ai8 PLEURISY. 



however, as we may expect, the same disinclination to move, for every motion must 

 give intense pain. 



Tlie pulse sliould be anxiously studied. It presents a decided difference of character 

 from that of pneumonia. It is increased in rapidity, but instead of being oppressed 

 and sometimes almost unappreciable, as in pneumonia, it is round, full, and strong. 

 Even at the last, when the strength of the constitution begins to yield, the pulse is 

 wiry, although small. 



I'he extremities are never deathy cold ; they may be cool, they arc oftener variable, 

 and they sometimes present increased heat. The body is far more liable to variations 

 of temperature ; and the cold aiid the hot fit more frequently succeed each other. 

 The mouth is not so hot as in pneumonia, and the breath is rarely above its usual 

 temperature. 



A dilference of character in the two diseases is here particularly evident en the 

 membrane of the nose. Neither the crimson nor the purple injection of pneumonia is 

 seen on the lining of the nose, but a somewhat darker, dingier hue. 



Both the pneumonic and pleuritic horse will look at his tianks, thus pointing cut 

 the seat of disease and pain; but the horse with pneumonia will turn himself more 

 slowly round, and long and steadfastly gaze at his side, while the action of the horse 

 with pleurisy is more sudden, agitated, spasmodic. The countenance of the one is 

 that of settled distress; the other brightens up occvisionally. The pang is severe, but 

 it is transient, and there are intervals of relief. While neither will lie down or wil- 

 lingly move, and the pneumonic horse stands fixed as a statue, the pleuritic one 

 shrinks, and crouches almost to falling. If he lies down, it is on the affected side, 

 when the disease is confined to one side only. The head of the horse with inflamma- 

 tion of the substance of the lungs hangs heavily ; that of the other is protruded. 



We here derive most important assistance from Jitscullalion. In a case of pleurisy 

 we have no crepitating, crackling sound, referable to the infiltration of the blood 

 through the gossamer membrane of the air-cells; we have not even a louder and 

 distincter murmur. Perhaps there is no variation from the sound of health, or, if 

 there is any ditference, the murmur is fainter; for the pleura] membrane is thick- 

 ened, and its elasticity is impaired, and the sound is not so readily transmitted. There 

 is sometimes a slight rubbing sound, and especially towards the superior region of the 

 chest, as if there was friction between the thickened and indurated membranes. 



To this may be added the different character of the cough, sore and painful enough 

 in both, but in pneumonia generally hard, and full, and frequent. In pleurisy it is 

 not so frequent, but faint, suppressed, cut short, and rarely attended by discharge 

 from the nose. -^ 



These are sufficient guides in the early stage of the disease, when it is most of all 

 of importance to distinguish the one from the other. 



If after a few days the breathing becomes a little more natural, the inspiration 

 lengthened and regular, and the expiration, although still prolonged, is suffered to be 

 completed — if the twitchings are less evident and less frequent — if the cough can be 

 fully expressed — if the pulse softens, although it may not dimir.ish in frequency, and 

 if the animal becrins to lie down, or walks about of his own accord, there is hope of 

 recovery. But if the pulse quickens, and, although smaller, yet possesses the wiry 

 character of infiammation — if the gaze at the fianks, previously by starts, becomes 

 fixed as well as anxious, and the dithculty of breathing continues (the difficulty of 

 accDinpli.ihing it, although the efforts are oftener repeated) — if patches of sweat break 

 out, and the animal gets restless — paws — shifts his posture every minute — is unable 

 longer to stand, yet hesitates whether he shall lie down — determines on it again and 

 again, but fears, and at length drops, rather than lies gently down, a fatal termination 

 is at hand. For some time before his death, the effusion and its extent will be evi- 

 dent enouiih. lie not only walks unwillintrly, but on the sliirhtest e.\(M-cise his pulse 

 is strangely accelerated ; the feeling of sulfocation comes over him, and be stc];S ail 

 of a sudden, and looks wildly about and trembles; but be quickly n^covrrs iiiniself 

 and proceeds. There is also, when the eil'usion is confirmed, o'deina cf s( me external 

 part, and that occasionally to a very great extent. This is rftrnesi observed in the 

 abdomen, the chest, and the point of the breast. 



The immediate cause of death is etfusiim in the chest, compressinir the lungs on 

 every side, renderinir expiration difficult and at lenoth inipossihie. and dest'-ving the 

 animal by sutTocation. The very commencement of effusion may be detected by au&- 



