LYMPHANGITIS. 77 



bounding, varying from fifty-five to eighty beats per minute. 

 The lameness and swelling vary, but are usually very 

 excessive, often causing the patient to hold the affected 

 limb up from the ground. The swelling usually appears on 

 the inside of the thigh, first involving a ganglion, then a 

 vessel, gradually extending downwards. The swelling, as 

 well as extending in area, becomes increased in size, causing, 

 in addition to excessive pain, great difficulty in moving the 

 limb; On palj)ation the corded condition of the l^^mphatic 

 vessel is discovered. The limb is also found to be hot; and, 

 on pressure, pain is manifested. The inflammation is of the 

 sthenic type ; the swelling usually extends to, and involves, 

 the inguinal glands. There may be perspiration about the 

 shoulders or flanks, as a result of the severe pain ; the 

 countenance bears a very anxious expression ; the patient 

 usually stands, but when the pain is excessive he will some- 

 times lie down, and cannot or will not rise unless assisted. 

 Constipation is usually present; urine decreased in quantity 

 and heightened in colour, and contains more urea than in 

 health. A well marked symptom is partial, or complete 

 anorexia, generally the latter, and a strong desire for w^ater. 

 If the case is not attended to at once, more or less change 

 takes place ; a slight exudate is thrown out, w^hich becomes 

 organized, and on repeated attacks further exudation takes 

 place, becomes organized, and causes further enlargement, 

 finally resulting in a condition known as elephantiasis. A 

 very rare termination of lymphangitis is suppuration. 

 AVhen the disease occurs in the anterior extremities, I do 

 not think it is quite so severe as when occurring in the 

 posterior extremities, although the constitutional symptoms 

 are about the same. When the disease is caused by a 

 puncture of the coronet, the swelling may begin below and 

 extend up^vards ; but otherwise it always begins above and 

 extends downwards. The symptoms of lymphangitis are 



