Prognosis in particular diseases involves the consideration not only of those signs of the general vital condition to which we have just been giving attention, but also of such as are more or less peculiar to each disorder. To a certain extent these signs may be grouped. We may refer to good and bad signs in pulmonary, cardiac, intestinal, renal, cerebral, and febrile affections respectively. Still, there will be for each malady, if it really has a distinctive character, some tokens which experience shows to be specially indicative of favorable or unfavorable progress and results. Let us notice some of these as examples. In pneumonia the best signs are the lowering of a high temperature, reduction of the number of respirations to 20 or 25 in the minute, expectoration of sputa less and less tinged with red or brown, and gradual reduction of the region of dulness on percussion. Worst, in the same disease, are an axillary temperature over 106°, respirations 40 or more per minute, with delirium, and expectoration becoming more abundant, grayish, and purulent; also with continued dulness on percussion and abundant mucous râles on auscultation. In croup the best sign is, after a hoarse, dry, barking cough and dyspnoea, a soft, liquid râle, heard in the larynx and trachea during respiration or coughing. Worst, in croup, is a steadily or paroxysmally increasing difficulty of breathing, with a dry hissing or whistling sound of respiration and cough succeeding the barking sounds of the earlier stage. In phthisis pulmonalis among the best signs are the patient's increasing in weight, coughing and expectorating less, ceasing to have hectic and night sweats. These may give renewed hope, even before much change is discernible in the physical signs. Of bad omen are intense hectic fever, incessant cough with abundant nummular sputa, copious perspirations, diarrhoea, breathing growing shorter and shorter, and extreme emaciation and debility. In all organic affections of the heart an extremely rapid and irregular pulse, with orthopnoea and increasing anasarca, and especially the Cheyne-Stokes respiration (described under DIAGNOSIS), must cause unfavorable expectations. In obstruction of the bowels the best of all symptoms is, usually, of course, a copious fecal evacuation. Yet a few cases have occurred in which a very large evacuation, delayed by obstruction for a week or two, has been almost immediately followed by collapse and death. The worst signs in cases of obstruction are (besides long-unyielding constipation) {171} stercoraceous vomiting, a small, rapid pulse, and increasing coldness and clamminess of the surface of the body.