Hatnoglobina-})! ia . — Azoi(sm ia . — Bfc. 455 



and materially cotitril)ute to recovery. If, however, he cannot 

 stand on his limbs at all, but must settle in the slings, the com- 

 pression of the chest will so excite the breathing that it will 

 induce dyspnoea, pulmonary congestion and a rapidly fatal result. 

 In such a case a good bed must be provided and the patient made 

 as comfortable as possible in the recumbent position. 



In some cases in the earliest stages a full dose of sweet spirits 

 of nitre or even half a pint of whiskey has seemed to assist in 

 aborting the disease though the urine was already of a deep red 

 color. It probably acted by supporting the alread}' oppressed 

 heart, and securing a prompt elimination b)^ the kidneys. 



Friedberger and Frohner strongly recommend bleeding in all 

 cases of dyspnoea and excited heart action, and considering the 

 plethoric condition of the animal it would equally commend 

 itself in other cases as well. This is the most prompt sedative 

 of the nervous and vascular excitement, and the most speedy 

 and certain means of removing nuich of the poisons accumulated 

 in the blood, and of diluting what remains by reason of the ab- 

 sorption of liquids from every available source. This will more 

 than counterbalance an}' temporary increase of poisons drawn 

 from the portal system to fill up the vacuum in the .systemic veins 

 caused by the emi,ssion of blood. When the thick tarry condi- 

 tion of the blood seriously hinders a .speed}' abstraction both 

 jugulars may be opened at once. 



In some ca.ses of great nervous excitement bromides may be 

 useful in moderating circulatory and re.spiratory movement, 

 but on the whole the advantage is greater from an immediate 

 re.sort to eliminating agents. 



One of the most effective agents is water. If the patient is 

 thirsty he should have all he will drink, and if not, it may even 

 be given from a bottle, or thrown into the rectum. A .still more 

 effective resort would be to introduce water intravenously in the 

 form of a normal saline solution, or even to pass it into the 

 trachea through a small cannula or large hypodermic needle. 

 This serves to dilute the over dense blood, to stimulate the kid- 

 neys and (>ther emunctories to active secretion, and to retain in 

 solution the haemoglobin, urea and other products which would 

 otherwise cause greater irritation. This would be especially ap- 

 plicable after the blood-tension had been diminished by 

 phlebotomy. 



