Morbid; modified in production or transmission. Bronchial, or whiffling; transmitted from the bronchi by condensed tissue of the lung.

Cavernous, produced in morbid cavities, communiAmphoric,cating with the bronchia.

Bronchi; produced by increased resistance to the air moving through the lungs.

Dry; Sibilant,) produced by viscid mucus in the bronSonorous, chi, or by swelling of the membranes, Dry;Mucous, or by pressure upon them.

Moist; Mucous, { produced by a bubbling liquid in the

passage of air through

bronchi.

Sounds of the Voice transmitted through the Chest.

Natural sounds, such as are heard in a healthy chest.

Tracheophony; in the neck and at the top of the

sternum.

Broncophony; near the top of the sternum, between the scapulæ, in the axillæ, etc.

Pectoral voice sound; in many parts of the chest.

Morbid sounds transmitted or produced by a diseased Chest.

Broncophony; the sound transmitted by condensed pulmonary tissue.

Egophony; the same vibrating through a thin layer of liquid.

Pectoriloquy; resounding in a cavity in the lung.

Tinkling; a changed echo of the voice or cough in a large cavity.

Sounds produced by the motion of the Lungs.

Sounds of friction, when the pleuræ are dry, or rough from deposits.

Emphysematous crackling, by the irregular passage of air between the lobules.

CHAPTER IX.

HYDROPS. (Dropsy.)

HYDROPS, (from the Greek, meaning water.) A preternatural collection of serous or watery fluid in the cellular substance, or different cavities of the body. It receives different appellations according to the particular situation of the fluid. (Hooper.)

When it is generally diffused through the cellular structure, it is termed anasarca; when deposited in the cavity of the cranium, (skull,) it is termed hydrocephalus; in the chest, hydrothorax, or hydrops pectoris; in the abdomen, ascites; in the uterus, hydrometra; in the scrotum, hydrocele; in the ovaries, hydrops ovarii; in the joint, hydrops articuli; and in the knee, hydrops genu.

GENERAL DIAGNOSIS.-In addition to a preternatural distension or enlargement of a part, there is almost universally a dry and harsh state of the skin (in consequence of a diminished cuticular exhalation); impaired appetite and increased thirst; and a small, irritable pulse; the bowels are inactive; the urine is scanty and high-colored, and generally contains serum, which is considered by Dr. Eberle as a pyrexometer in dropsical affections. The fallibility of which must have been observed by every practitioner of any note, especially in cases ab inanitione, caused by excessive hæmorrhages, or a tedious and lingering illness, and in that enfeebled state during a tardy convalescence,

when the fluids are not held in proper equilibrium, and are acted upon by gravitation, producing anasarca of the inferior extremities.

CAUSES. The causes of dropsy are rather numerous; such as cold acting upon the surface, producing a constringed state of the cutaneous exhalents, and thereby congesting the internal organs, particularly the kidneys; excessive hæmorrhages; mechanical obstructions to the free return of the blood to the heart, and also obstructions of the excretory ducts; inflammation of particular organs; suppressed perspiration and habitual discharges; repelled eruptions; debility from chronic diseases; scirrhus of the liver; the continued use of arsenic in intermittent fevers;* and the intemperate use of intoxicating liquors; it is also frequently secondary to eruptive diseases, such as Measles and Scarlet Fever.

I. HYDROCEPHALUS. (Dropsy of the Brain.) HYDROCEPHALUS, (from the Greek words for water and head.) Dropsy of the brain.

DIAGNOSIS. This disease in general commences rather gradually, particularly in children; the little patient is restless, wakeful and irritable; and during the early or irritative stage evinces a repugnance to light; the pupils of the eyes are contracted, attended with a frequent knitting together of the brow; sudden starting in sleep, and waking with a scream or fright; accelerated pulse and increased heat in the head. These symptoms may continue for a few days, or even weeks, before we have a

* I have seen several cases of dropsy caused by the continued use of Fowler's solution (arsenite of potas.) in intermittent fevers.

full development of the disease, which is marked with more decided inflammatory symptoms; such as pain in the head; eyes injected; face flushed; pulse rather tense; increased heat of the skin; intolerance of light and sound; and the little sufferer frequently places his hands on his forehead, thereby evincing the distress in his head.

At this stage of the disease the stomach frequently becomes very irritable, attended with a distressing retching and vomiting; and during sleep there is constant tossing about and moaning. As the disease advances there is an occasional rolling of the head on the pillow, and a disposition to Coma; the heat diminishes; pulse becomes small and not so frequent; the pupils of the eyes from being contracted now become dilated; drowsiness increases until a full coma supervenes. Paralysis, particularly of one side, often occurs, which is manifested by a tremulous motion of the arm, with the hand or fingers contracted, and frequently by a squinting of the eyes. At this stage of the disease the inflammation is in that passive state that terminates in effusion. It is quite common for the sight and hearing to be entirely gone, and the little patient readily nurses when the lips are brought in contact with the milky fount; one arm is kept almost constantly in motion, and in the latter stages of the disease convulsions are seldom absent.

CAUSES.-There appears, in many instances, to be a constitutional predisposition to this disease. Dr. Eberle says that he has known families, of which nearly all of the children died from it during the period of teething; and I knew the same to exist in a very respectable Scotch family; the only surviving son had frequent attacks until he had passed through the period of puberty.