2311 A41 1861

ΤΟ

THE CHAIRMAN, THE VICE-CHAIRMAN, AND THE OTHER MEMBERS

OF THE COMMITTEE OF MANAGEMENT

OF THE

HOSPITAL FOR CONSUMPTION AND

DISEASES OF THE CHEST,

BROMPTON,

This Work is respectfully Dedicated

BY

THE AUTHOR.

PREFACE.

THE chief object of the Author in the following work has been to give a detailed account of the leading physical signs of the chest, &c. in pulmonary consumption. It has appeared to him that it would be to add to the means of the diagnosis of this important disease to describe them at greater length than has yet been done. Some of the signs have been treated more largely than before; some have been described, it is believed, for the first time: as a whole, they have been comprehensively dealt with: their mechanism has been regarded, and the phenomena of physical science have been freely adduced to serve in their illustration.

The most important signs, in a practical point of view, have been particularly regarded; but no ascertained sign of pulmonary consumption has been altogether omitted, for the Author, he believes justly, has felt that the movements, and the form, and the sounds of the human chest in disease, illustrating and depending upon physical laws, not less than the movements, the form, and sounds of other things in nature, must be full of interest to the physician, -the enlightened physician of these days, -even when leading to no immediate and obvious practical advantage.

A minor, though an important object, has been to give some practical directions for the examination of the sufferer from pulmonary consumption, and to offer a full account of the instruments employed in exploration, and of the principles of their construction, and of their mode of operation. In furtherance of this object, various papers written by the Author, and published within the last few years, have been added to the work.

The Author's position of Physician to the Hospital for Consumption has afforded him the most ample means of observing the signs he has described. These, both in a practical and a scientific point of view, have had an absorbing interest for him; and this, perchance, may have on some occasions led him to be prolix. The concentration of thought which they favour, and the opportunities which they afford for investigation, are believed by many to be among the most important advantages of special hospitals,-centres for relief and study, which have happily been accorded a secure place amongst the most valued institutions of modern times, and of this progressive and labour-dividing age.

Much of the materials upon which the following descriptions are based, much of the means for testing instruments, and of general observation, have been found in the hospital to which he has the honour to belong.

His colleagues have greatly aided the Author. The observation of their practice, and the instruction which has casually fallen from them, have been a guide to him. He would thus gratefully acknowledge their aid; but at the same time, he by no means desires to shelter himself from criticism for his opinions, for which he holds himself alone responsible.