Sec. 84. If the _Vomica_, instead of breaking within the Substance of the Lungs affected, should break without it, the Pus must be received into the Cavity of the Breast. We know when that has happened, by the Sensation or Feeling of the Patient; who perceives an uncommon, a singular kind of Movement, pretty generally accompanied with a Fainting. The Oppression and Anguish cease at once; the Fever abates; the Cough however commonly continues, tho' with less Violence, and without any Expectoration. But this seeming Amendment is of a short Duration, since from the daily Augmentation of the Matter, and its becoming more acrid or sharp, the Lungs become oppressed, irritated and eroded. The Difficulty of Breathing, Heat, Thirst, Wakefulness, Distaste, and Deafness, return, with many other Symptoms unnecessary to be enumerated, and especially with frequent Sinkings and Weakness. The Patient should be confined to his _Regimen_, to retard the Increase of the Disease as much as possible; notwithstanding no other effectual Remedy remains, except that of opening the Breast between two of the Ribs, to discharge the Matter, and to stop the Disorder it occasions. This is called the Operation for the _Empyema_. I shall not describe it here, as it should not be undertaken but by Persons of Capacity and Experience, for whom this Treatise was not intended. I would only observe, it is less painful than terrifying; and that if it is delayed too long, it proves useless, and the Patient dies miserably. Sec. 85. We may daily see external Inflammations turn gangrenous, or mortify. The same Thing occurs in the Lungs, when the Fever is excessive, the Inflammation either in its own Nature, extremely violent, or raised to such a Height by hot Medicines. Intolerable Anguish, extreme Weakness, frequent Faintings, Coldness of the Extremities, a livid and foetid thin Humour brought up instead of concocted Spitting, and sometimes blackish Stripes on the Breast, sufficiently distinguish this miserable State. I have smelt in one Case of this Kind, where the Patient had been attacked with this Disease (after a forced March on Foot, having taken some Wine with Spices to force a Sweat) his Breath so horribly stinking, that his Wife had many Sinkings from attending him. When I saw him, I could discern neither Pulse nor Intellect, and ordered him nothing. He died an Hour afterwards, about the Beginning of the third Hour.