Page:Transactions of the Provincial Medical and Surgical Association, volume 2.djvu/211

 commonly than any other active inflammation of the chest, succeeds sudden transitions from heat to cold. In Naples, as we are told by Dr. James Johnson and other writers, this disease is endemic, and is very reasonably attributed by them to the chilling tramontanes, which are constantly surprising the inhabitants enervated by sultry skies and siroccos. It is possible that the foreign particles abounding in the air of Bristol, may have something to do with the frequency of bronchitis. We seldom find this disease fatal in its acute form, when judiciously treated, but it is very prone to pass into the chronic form, and then becomes extremely intractable.

Of the chronic diseases of the lungs, phthisis maintains its predominance here as elsewhere. Sometimes it supervenes on acute inflammation of the bronchial membrane, or of the pulmonary tissue, but far more frequently it takes its origin solely from the peculiar structural degeneration in which its essence consists. Our consumptive patients often, indeed, with that confidence and self-delusion which characterise the disease, refer their complaints to some accidental occasion of taking cold, suffering “ a chill,” exposure to rain or fog, and similar causes, fancying that their symptoms are consequently of a less serious description; but on close cross-questioning, it generally appears that, for some time prior to the date, which they would fain assign to their indisposition, they had experienced an acceleration of breathing on any increase of exertion, had been sensible of a slight oppression on the chest in the recumbent posture, had been troubled with a short cough, and had even expectorated small quantities