314 PLEURISY. 



influenza or bronchitis. The skin also has a con'iigated 

 appearance after the cough. The nostrils are dilated, as 

 in pneumonia, to aid the diflicult respiration ; but the nasal 

 membranes are but little tinged. It is particularly charac- 

 terized by the pain which pressure on the sides produces. 

 The pulse is usually hard, full, and but slightly accelerated, 

 until the constant pain has weakened the system. From 

 this detail of symptoms, as well as from what has already 

 appeared in the account of pneumonia, the distinguishing 

 marks between pleurisy and inflammation of the substance 

 of the lungs may be gained. If the symptoms quoted do 

 not become aggravated by the fifth or sixth day, a favour- 

 able termination may be expected ; but if, on the contrary, 

 the pulse becomes much quickened, small or wiry, and in- 

 distinct, and great restlessness with irregular sweating come 

 on, it wuU prove fatal, and the post-mortem examination 

 will detect indications of severe hydrothorax. 



Hydrothorax, or serous effusion within the cavities of 

 the pleura, is either acute and rapid, or rather gradual. 

 In the former it occurs from the third to the fourteenth 

 day ; the pleurae secrete a serous fluid, and pour this forth 

 in a diseased quantity, until it fill one or both cavities, 

 the animal dying from suffocation. This termination is 

 usually betokened before death by a yellow serous discharge 

 from the nose, without foetor, and may always be detected 

 by placing the ear to the side : the pulse in these cases is 

 irregular, but the general symptoms are so little intense as 

 frequently to deceive the practitioner. The less acute kydro- 

 thorax frequently does not occur until the third or fourth 

 week, and sometimes even a longer period from the pleu- 

 ritic attack, and is even more deceptive than the other ; 

 for it seldom commences until there has been for a con- 

 siderable time, perhaps two or three weeks, an apparent 

 remission of all the inflammatory symptoms ; and it is 

 only by an aural examination, aided by the eye and touch 

 of the experienced observer, that any remaining disease 

 can be detected. To such a one the disposition to eff'usion 

 will manifest itself; the pulse will give a peculiar vibratory 

 stroke, with some hurried irregularity ; and as soon as only 

 a moderate portion of fluid is collected, it may be felt by 

 means of the hand applied to the region of the heart, which 



