See also:

• PNEUMONIA (Gr. ?rveu AMP, lung)

PNEUMONIA (Gr. ?rveu AMP, See also:

• LUNG

lung)  , a See also:

• TERM

term used for inflammation of the See also:

• LUNG

lung substance . Formerly the disease was divided into three varieties: (I) Acute Croupous or lobar See also:

• PNEUMONIA (Gr. ?rveu AMP, lung)

pneumonia; (2) Catarrhal or Broncho-pneumonia; (3) Interstitial or Chronic pneumonia . i . Acute Croupous or Lobar Pneumonia (Pneumonic See also:

• FEVER (Lat. febris, connected with fervere, to burn)

Fever) is now classed as an acute infective disease of the lung, characterized by fever and toxaemia, See also:

• RUNNING

running a definite course and being the See also:

• DIRECT

direct result of a specific micro-organism or micro-organisms . The micrococcus lanceolatus (pneumococcus, or diplococcus pneumoniae) of See also:

• FRANKEL, ZECHARIAS (1801-1875)

Frankel and Weichselbaum is See also:

• PRESENT

present in a large number of cases in the bronchial secretions, in the affected lung and in the See also:

• BLOOD

blood . This organism is also present in many other infective processes which may complicate or terminate lobar pneumonia, such as pericarditis, endocarditis, See also:

• PERITONITIS

peritonitis and See also:

• EMPYEMA (from Gr. iv, within, and srvov, pus)

empyema . The bacillus pneumoniae of Friedlander is also present in a proportion of cases, but is probably not the cause of true lobar pneumonia . Various other organisms may be associated with these, but they are. to be regarded as in the nature of a secondary invasion . Lobar pneumonia may be considered as an acute endemic disease of temperate climates, though epidemic forms have been de-scribed . It has a distinct seasonal incidence, being most frequent in the See also:

• WINTER, JOHN STRANGE
• WINTER, PETER (c. 1755-1825)

winter and See also:

• SPRING (from " to spring," " to leap or jump up," " burst out," O. Eng., springau, a common Teut. word, cf. Ger. springer, possibly allied to Gr. QnrFpxecOac, to move rapidly)

spring . See also:

• OSIER (through Fr. from Late Lat. osaria, auxaria, a bundle of osier or willow twigs)

Osier strongly supports the view that it is an infectious disease, quoting the outbreaks reported by W . L .

Rodman of See also:

• FRANKFORT

Frankfort, See also:

• KENTUCKY

Kentucky, where in a See also:

• PRISON (derived through the Fr. from the Lat. prehensio, seizure)

prison of 735 inhabitants there were See also:

• RIB (from 0. Eng. ribb; the word appears' in many Teutonic languages, cf. Ger. Rippe, Swed. reb)

rib cases in one See also:

• YEAR

year; but direct contagion does not seem to be well proved, and it is undoubted that the pneumococcus is present in the See also:

• FAUCES (a Latin plural word for " throat "; the singular faux is rarely found)

fauces of See also:

• NUMBERS, BOOK OF
• NUMBERS, PARTITION OF

numbers of healthy persons and seems to require a lowered See also:

• POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power of resistance or other favouring See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition for the See also:

• PRODUCTION (Lat. productionem, from producere, to pro-duce)

production of an attack . Lobar Pneumonia begins by the setting up of an acute inflammatory See also:

• PROCESS

process in the alveoli . The changes which take See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place in the lung are chiefly three . (I) Congestion, or engorgement, the blood-vessels being distended and the lung . more voluminous and heavier than normal, and of dark red See also:

• COLOUR (Lat. color, connected with celare, to hide, the root meaning, therefore, being that of a covering)

colour . Its See also:

• AIR (from an Indo-European root meaning " breathe," " blow ")
• AIR, or ASBEN

air cells still contain air . (2) Red Hepatization, so called from its resemblance to See also:

• LIVER (O. Eng. lifer; cf. cognate forms, Dutch lever, Ger. Leber, Swed. lefver, &c.; the O. H. Ger. forms are libara, lipora, &c.; the Teut. word has been connected with Gr. i'prap and Lat. jecur)

liver See also:

• TISSUE (Fr. tissu, tissue, participle of tisser, Lat. texere, to weave)

tissue . In this See also:

• STAGE (Fr. 6/age; from Lat. stare, to stand)

stage there is poured into the air cells of the affected See also:

• PART

part an exudation consisting of amorphous See also:

• FIBRIN, or FIBRINE

fibrin together with See also:

• EPITHELIAL, ENDOTHELIAL

epithelial cells and red and See also:

• WHITE
• WHITE, ANDREW DICKSON (1832– )
• WHITE, GILBERT (1720–1793)
• WHITE, HENRY KIRKE (1785-1806)
• WHITE, HUGH LAWSON (1773-1840)
• WHITE, JOSEPH BLANCO (1775-1841)
• WHITE, RICHARD GRANT (1822-1885)
• WHITE, ROBERT (1645-1704)
• WHITE, SIR GEORGE STUART (1835– )
• WHITE, SIR THOMAS (1492-1567)
• WHITE, SIR WILLIAM ARTHUR (1824--1891)
• WHITE, SIR WILLIAM HENRY (1845– )
• WHITE, THOMAS (1628-1698)
• WHITE, THOMAS (c. 1550-1624)

white blood corpuscles, the whole forming a viscid See also:

• MASS (O.E. maesse; Fr. messe; Ger. Messe; Ital. messa; from eccl. Lat. missa)
• MASS, IN

mass which occupies not only the cells but also the finer bronchi, and which speedily coagulates, causing the lung to become firmly consolidated . In this condition the cells are entirely emptied of air, their blood-vessels are pressed upon by the exudation, and the lung substance, rendered brittle, sinks in See also:

• WATER

water . The See also:

• APPEARANCE (from Lat. apparere, to appear)

appearance of a See also:

• SECTION
• SECTION (Lat. sectio, cutting, secare, to cut)

section of the lung in this stage has been likened to that of red See also:

• GRANITE (adapted from the Ital. granite, grained; Lat. granum, grain)

granite . It is to the See also:

• CHARACTER (Gr. xapareri7p, from xap&crew, to scratch)

character of the exudation, consisting largely of coagulable fibrin, that the term croupous is due . (3) See also:

• GREY, CHARLES GREY, 2ND EARL (1764-1845)
• GREY, HENRY GREY, 3RD EARL (1802-1894)
• GREY, LADY JANE (1537-1554)
• GREY, SIR EDWARD
• GREY, SIR GEORGE (1812–1898)

Grey Hepatization . In this stage the lung still retains its liver-like consistence, but its colour is now grey, not unlike the appearance of grey granite .

This is due to the See also:

• CHANGE (derived through the Fr. from the Late Lat. cambium, cambiare, to barter; the ultimate derivation is probably from the root which appears in the Gr. «a urmu', to bend)

change taking place in the exudation, which undergoes See also:

• RESOLUTION

resolution by a process of fatty degeneration, pus formation, liquefaction and ultimately absorption—so that in a comparatively See also:

• SHORT, FRANCIS JOB (1857– )

short See also:

• PERIOD
• PERIOD (Gr. irepioSos, a going or way round, circuit, aepi, round, and &Sis, way, road)

period the air vesicles get rid of their morbid contents and resume their normal See also:

• FUNCTION

function . During resolution the changes in the exudate take place by a process of autolysis or peptonization of the inflammatory products by unorganized ferments, absorption taking place into the lymphatics and circulation . The absorbed exudate is mainly excreted by the kidneys, excess of See also:

• NITROGEN [symbol N., atomic weight 14.01, 0=16]

nitrogen being found in the urine during this period . This is happily the termination of the See also:

• MAJORITY (Fr. majorite; Med. Lat. majoritas; Lat. major, greater)

majority of cases of lobar pneumonia . One of the most remarkable phenomena is the rapidity with which the lung tissue clears up, and its freedom from alteration or from infiltration into the connective tissue as frequently takes place after broncho-pneumonia . When resolution does not take place, See also:

• DEATH

death may occur from See also:

• EXTENSION (Lat. ex, out ; tendere, to stretch)

extension of the disease and subsequent toxaemia, from circulatory failure, from the formation of one or more abscesses or more rarely from See also:

• GANGRENE (from Gr. y&yypawa, an eating sore, from ypaivewv, to gnaw)

gangrene of the lung or from the complication mentioned below . Chronic interstitial pneumonia is infrequent, following on the acute variety . The most frequent seat of pneumonia is the See also:

• BASE

base or See also:

• LOWER

lower lobes, but occasionally the apices are the only parts affected . The right lung is the most often attacked . Pneumonia may extend to the entire lung or it may affect both lungs . The death See also:

• RATE

rate of acute lobar pneumonia in the See also:

• CHIEF (from Fr. chef, head, Lat. caput)

chief See also:

• LONDON

London hospitals is 20% . With an organism so prevalent as the pneumococcus it follows that alcoholism, See also:

• DIABETES (from Gr. &a, through, and faivecv, to pass)

diabetes and other See also:

• GENERAL
• GENERAL (Lat. generalis, of or relating to a genus, kind or class)

general diseases and intoxications must render the See also:

• BODY

body liable to an attack .

See also:

• MALES

Males are more commonly attacked than See also:

• FEMALES

females, and a previous attack seems to give a See also:

• SPECIAL

special liability to another . The See also:

• INCUBATION

incubation period of pneumonia is unknown; it is probably very short . The symptoms are generally well marked from the beginning . The attack is usually ushered in by a rigor (or in See also:

• CHILDREN, LAW RELATING TO

children a convulsion), and the speedy development of the febrile condition, the temperature rising to a considerable degree ma° to 104° or more . The See also:

• PULSE

pulse is quickened, and there is a marked disturbance in the respiration, which is rapid, shallow and difficult, the rate being usually accelerated to some two or three times its normal amount . The lips are livid, and the See also:

• FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)

face has a dusky flush . See also:

• PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
• PAIN, BARRY (1867– )

Pain in the See also:

• SIDE
• SIDE (mod. Eski Adalia)

side is See also:

• FELT (cognate with Ger. Filz, Du. vilt, Swed. and Dan. fill; the root is unknown; the word has given Med. Lat. filtrum, " filter ")

felt, especially should any amount of See also:

• PLEURISY, or PLEURITIS (Gr. srXeiipc =ribs)

pleurisy be present, as is often the See also:

• CASE
• CASE, JOHN (d. 1600)

case . Cough is an See also:

• EARLY
• EARLY, JUBAL ANDERSON (1816-1894)

early symptom . It is at first frequent and hacking, and is accompanied with a little tough colourless expectoration, which soon, however, becomes more copious and of a rusty red colour, either tenacious or frothy and liquid . Microscopically this consists mainly of epithelium, casts of the air cells and tine bronchi, together with granular See also:

• MATTER

matter, blood and pus corpuscles and haematoidin crystals . The micro-organisms usually present are the pneumococcus, Friedlander's bacillus, and sometimes the See also:

• INFLUENZA (syn. " grip," la grippe)

influenza bacillus . The following are the chief See also:

• PHYSICAL

physical signs in the various stages of the disease .

In the stage of congestion See also:

• FINE

fine crackling or crepitation is heard over the affected See also:

• AREA

area; some-times there is very little change from the natural breathing . In the stage of red hepatization the affected side of the See also:

• CHEST (Gr. Kiarl, Lat. cista, O. Eng. cist, test, &c.)

chest is seen to expand lest freely than the opposite side; there is dullness on percussion, and increase of the vocal fremitus; while on See also:

• AUSCULTATION (from Lat. auscultare, to listen)

auscultation the breath sounds are tubular or bronchial in character, with, it may be, some amount of fine crepitation in certain parts . In the stage of grey hepatization the percussion See also:

• NOTE
• NOTE (Lat. nota, mark, sign, from noscere, to know)

note is still dull and the breathing tubular, but crepitations of coarser quality than before are also audible . These various physical signs disappear more or less rapidly during convalescence . With the progress of the inflammation the febrile symptoms and rapid breathing continue . The patient during the greater part of the disease lies on the back or on the affected side . The pulse, which at first was full, becomes small and soft owing to the interruption to the pulmonary circulation . Occasionally slight See also:

• JAUNDICE (Fr. jaunisse, from jaune, yellow), or IUTERUS (from its resemblance to the colour of the golden oriole, of which Pliny relates that if a jaundiced person looks upon it he recovers but the bird dies)

jaundice is present, due probably to a similar cause . The urine is scanty, sometimes albuminous, and its chlorides are diminished . In favourable cases, however severe, there generally occurs after six or eight days a distinct crisis, marked by a rapid fall of the temperature accompanied with See also:

• PERSPIRATION (Lat. per, through, and spirare, to breathe)

perspiration and with a copious See also:

• DISCHARGE (adapted from the O. Fr. discharge, modern decharge, from a med. Lat. discargare, to unload, dis- and earn care, to load, cf. " charge ")

discharge of lithates in the urine . Although no material change is as yet noticed in the physical signs, the patient breathes more easily, See also:

• SLEEP (0. Eng. slcepan; Ger. schlafen; cf. Lat. labi, to glide, and " slip ")

sleep returns, and convalescence advances rapidly in the majority of instances . In unfavourable cases death may take place either from the extent of the inflammatory See also:

• ACTION

action, especially if the pneumonia is See also:

• DOUBLE
• DOUBLE (from the Mid. Eng. duble, the form which gives the present pronunciation, through the Old Er. duble, from Lat. duplus, twice as much)

double, from excessive fever, from failure of the See also:

• HEART
• HEART, LUNG

heart's action or general strength at about the period of the crisis, or again from the disease assuming from the first a See also:

• LOW, SETH (1850- )
• LOW, WILL HICOK (1853- )

low adynamic See also:

• FORM (Lat. forma)

form with See also:

• DELIRIUM (a Latin medical term for madness, from delirare, to be mad, literally to wander from the lira, or furrow)

delirium and with scanty expectoration of greenish or " See also:

• PRUNE (adapted in various forms, e.g. prunne, proyne, &c., from Fr. prune, Med. Lat. pruna, Lat. prunum, Gr. irpovvov, earlier Trpouµvov, plum)

prune juice " appearance .

Such cases are seen in persons worn out in strength, in the aged, and especially in the intemperate . The complications of acute pneumonia are pleurisy, which is practically inevitably present, empyema (in which the pneumococcus is frequently present and occasionally the streptococcus), pericarditis and endocarditis, both due to septic poisoning, while perhaps the most serious complication is See also:

• MENINGITIS (from Gr. z veyE, a membrane)

meningitis, which is responsible for a large percentage of the fatal cases . The pneumococcus has been found in the exudate . Secondary pneumonias chiefly follow the specific fevers, as See also:

• DIPHTHERIA (from 8c4BEpa, a skin or membrane)

diphtheria, enteric fever, See also:

• MEASLES, (Morbilli, Rubeola; the M. E. word is maseles, properly a diminutive of a word meaning " spot," O.H.G. m¢sa, cf. " mazer "; the equivalent is Ger. Masern; Fr. Rougeole)

measles and influenza, and are the result of a direct poisoning . Bacteriologically a number of different organisms have been found, together with the specific microbe of the See also:

• PRIMARY

primary disease; the striking features of primary lobar pneumonia are often masked in these types . The treatment of acute pneumonia has of See also:

• LATE

late undergone a marked change, and may be divided into 3 heads: (r) General hygienic treatment; (2) the treatment of special symptoms; (3) treatment by vaccines and sera . The same treatment of See also:

• ABSOLUTE (Lat. absolvere, to loose, set free)

absolute See also:

• REST (O. Eng. rest, reste, bed, cognate with other Teutonic forms, e.g. Ger. Rast, Riiste, rest, and probably Gothic Rasta, league, i.e. resting or stopping place)

rest should be carried out as in enteric fever; this absolute rest is necessary to limit the auto-inoculation by the absorption of toxins . Fresh air in abundance and even open-air treatment if possible has been attended with See also:

• GOOD, JOHN MASON (1764-1827)

good results . See also:

• ICE (a word common to Teutonic languages; cf. Ger. Eis)

Ice poultices over the affected part are useful in the See also:

• RELIEF

relief of pain, while tepid sponging and tepid or even See also:

• COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude

cold See also:

• BATHS

baths may be freely given, and the patient's strength supported by See also:

• MILK (0. Eng. meoluc; from a common Indo-European root, cf. Lat. mulgere, Gr. ?t dXyetv)

milk, soups and other See also:

• LIGHT

light forms of nourishment . Stimulants may be called for, and See also:

• STRYCHNINE

strychnine and digitalin are the most valuable; disinfection of the sputum should be systematically carried out . Many trials have been made with antipneumococcic serum, but it has not been shown to ha"•e a very marked effect in cutting short the disease . The polyvalent serum of Romer l;as given the best results .

Much more favour-able results have been obtained from the use of a vaccine . The results of vaccine treatment obtained by Boellke in 30 cases of severe pneumonia and one case of pneumococcic endocarditis are encouraging . The vaccine, to produce the best effects, should be made from the patient's own pneumococcus, as it is evident there are different strains of pneumococci, the doses (5 to 50 million dead pneumococci) being regulated by the guidance of the opsonic See also:

• INDEX

index . The objection to the preparation of the vaccine from the patient's own organisms is the See also:

• TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
• TIME, MEASUREMENT OF
• TIME, STANDARD

time (several days) which is required, valuable time being thereby lost; but the results are much more certain than with the use of a " stock" vaccine . 2 . Broncho-Pneumonia (Catarrhal or Lobular-Pneumonia or Capillary See also:

• BRONCHITIS

Bronchitis) . An acute form of lobular pneumonia has been described, having all the characters of acute lobar pneumonia except that the pneumonic patches are disseminated . The term " broncho-pneumonia" is however here used to denote a widespread catarrhal inflammation of the smaller bronchi which spreads in places to the alveoli and produces consolidation . All forms of broncho-pneumonia depend on the invasion of the lung by micro-organisms._ No one organismhas however been constantly found which can be said to be specific, as in lobar pneumonia; the influenza bacillus, micro-coccus catarrhalis, pneumococcus, Friedlander's bacillus and various staphylococci having been found . See also:

• JOHN
• JOHN (1167–1216)
• JOHN (1290-c. 1320)
• JOHN (1296-1346)
• JOHN (1371–1419)
• JOHN (1468-1532)
• JOHN (1801-1873)
• JOHN (Heb. llni')
• JOHN (ZAPOLYA) (1487-1540)
• JOHN, 4TH MARQUESS OF TWEEDDALE (c. 1695-1762)
• JOHN, DON (1545-1578)
• JOHN, DON (1629–1679)
• JOHN, GOSPEL OF ST
• JOHN, or HAYS (1513–1571)
• JOHN, THE APOSTLE
• JOHN, THE EPISTLES OF

John See also:

• EYRE, EDWARD JOHN (1815-1901)
• EYRE, SIR JAMES (1734-1799)

Eyre, in Allbutt's See also:

• SYSTEM

System of See also:

• MEDICINE

Medicine, gives 62% of mixed infection in the cases investigated by him . Broncho-pneumonia may occur as an acute primary See also:

• AFFECTION (Lat. ad, and facere, to do something to, sc. a person)

affection in children, but is more usually secondary . It may be a sequence of infectious fevers, measles, diphtheria, whooping cough, See also:

• SCARLET

scarlet fever and sometimes typhoid fever .

In these it forms a frequent and often a fatal complication . The large majority of the fatal cases are those of early childhood . In adults it may follow influenza or complicate chronic See also:

• BRIGHT, JOHN (1811-188g)
• BRIGHT, SIR CHARLES TILSTON

Bright's disease or various other disorders . Broncho-pneumonia also may follow operations on the mouth or trachea, or the inhalation of See also:

• FOREIGN

foreign bodies into the trachea . It is a frequent complication of pulmonary See also:

• TUBERCULOSIS

tuberculosis . The following changes take place in the lung: at first the affected patches are dense, non-crepitant, with a bluish red appearance tending to become grey or yellow . Under the See also:

• MICROSCOPE (Gr. µucp6s, small, asenreiv, to %view)

microscope the air vesicles and finer bronchi are crowded with cells, the result of the inflammatory process, but there is no fibrinous exudation such as is present in croupous pneumonia . In favourable cases resolution takes place by fatty degeneration, liquefaction, and absorption of the cells, but on the other See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

hand they may undergo caseous degenerative changes, abscesses may form, or a condition of chronic interstitial pneumonia be See also:

• DEVELOPED

developed, in both of which cases the condition passes into one of pulmonary tuberculosis . See also:

• EVIDENCE (Lat. evidentia, evideri, to appear clearly)

Evidence of previous bronchitis is usually present in the lungs affected with catarrhal pneumonia . In the See also:

• GREAT

great majority of instances catarrhal pneumonia occurs as an See also:

• ACCOMPANIMENT (i.e. that which " accompanies ")

accompaniment or sequel of bronchitis, either from the inflammation passing from the finer bronchi to the pulmonary air vesicles, or from its affecting portions of lung which have undergone collapse . The symptoms characterizing the onset of catarrhal pneumonia in its more acute form are the occurrence during an attack of bronchitis or the convalescence from measles or whooping cough, of a sudden and marked See also:

• ELEVATION

elevation of temperature, together with a quickened pulse and increased difficulty in breathing . The cough becomes short and painful, and there is little or no expectoration .

The physical signs are not distinct, being mixed up with those of the antecedent bronchitis; but, should the pneumonia be extensive. there may be an impaired percussion note with tubular breathing and some bronchophony . Dyspnoea may be present in a marked degree; and death frequently occurs from See also:

• PARALYSIS, or PALSY (from Gr. aapal,6a , to relax; Wycliffe has palesy, and another old form of the word is parlesy)

paralysis of the heart . Broncho-pneumonia is a serious disease, the death-rate in children under five has been estimated at 30 to So % . The treatment of broncho-pneumonia is mainly symptomatic . At the outset a mild purgative is given, and should the secretion accumulate in the bronchial tubes an emetic is useful . Inhalations are useful to relieve the cough, and circulatory stimulants such as strychnine are valuable, together with See also:

• BELLADONNA (from the Ital. belle donna, " beautiful lady," the berries having been used as a cosmetic)

belladonna and See also:

• OXYGEN (symbol 0, atomic weight 16)

oxygen . When orthopnoea and lividity are present, with distension of the right heart, venesection is necessary . The treatment of broncho-pneumonia by serum and vaccines is not so successful as in lobar pneumonia, owing to the difficulty of ascertaining the precise bacterial infection . The great danger of broncho-pneumonia is. the subsequent development of pulmonary tuberculosis . 3 . Chronic Interstitial Pneumonia (Cirrhosis of the Lung) is a fibroid change in the lung, chiefly affecting the fibrous stroma and may be either See also:

• LOCAL

local or diffuse . The changes produced in the lung by this disease are marked chiefly by the growth of nucleated fibroid tissue around the walls of the bronchi and vessels, and in the intervesicular septa, which proceeds to such an extent as to invade and obliterate the air cells .

The lung, which is at first enlarged, becomes shrunken, dense in texture and solid, any unaffected portions being emphysematous; the bronchi are dilated, the pleura thickened, and the lung substance often deeply pigmented, especially in the case of miners, who are See also:

• APT

apt to suffer from this disease . The other lung is always greatly enlarged and distended from See also:

• EMPHYSEMA (Gr. Eµ / vuav to inflate)

emphysema; the heart becomes hypertrophied, particularly the right ventricle; and there may be marked atheromatous changes in the blood vessels . Later the lung becomes converted into a See also:

• SERIES (a Latin word from serere, to join)

series of bronchiectatic cavities . This condition is usually present to a greater or less degree in almost all chronic diseases of the lungs and bronchi, but it is specially apt to arise in an extensive form from pre-existing catarrhal pneumonia, and not unfrequently occurs in connexion with occupations which necessitate the habitual inhalation of particles of dust, such as those of colliers, See also:

• FLAX

flax-dressers, stonemasons, millers, &c., to which the term pneumonokoniosis is now applied (including anthracosis, siderosis, chalicosis and the so-called " grinder's rot" ) . The symptoms are very similar to those of chronic See also:

• PHTHISIS (Gr. 49Lnns " wasting ")

phthisis (see TUBERCULOSIS), especially increasing difficulty of breathing, particularly on exertion, cough either dry or with expectoration, some-times copious and fetid . In the case of See also:

• COAL

coal-miners the sputum is See also:

• BLACK
• BLACK, ADAM (1784-1874)
• BLACK, JEREMIAH SULLIVAN (1810–1883)
• BLACK, WILLIAM (1841-1898)

black from containing carbonaceous matter . The physical signs are deficient expansion of the affected side—the disease being mostly confined to one lung—increasing dullness on percussion, tubular breathing and moist sounds . As the disease progresses retraction of the side becomes See also:

• MANIFEST (Lat. manifestus, clear, open to view)

manifest, and the heart and liver may be displaced . Ultimately the condition, both as regards physical signs and symptoms, takes the characters of the later stages of pulmonary phthisis with colliquative symptoms, in-creasing emaciation and death . Occasionally See also:

• DROPSY (contracted from the old word hydropisy, derived from the Gr. 154w¢; i Swp, water, and appearance)

dropsy is present from the heart becoming affected in the course of the disease . The malady is usually of See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

long duration, many cases remaining for years in a stationary condition and even undergoing temporary improvement in mild See also:

• WEATHER (O. Eng. weder; the word is common to Teutonic languages; cf. Du. weder, Dan. veir, Icel. ve8r, and Ger. Wetter and Gewitter, storm; the root is wa- to blow, from which is derived " wind ")

weather, but the tendency is on the whole downward . See Allbutt and Rolleston, System of Medicine (1909) ; R .

W . See also:

• ALLEN, BOG OF
• ALLEN, ETHAN (1739–1789)
• ALLEN, GRANT CHARLES GRANT BLAIRFINDIEI, (1848–1899)
• ALLEN, JAMES LANE (1850– )
• ALLEN, JOHN (1476–1534)
• ALLEN, or ALLEYN, THOMAS (1542-1632)
• ALLEN, WILLIAM (1532-1594)
• ALLEN, WILLIAM FRANCIS (183o-1889)

Allen, Vaccine Therapy and the Opsonic Method of Treatment (1908); Oster, Practice of Medicine (1909) ; The Practitioner (May 19o8); Clinical See also:

• JOURNAL
• JOURNAL (through Fr. from late Lat. diurnalis, daily)

Journal (See also:

• JAN

Jan . 1908) ; See also:

• AMERICAN

American Journal of the Medical Sciences (Jan . 19o8); W . C . Bosanquet and J . Eyre, Serums, Vaccines and Toxines (1909) . PNOM-PENH, a See also:

• TOWN

town of See also:

• FRENCH
• FRENCH, DANIEL CHESTER (1850– )
• FRENCH, NICHOLAS (1604-1678)

French Indo-See also:

• CHINA

China, See also:

• CAPITAL (i.e. capital stock or fund)
• CAPITAL (Lat. caput, head)

capital, since 1866, of the See also:

• PROTECTORATE

protectorate of See also:

• CAMBODIA

Cambodia and seat of the See also:

• RESIDENT

resident-and 1893 the See also:

• ANNUAL

annual increase was at the See also:

• AVERAGE

average rate of 173 to 175 acres, and the See also:

• TOTAL

total See also:

• ACCRETION (from Lat. ad, to, and crescere, to grow)

accretion at about 20 sq. m . ; and the total area of inundated See also:

• LAND

land See also:

• NORTH
• NORTH, BARONS
• NORTH, MARIANNE (1830—1890)
• NORTH, ROGER (1653-1734)
• NORTH, SIR THOMAS (1535?-16o1?)

north and See also:

• SOUTH
• SOUTH, ROBERT (1634–1716)

south of the See also:

• DELTA (from the shape of the Gr. letter A, delta, originally used of the mouth of the Nile)

delta at nearly 6o sq. m.' He further estimated that the Po della Maestra advances 282 ft. annually, the Po delle Tolle 262 ft., the Po delta Gnocca 1112 ft., and the Po di See also:

• CORO

Coro 259 ft . The low ground between the lower Po and the lower See also:

• ADIGE (Ger. Etsch, anc. Athesis)

Adige and the See also:

• SEA (in O. Eng. sae, a common Teutonic word; cf. Ger. See, Dutch Zee, &c.; the ultimate source is uncertain)
• SEA, COMMAND OF THE

sea is known as Polesine, a name the derivation of which is much discussed . It is generally applied only to the See also:

• PROVINCE
• PROVINCE (Lat. provincia; perhaps a contraction of providentia)

province of See also:

• ROVIGO

Rovigo, but is sometimes extended to the neighbourhood of See also:

• ADRIA (anc. Atria; the form Adria or Hadria is less correct: Hatria was a town in Picenum, the modern Atri)

Adria and See also:

• FERRARA

Ferrara . All along its course from See also:

• CHIVASSO

Chivasso (below See also:

• TURIN

Turin) down to the delta the See also:

• RIVER

river is connected with several of its tributaries by canals, and at the same time other canals connect the tributaries and carry off their See also:

• WATERS, TERRITORIAL

waters and the waters of the Po purely for purposes of See also:

• IRRIGATION (Lat. in, and rigare, to water or wet)

irrigation .

The researches of Helbig (See also:

• DIE
• DIE (Fr. de, from Lat. datum, given)

Die Italiker in der Po-Ebene, See also:

• LEIPZIG

Leipzig, 1879) show that the lower valley of the Po was at an early period occupied by See also:

• PEOPLE

people of the See also:

• PALAEOLITHIC (Gr. iraXates, old, and )tWBor, stone)

Palaeolithic and See also:

• NEOLITHIC, or LATER STONE AGE (Gr. vEOr, new, and XLOos, stone)

Neolithic stages of See also:

• CIVILIZATION

civilization, who built houses on piles along the swampy See also:

• BORDERS, THE

borders of the streams . It is possible that even they may have begun by crude dikes the great system by which the waters are now See also:

• CON

con-trolled; at least it is certain that these See also:

• WORKS

works date their origin from pre-See also:

• ROMAN

Roman antiquity . See also:

• PLINY, THE ELDER
• PLINY, THE YOUNGER

Pliny refers them to the Etruscans . The reclaiming and protecting of the riparian lands went on rapidly under the See also:

• ROMANS
• ROMANS, EPISTLE TO THE

Romans, and in several places the rectangular divisions of the ground, still remarkably distinct, show the military character of some of the agricultural colonies . During the time of the See also:

• BARBARIAN (Gr. fap/3apos)

barbarian invasions much of the protective system was allowed to fall into decay ; but the latter part of the See also:

• MIDDLE

middle ages saw the works resumed with great See also:

• ENERGY (from the Gr. ivipyela; iv, in, ipyov, work)

energy, so that the See also:

• MAIN (from the Aryan root which appears in " may " and " might," and Lat. magnus, great)
• MAIN (Lat. Moenus)

main features of the present arrangement were in existence by the See also:

• CLOSE
• CLOSE (from Lat. clausum, shut)
• CLOSE, MAXWELL HENRY (1822-1903)

close of the 15th See also:

• CENTURY (from Lat. centuria, a division of a hundred men)

century . The earlier Roman writers speak of the region between the See also:

• NORTHERN

northern boundaries of See also:

• ETRURIA

Etruria and See also:

• UMBRIA
• UMBRIA ('Opj3pucrl)

Umbria and the See also:

• ALPS

Alps as Gallia Cisalpina . It was See also:

• SEPARATE

separate from See also:

• ITALY
• ITALY (Italia)

Italy proper, the Aesis first and then the See also:

• RUBICON

Rubicon being the boundary on the See also:

• EAST
• EAST, ALFRED (1849- )

east, and the Arnus the boundary on the See also:

• WEST
• WEST, BENJAMIN (1738-1820)
• WEST, NICHOLAS (1461-1533)

west, so that, for example, Luca remained outside the boundaries of Italy proper, even in 89 B.C . Romanization had, however, progressed considerably, the See also:

• FOUNDATION (Lat. fundatio, from fundare, to found)

foundation of colonies and the construction of roads had gone on during the 2nd century, and the whole See also:

• DISTRICT

district as far as the Padus was given the Roman See also:

• FRANCHISE (from 0. Fr. franchise, freedom, franc, free)

franchise in 89 B.C., while the Transpadanes received Latin rights, and were fully enfranchised See also:

• FORTY

forty years later . Cis-alpine See also:

• GAUL
• GAUL, GILBERT WILLIAM (1855— )

Gaul was apparently formed into a province by See also:

• SULLA, LUCIUS CORNELIUS (138–78 B.C.)

Sulla in 81 B.C. and continued to be so until the fall of the See also:

• REPUBLIC (Lat. respublica, a commonweal or common-wealth)

Republic . The Ligurian name of the Po was Bodincus or Bodencus, i.e. the bottomless . The name Padus was taken from the Celts or the See also:

• VENETI

Veneti . Thus we find Bodincomagus as a town name (See also:

• INDUSTRIA (mod. Monteu da Po)

Industria) on the upper course, and HaSoa (See also:

• PADUA (Lat. Patavium ; Ital. Padova)

Padua, Cattail .

95, 7) as a name of one of the mouths of the river . The name 'Hp1Savbs (See also:

• ERIDANUS

Eridanus) of See also:

• GREEK
• GREEK, ETRUSCAN AND

Greek See also:

• POETRY

poetry was: identified with it at a comparatively late period .