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As stated above, the demonstrable pathology was in the lower lobe, and more frequently in the left than in the right, only occasionally in the middle lobe, and never, we might say, in the upper lobes. The very earliest definite signs were found at the apex of the left lower lobe.

This observation seems to be entirely contradictory to that of the pathologist, who found in 65 per cent. of all cases coming to autopsy a lesion in all the lobes of the lungs (Klotz). The only explanation we can give which seems at all satisfactory to us is that the pathology in the upper and middle lobes must not have been sufficient, or must have been of such a nature that it did not yield the physical signs, i. e., definite impaired percussion resonance, increased vocal fremitus and tubular breathing, with varying shades of moist râles—signs upon which we insisted before we were willing to state definitely that there is a demonstrable pneumonia present.

In this description it has been attempted to follow the order of invasion in a lung which seemed to go through the entire course of the disease. There were, necessarily, all degrees of the process, some cases showing few signs and yet being remarkably ill, and others all of the signs with very little other evidence of serious illness.