150 DISEASES OF THE RESPIRATORY ORGANS 



total stagnation of the circulation of the blood, from pressure of the 

 exudate on the large blood vessels and the heart, or later on ljy exhaus- 

 tion and by seconclary diseases. To this class belong dropsy caused l)y 

 stagnation of the blood circulation, from weakness of the heart, and amy- 

 loid degeneration of the kidneys, liver, or spleen. Death may also occur 

 from complicating diseases, such as bronchitis and lobular pneumonia. 



The prognosis is generally favorable; as a rule, very severe cases of 

 primary pleuritis make good recoveries, depending largely on the aninud 

 and character of the exudate and the realworption of the lymph, and there 

 may at times be adhesion of the whole or part of the pleuritic surfaces. 

 In secondary pleuritis the prognosis depends on the original disease. 



Therapeutics. — The treatment of secondary pleuritis is the same as 

 the primar}', but in the former we must take into consideration the treat- 

 ment of the original disease. In the early stages of the disease, when 

 the exudate is collecting, we must apply counter-irritants, such as lini- 

 ments or plasters of mustard. When a copious exudate has been formed 

 we try to induce its real^sorption by stimulating the kidneys by means 

 of acetate of potassium, acetate of sodium, with the Priessnitz compress. 

 When the heart is weak we use digitalis and sciuiils. Small doses of 

 calomel are also useful. 



1^. Hydrarg. chlor. mitis, 0.03 



Digitalis pulv., ' 0.05 



8accharum lactis, 0.5 



M. et fiat pulv. No. vi. 



Sig. — One i^owder three times daily. 



Diuretics and cardiac stimulants have only an indirect influence on 

 the accumulations, and when the exudate is gradually absorbed one can 

 hardly credit these drugs with accomplishing the results, as the exudate 

 is usually reabsorbed, w^hen the acute inflammatory stage of the disease 

 has passed. The best method of treatment is the removal of the secretion 

 by surgical means, that is, by puncturing the chest wall. This operation 

 is not at all dangerous in the dog, and is generally sucessful, unless the ad- 

 hesions are too thick. 



The operation must be performed where there is a very large exudate 

 and the dull sound can be heard over the entire lung, that is, where there 

 is oedema of the lung and intense dyspnoea caused by the pressure of 

 the exudate; or where there is deficient reabsorption as is seen where 

 the fever has entirely disappeared and the fluid does not show any signs 

 of becoming real^sorbed. 



Puncture of the Cavity of the Chest. — This must be on the side 

 where the exudate; is higliest; this can be detected by auscultation. 



The trocar used in this opei'ation is an ordinary sized trocar, seen 

 in Fig. 65, or, if we wish to make first an exploring punctvire, we use the 



