ACUTE PLEURISY. 27 



sound is a sound of grazing, rubbing, or grating, due to the movements, in 

 opposite directions of the pleural surfaces with inspiration and expiration. 

 The sound is more or less intense, dry, and appears to be near the ear, 

 conveying the idea of friction of roughened surfaces. If this is distinctly 

 present, its diagnostic significance is important, showing pleurisy exists. 



The signs belonging to the second stage manifest themselves without 

 much delay. Liquid effusion having taken place in sufficient quantity to 

 be apparent, the diagnosis is easier. 



The signs of an effusion are obtained by percussion, auscultation, and 

 inspection. To determine by percussion, press the palm and fingers of the 

 left hand firmly against the side of the chest, then tap lightly one finger 

 with the second finger of the right hand, giving a sharp quick blow. 

 If the sound given forth is dead and flat, it denotes an absence of air within 

 the part of the chest percussed. On auscultation the respiratory sound is 

 either suppressed or but feebly heard, unless the quantity of liquid is 

 sufficient to compress the lung into a solid mass, then the sound is intensi- 

 fied, rude, and harsh, like that heard on placing the ear to the neck of the 

 animal. If the quantity of liquid be large enough to distend the pleural 

 sac, the depression between the ribs of affected side may be diminished 

 and even swell out. This complete distension by liquid effusions is, how- 

 ever, exceptionally rare. 



2*rog nost's .—The prognosis in acute, uncomplicated cases of pleurisy, 

 with but little effusion, is favorable , provided the constitution of the 

 animal is not enfeebled. The presence of a large liquid effusion is a very 

 unfavorable sign, and death may result from suffocation or exhaustion. 



When recovery takes place from pleurisy, the roughened surfaces of the 

 pleura come together and are united by adhesion of newly found tissue. 



Treatment .— The objects of treatment in acute pleurisy, differ in its 

 different stages. The purposes in the first, are to arrest, if possible, the 

 progress of the disease, to diminish its intensity, if it be not arrested, and 

 to relieve suffering. The indications are essentially the same as in the 

 earlier period of most acute inflammations. 



The remedy of the first importance is opium in some form. It is invalu- 

 able not only for its palliative, but its curative action. By relieving pain, 

 it diminishes the determination of blood to the inflamed parts. It also 

 lessens the constitutional disturbance, and enables the system to tolerate 

 better the local affection. Conjoined with the use of opium, remedies 

 addressed to the circulation, may be employed. Aconite is preferred, 

 because its sedative effect upon circulation is produced without depress- 

 ion. Blisters should not be applied in this stage. Cloths wrung out of hot 

 water and bound around the chest will act as a palliative, and afford 

 marked relief. 



