PLEURISY. 283 



These are sufficient guides in the early stage of the disease, when it is most 

 of all of importance to distinguish the one from the other. 



If after a few days the breathing becomes a little more natural, the inspira- 

 tion lengthened and regular, and the expiration, although still prolonged, is 

 suffered to be completed if the twitchings are less evident and less frequent 

 if the cough can be fully expressed if the pulse softens, although it may not 

 diminish in frequency, and if the animal begins to lie down, or walks about of 

 his own accord, there is hope of recovery. But if the pulse quickens, and, 

 although smaller, yet possesses the wiry character of inflammation if the 

 gaze at the flanks, previously by starts, becomes fixed as well as anxious, 

 and the difficulty of breathing continues (the difficulty of accomplishing it, 

 although the efforts are oftener repeated) if patches of sweat break out, and 

 the animal gets restless paws shifts his posture every minute is unable longer 

 to stand yet hesitates whether he shall lie down determines on it again and again, 

 but fears, and at length drops, rather than lies gently down, a fatal termination 

 is at hand. For some time before his death, the effusion and its extent will be 

 evident enough. He not only walks unwillingly, but on the slightest exercise 

 his pulse is strangely accelerated ; the feeling of suffocation comes over him, and 

 he stops all of a sudden, and looks wildly about and trembles ; but he quickly 

 recovers himself and proceeds. There is also, when the effusion is confirmed, 

 oedema of some external part, and that occasionally to a very great extent. 

 This is oftenest observed in the abdomen, the chest, and the point of the breast. 



The immediate cause of death is effusion in the chest, compressing the lungs 

 on every side, rendering expiration difficult and at length impossible, and 

 destroying the .animal by suffocation. The very commencement of effusion 

 may be detected by auscultation. There will be the cessation of the respira- 

 tory murmur at the sternum, and the increased gratingnot the crepitating, 

 crackling noise as when congestion is going on not the feebler murmur as 

 congestion advances; but the absence of it, beginning from the bottom of the chest. 



It is painfully interesting to watch the progress of the effusion how the 

 stillness creeps up, and the murmur gets louder above, and the grating sound 

 louder too, until at length there is no longer room for the lungs to play, and 

 suffocation ensues. 



The fluid contained in the chest varies in quantity as well as appearance and 

 consistence. Many gallons have been found in the two sacs, pale, or yellow, or 

 bloody, or often differing in the two sides of the thorax ; occasionally a thick 

 adventitious coat covering the costal or the pulmonary pleura rarely much 

 adhesion, but the lungs purple-coloured., flaccid, compressed, not one-fourth 

 of their usual size, immersed in the fluid, and rendered incapable of expanding 

 by its pressure. 



Here, as in pneumonia, the bleeding should be prompt and copious. 

 Next, and of great importance, aperient medicine should be administered 

 that, the effect of which is so desirable, but which we do not dare to 

 give when the mucous membrane of the respiratory passages is the seat of 

 disease. Here we have to do with a serous membrane, and there is less sym- 

 pathy with the mucous membranes of either cavity. Small doses of aloes 

 should be given with the usual fever medicine, and repeated morning and night 

 until the dung becomes pultaceous, when it will always be prudent to stop. 

 The sedative medicine is that which has been recommended in pneumonia, and 

 in the same doses. Next should follow a blister on the chests and sides. It ia 

 far preferable to setons, for it can be brought almost into contact with the 

 inflamed surface, and extended over the whole of that surface. An airy, but 

 a comfortable box, is likewise even more necessary than in pneumonia, and the 

 practice of exposure, uncovered, to the cold even more absurd and destructive. 



