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Exception may be taken to this on the ground that the accompanying fever is and modified by the constitutional state, and that an extension of the disease may be unmarked by a notable aggravation of the febrile disturb ance, as the system has become unable to sustain a corresponding symptomatic action. The more exact bacteriological methods comparatively -mall number of infi whi:h bs I a ted and cultival and those methods hitherto have "for" been applied to this question only imperfectly. Chronic alfections are also usually benefitted and the climate, especially during the winter and spring, is particularly adapted for the af earlier stages of consumption and for bronchial and throat alfections. On laying my right hand over the prominence and my left over a corresponding point on the dorsal aspect of the thorax and making firm pressure I elicit a distinct sense of pulsation or throbbing which is walmart expansile in character.

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