Give the freedom of a well person to the tuberculous who is instructed and conscientious in the observance of necessary precautions.  Be very much afraid of the tuberculous person who is ignorant or careless in the observance of necessary precautions.

[218 Mothers’ remedies]

Pneumonia (Lobar) Lung Fever.—­Inflammation of the lungs.  This is an acute infectious disease characterized by an exudative inflammation of one or more lobes of the lungs, with constitutional symptoms due to the absorption of toxins (poison), the fever terminating by crisis (suddenly).  In speaking of pneumonia you frequently hear the expression “the lungs are filling up.”  This is the real condition.  The structures surrounding the air cells are inflamed and from the inflamed tissues a secretion exudate is poured out into the cells.  This is expectorated, thrown out, by coughing; but it is poured out into the cells faster than it can be spit up and consequently it remains in some of the cells and fills them up.

The air does not get into such cells and they fill, with many others, and make that section solid.  When the patient is improving he keeps on spitting this up, until all is out and the air cells resume their normal work.  Sometimes they remain so and we have chronic pneumonia.

Causes of Pneumonia.—­Pneumonia occurs frequently as a complication of other diseases, such as typhoid fever and measles.  Yet the majority of cases occur spontaneously.  Many times the disease seems to be induced by exposure to the cold, and there can be no doubt that such exposure does at least promote the development of this affection.  It seems, however, probable that there is some special cause behind it without which the exposure to cold is not sufficient to induce this disease.  Pneumonia may occur at any period of life, and is more common among males than females.  It occurs over the entire United States, oftener in the southern and middle, than in the Northern States; it is more frequently met with during the winter and spring months than at other times in the year.

Symptoms.—­The onset is usually abrupt with a severe chill and chills lasting from fifteen minutes to an hour, with the temperature suddenly rising and an active fever.  There is usually intense pain in a few hours, generally in the lower part of the front of the chest, made worse by breathing and coughing.  The patient lies on the affected side so as to give all chance for the other lung to work, cheeks are flushed, with anxious expression; the wings of the nostrils move in and out with each breath.  The cough is short, dry and painful.  Rapid, shallow, jerky breathing, increasing to difficult breathing.  On the first day the characteristic expectoration mixed with blood appears (called rusty).  Pulse runs from 100 to 116, full bounding, but may be feeble and small in serious cases.  After three or four days the pain disappears, the temperature keeps to