106 DISEASES OF THE LUNGS. 



worse, we may consider the inflammation to have assumed 

 the sub-acute or chronic form, and the duration and termi- 

 nation of the case to have now become extremely uncertain. 

 The critical days, in pneumonic cases in general, have ap- 

 peared to me to be the third, the seventh, and the eleventh 

 days : beyond this last, little hope remains, without relapsed 

 crisis, for a favorable termination. 



Diagnosis. — Pneumonia, in its true or inflammatory 

 form, is very apt to be complicated with bronchitis and 

 with pleurisy; though bronchitis may exist without the 

 parenchyma being affected ; and, but very rarely so, may, 

 I believe, pleurisy. Bronchitis is characterised by the 

 short, catching, painful breathing; by the frequent pre- 

 sence or precedence of sore throat and catarrhal symptoms, 

 with concomitant irritation and soreness of the air- passages ; 

 while pneumonia is known to be absent by the sound con- 

 dition of the lungs, as indicated by the respiratory murmur 

 being everywhere audible. Moreover, in bronchitis, with 

 the return of the secretion of the bronchi comes the mucous 

 rale, and occasionally the sibilous rale. On the other hand, 

 the characteristics of pneumonia are — absence of any symp- 

 tom or direct manifestation of pain : the horse is spiritless, 

 listless, gloomy ; stands in one place and posture with his 

 head dependent, and notices nothing; hardly condescending 

 to raise it, though offered a handful of hay or corn, or perhaps 

 he takes a mouthful, and retains it between his teeth 

 Avithout offering to masticate it, as though he had forgotten 

 he had accepted it. Another marked symptom is, the 

 death-like coldness and stiffness of the legs, and the 

 difficulty there is in restoring warmth to them, and the still 

 greater difliculty in retaining that warmth. 



Prognosis, commonly dated from one or other of the cri- 

 tical days, is marked by a general abatement of the 

 symptoms of pain and danger, Avith some attempt at feeding, 

 and, perhaps, a disposition to lie down ; with an inclination 

 to some other posture or place than the one originally 

 taken up, and which is in fatal cases persevered in to 

 the last. This standing-place will often be in one parti- 



