CHAPTER I. ON PNEUMONIA
ANIMALS live by two principal things, food and breath (
spirit,
pneuma); of these by far the most important is the respiration,
for if it be stopped, the man will not endure long, but immediately
dies. The organs of it are many, the commencement
being the nostrils; the passage, the trachea; the containing
vessel, the lungs; the protection and receptacle of the lungs,
the thorax. But the other parts, indeed, minister only as instruments
to the animal; but the lungs also contain the cause
of attraction, for in the midst of them is seated a hot organ,
the heart, which is the origin of life and respiration. It
imparts to the lungs the desire of drawing in cold air, for it
raises a heat in them; but it is the heart which attracts. If,
therefore, the heart suffer primarily, death is not far off.
But if the lungs be affected, from a slight cause there is
difficulty of breathing; the patient lives miserably, and death
is the issue, unless some one effects a cure. But in a great
affection, such as inflammation, there is a sense of suffocation,
loss of speech and of breathing, and a speedy death. This is
what we call Peripneumonia, being an inflammation of the
lungs, with acute fever, when they are attended with heaviness
of the chest, freedom from pain, provided the lungs alone are
inflamed; for they are naturally insensible, being of loose
texture, like wool. But branches of the aspera arteria are
spread through them, of a cartilaginous nature, and these,
also, are insensible; muscles there are nowhere, and the nerves
are small, slender, and minister to motion. This is the cause
of the insensibility to pain. But if any of the membranes, by
which it is connected with the chest, be inflamed, pain also is
present; respiration bad, and hot; they wish to get up into an
erect posture, as being the easiest of all postures for the respiration.
Ruddy in countenance, but especially the cheeks; the
white of the eyes very bright and fatty; the point of the nose
flat; the veins in the temples and neck distended; loss of appetite;
pulse, at first, large, empty, very frequent, as if forcibly
accelerated; heat indeed, externally, feeble, and more humid
than natural, but, internally, dry, and very hot, by means of
which the breath is hot; there is thirst, dryness of the tongue,
desire of cold air, aberration of mind; cough mostly dry, but
if anything be brought up it is a frothy phlegm, or slightly
tinged with bile, or with a very florid tinge of blood. The
blood-stained is of all others the worst.
But if the disease tend to a fatal termination, there is insomnolency;
sleep brief, heavy, of a comatose nature; vain
fancies; they are in a doting state of mind, but not violently
delirious; they have no knowledge of their present sufferings.
If you interrogate them respecting the disease, they will not
acknowledge any formidable symptom; the extremities cold;
the nails livid, and curved; the pulse small, very frequent, and
failing, in which case death is near at hand, for they die
mostly on the seventh day.
But if the disease abate and take a favourable turn, there is
a copious hemorrhage from the nose, a discharge from the
bowels of much bilious and frothy matters, such as might seem
to be expelled from the lungs to the lower belly, provided it
readily brings off much in a liquid state. Sometimes there is a
determination to the urine. But they recover the most speedily
in whose cases all these occur together.
In certain cases much pus is formed in the lungs, or there is
a metastasis from the side, if a greater symptom of convalescence
be at hand. But if, indeed, the matter be translated
from the side to the intestine or bladder, the patients immediately
recover from the peripneumony; but they have a
chronic abscess in the side, which, however, gets better. But
if the matter burst upon the lungs, some have thereby been
suffocated, from the copious effusion and inability to bring it
up. But such as escape suffocation from the bursting of the
abscess, have a large ulceration in the lungs, and pass into
phthisis; and from the abscess and phthisis old persons do not
readily recover; but from the peripneumony, youths and adults.
