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LONDON :
PRINTÉd FOR LONGMAN, ORME, BROWN, GREEN, & LONG MANS,

- PATERNOSTER-ROW.

1838.

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GENTLEMEN,+A course of lectures devoted specially to the consideration of the viscera of the chest in their healthy and diseased state, may be open to the objection, that any partial study of a set of organs and their diseases tends to engross the mind with a disproportionate attention to these organs, to the neglect of general disorder of the system, and of affections of other important viscera. In answer to this objection, we might urge the great prevalence and fatality of thoracic diseases in this country; constituting nearly one half of the fatal cases, and perhaps quite one half of the slighter disorders; and wenight strengthen

513,-xxi.

this argument by the fact, that many other diseases, both local and general, owe their serious or fatal character to secondary thoracic lesions. In fact, such is the immediate relation between the thoracic organs and life, that when diseases of other parts prove fatal, it is by arresting the functions of those organs, and when the process of this arrest is slow, morbid conditions are often produced in the lungs and heart, resembling those of their primary diseases, which speedily accelerate the fatal event by their superadded influence. It is thus found that in many of those who die of lesions of the brain, abdominal viscera, &c., especially those of a chronic character, the lungs are congested, and even hepatized, and effusions of serum and of lymph are found in the thoracic cavities.

But the great prevalence and fatality of thoracic diseases are not sufficient reasons for making the lungs and heart exclusive objects of study; the condition of extrathoracic organs in these as well as in other disorders requires notice; and it will be a leading aim of the following lectures to direct attention continually to the general states of the system, as well as to the local disorder, and to show how important it is for the practitioner to instruct and guide himself by all the symptoms, general and local, vital and physical, in combination. I would, therefore, rather give another character of thoracic diseases, as a sufficient reason for treating of them separately. They are, in the present state of our knowledge, more than any other internal diseases, susceptible of clear and conclusive illustration; and this for two reasons:– First, because the structure and functions of the organs within the chest are, for the most part, simple and intelligible; secondly, because these organs, in the performance of their functions, have certain mechanical and physical relations, which may bring their conditions, healthy and morbid, under the more or less immediate cognizance of our external senses; so that

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