Inflammation of the Lungs is accompanied by a difficulty of breathing, a dull pain in some part of the chest, a moist cough, a frequent full pulse, vibrating under the finger like a tight string of a musical instrument, white tongue, high-coloured urine, and other symptoms of inflammatory fever.

The most general cause of inflammation of the lungs is the application of cold to the body, which gives a check to the perspiration, and determines a great flow of blood to the lungs. It attacks those principally of a robust constitution and plethoric habit; hence it is more frequently met with in men than in women, and occurs most frequently in the winter and spring of the year; but it may arise at any time when there are great changes from heat to cold.

Other causes, such as violent exertions in singing, speaking, or playing on wind instruments, have been known to occasion inflammation. Severe exercise, external injuries, a free indulgence in the use of fermented liquors, repelled eruptions, suppressed evacuations, and the striking in of other diseases, such as gout or rheumatism, may also give rise to it. Those who have once been attacked with this disease are very liable to a return of it.

At the commencement there is usually obtuse pain in the chest or side, great difficulty of breathing, particularly when lying down, with cough, dryness of the skin, heat, anxiety, flushing of the face, and thirst. The pain is much increased on coughing or drawing a full breath. The pulse is usually full, strong, hard, and frequent, but in an advanced stage it is commonly weak, soft, and often irregular. In the beginning the cough is frequently dry without expectoration; but in some cases it is moist even from the first,and is sometimes streaked with blood.

If relief is not afforded in time, and the inflammation proceeds with such violence as to endanger suffocation, the vessels of the neck will become full and swelled; the face will become purple; an effusion of blood will take place into the substance of the lungs, so as to prevent their action, and the patient will soon be deprived of life.

Should these violent symptoms not arise, and the proper means for carrying off the inflammation have been neglected, or not been successful, although adopted at an early period of the disease, suppuration may then ensue; this may happen in the first, but more usually in the second week after the attack, and may be known by frequent slight shiverings, an abatement of the pain, and a sense of fulness in the parts; by the patient being able to lie with greater ease on the side which was affected; by a remission of the previous feverish symptoms, and the accession of hectic, and by the respiration being less painful, but more compressed.

When the gathering has come to maturity it sometimes bursts in the air vessels and occasions instant suffocation; in some cases the matter will be spit up, and a large quantity will occasionally be got rid of in this way. This spitting often continues long, and the patient falls into a state resembling pulmonary consumption. Sometimes the collection bursts into the cavity of the chest. At other times the complaint ends in dropsy of the chest; or sometimes lymph is thrown out, and adhesions take place.

Where recovery takes place, there is usually some considerable evacuation takes place, such as a great flow of urine with a copious sediment, diarrhoea, mild sweats diffused over the whole body, or bleeding from the nose; but the evacuation which most frequently terminates the complaint, and which is the most effectual, is a free and copious expectoration of a thick, white or yellow mucus; and by this the disease is carried off in about twelve or fourteen days, the pulse gradually becoming slower, and the feverish symptoms disappearing. Cases of Pneumonia terminating in health without a free expectoration are said to be very rare. A high degree of fever, attended with delirium, much difficulty of breathing, acute pain, a dry cough, or an expectoration of a dark colour, sudden cessation of pain or of the expectoration, followed by lividness of the lips and of the countenance, and sinking or irregularity of the pulse, denote great danger: on the contrary an abatement of the fever and of the difficulty of breathing and pain taking place on the occurrence of free expectoration, or any other copious evacuation are favorable symptoms, and may lead us to hope for the recovery of the patient.

Treatment

In the present day it is not generally considered necessary to take blood from the arm in attacks of Pneumonia; there are cases, however, when it is absolutely necessary to do so in order to save the life of the patient. When there is extreme difficulty of breathing, while the veins of the head and neck are swelled, and appear to be filled with dark blood, and the pulse at the same time is both feeble and frequent, it is evident that the right side of the heart is so distended with blood as to be unable to contract, and it is "necessary to bleed with the chance of saving the patient's life, with the certainty of prolonging it, and of giving immediate relief to his great suffering.

But in the majority of cases the application of leeches to the seat of pain will be sufficient; the number to be applied must depend upon the amount of inflammation, and the constitution of the patient. A grown person of moderately robust habit may require six or eight, or even a greater number, and they may be repeated next day if the inflammation is not subdued.

After the fever is somewhat lessened by the leeches,and the burning heat of the skin subdued, a large blister should be applied to the chest, and this may be repeated, from time to time, as soon as the previous one has perfectly healed, or smaller blisters may be applied to any spot where the skin is sound, so as to keep up what is called counter-irritation.

At the commencement of the attack the patient should take a purgative; the Cathartic Powder, No. 3, will answer as well as anything; his feet and legs should be put into hot water, as hot as he can bear; he should then go to bed; his feet and legs should be wrapped up in flannel, and bottles of hot water should be kept to his feet.

The following mixture may be taken in doses of a tablespoonful every two hours; and continued till the inflammatory symptoms subside, when it may be taken less frequently.

Antimonial Wine...............................One Ounce.

Tincture of Henbane..........................Three Drams.

Oxymel of Squills..............................One Ounce.

Syrup of Poppies..............................One Ounce.

Oatmeal Gruel, sufficient to make a Pint.

After the inflammation and fever have completely subsided, and nothing but a little cough remains behind, the following mixture may be taken several times a day, according to the state of the cough:

Ipecacuanha Wine......................Three Drams.

Tincture of Henbane....................Two Drams.

Oxymel of Squills........................One Ounce.

Syrup of Poppies.........................One Ounce.

Tincture of Tolu.........................Half an Ounce.

Water sufficient to make half a Pint.

A teaspoonful may be taken occasionally. These doses are intended for a grown person.

Dr. A. Patton recommends the use of Carbonate of Ammonia in Pneumonia. He says "it should be given from the very commencement, in doses of 5 to 10 grains every two hours. Out of 96 severe cases so treated only two died."

Mr. C. C. Balding recommends Arnica in Acute Pneumonia. He says it has a powerful controlling influence over the action of the heart and general circulation. Ten minims of the Tincture of the British Pharmacopoeia every three hours, will control the severity of the symptoms within 48 hours.

As long as inflammatory symptoms remain, the diet of the patient must be confined to gruel, milk, arrow root, corn starch or sago, which may be afterwards changed to beef tea, boiled chicken, and light puddings.

It must not be forgotten that a person who has been attacked with Inflammation of the Lungs is very liable to a relapse, if he exposes himself too soon to changes of heat or cold; he should therefore be very careful, and, if compelled to go out, should wrap himself up warmly and completely.

Pure Inflammation of the Lungs is not as common as it was once supposed to be; but Inflammation of the Lungs as a consequence of other diseases, as Bronchitis, Phthisis, disease of the Heart, and some fevers.