which is regarded as Secondary or Symptomatic. The local signs enumerated are those which pretty uniformly distinguish inflammation seated externally, and dissection leads to the belief that all of them are present also, in a greater or less degree, in inflammation of an internal part. But although these local signs when present are usually sufficient to indicate the existence of inflammation, we should entertain an extremely imperfect notion of that morbid condition were we to rest contented with |