220 PLEURISY. 



of tl. ng that had been long compressed by the fluid, can conceive of the extern 

 which trfts is carried. It should be added a fact important and alarming that tb. 

 records of vjterinary surgery contain very few cases of permanently successful per 

 formance of the operation. This should not discourage the practitioner from attempt 

 ing it, but should induce him to consider whether he may not perform it under happiei 

 auspices, before the lungs and the serous membrane which lines the cavity have been 

 too much disorganised, and the constitution itself sadly debilitated. There could not 

 be any well-founded objection to an earlier resort to paracentesis, and he must be a 

 bungler indeed who wounded any important part. 



It should be ascertained by auscultation whether there is fluid in both cavities. If 

 there should be, and in considerable quantity, it will not be prudent to operate on 

 both sides at once. If much fluid is discharged, there will be acceleration and diffi- 

 culty of respiration to a very great degree. The practitioner must not be alarmed at 

 this ; it will pass over, and on the next day he may attack the other side ; or open 

 both at once, if there is but little fluid in either. 



Having resorted to this operation, a course of diuretics with tonics should be 

 'mmediately commenced, and the absorbents roused to action before the cavity fills 

 again. 



There is in pleurisy a far greater tendency to relapse than in pneumonia. The 

 flings do not perfectly recover from their state of collapse, nor the serous membrane 

 from its long maceration in the effused fluid : o3dema, cough, disinclination to work, 

 incapability of rapid progression, colicky pains as the unobservant practitioner 

 would call them but in truth pleuritic stitches ; these are the frequent sequelae of 

 pleurisy. This will afford another reason why the important operation of paracentesis 

 should not be deferred too long. 



There is much greater disposition to metastasis than in pneumonia : indeed it is 

 easy to imagine that the inflammation of a mere membrane may more readily and 

 oftener shift than that of the substance of so large a viscus as the lungs. The inflam- 

 mation shifting its first ground, attacks almost every part indiscriminately, and 

 appears under a strangly puzzling variety of forms. Dropsy is the most frequent 

 change. Effusion in the abdomen is substituted for that of the chest, or rather the 

 exhafent or absorbent vessels of the abdomex, or both of them, soon sympathise in 

 the de jility of those or' *zke thorax. 



