ers.

PULSE. Usually the pulse beats four times during one respiration, but
both in health and disease its frequency may be accelerated or retarded.
In adults, there are from sixty-five to seventy-five beats in a minute,
and yet in a few instances we have found, in health, only forty
pulsations per minute. But when the heart beats from one hundred and
twenty to one hundred and forty times a minute, there is reason to
apprehend danger, and the case should receive the careful attention of a
physician.

Irregularity of the pulse may be caused by disease of the brain, heart,
stomach, or liver; by the disordered condition of the nervous system; by
lack of muscular nutrition, as in gout, rheumatism, or convulsions; by
deficiency of the heart's effective power, when the pulse-wave does not
reach the wrist, or when it intermits and then becomes more rapid in
consequence of septic changes of the blood, as in diphtheria,
erysipelas, and eruptive fevers.

PAIN. The import of pain depends on its seat, intensity, nature, and
duration. An acute, intense pain usually indicates inflammation of a
nerve as well as the adjacent parts. Sharp, shooting, lancinating pains
occur in inflammation of the serous tissues, as in pleurisy. A smarting,
stinging pain attends inflammation of the mucous membrane. Acute pain is
generally remittent and not fixed to one spot. Dull, heavy pain is more
persistent, and is present in congestions, or when the substance of an
organ is inflamed, and it often precedes hemorrhage. Burning pain
characterizes violent inflammations involving the skin and subjacent
cellular tissue, as in case of boils and carbuncles. Deep, perforating
pain accompanies inflammation of the bones, or of their enveloping
membranes. Gnawing, biting, lancinating pain attends cancers.

The location of pain is not always at the seat of the disease. In
hip-disease, the pain is not first felt in the hip, but in the
knee-joint. In chronic inflammation of the liver, the pain is generally
most severe in the right shoulder and arm. Disease of the kidneys
occasionally produces numbness of the thigh and drawing up of the
testicle, and commonly causes colicky pains. Inflammation of the
meninges of the brain is often indicated by nausea and vomiting before
attention is directed to the head. These illustrations are sufficient to
show that pain often takes place in some part remote from the disease.

In chronic, abdominal affections, rheumatic fevers