DISEASES OF THE RESPIRATORY ORGANS. 9 1 



of the chest, the rubbing sound ceases, the catching breathing 

 and ridge on the belly disappear, the pulse becomes soft, the 

 anxiety of countenance passes away, and the patient may begin 

 to feed as if well. But soon the pulse loses its fullness, and 

 gains in rapidity, breathing becomes laboured and attended 

 with a lifting of the flank and loins, the nostrils are widely 

 dilated, the nose protruded, the elbows turned out, the skin 

 sweats, and there may be signs of imminent suffocation, Aus 

 cultation detects no sound over the lower part of the chest up 

 to a given horizontal line, and up to the same level there is 

 dullness on percussion. This shows the extent of watery 

 effusion. The pulse becomes weak, with a peculiar thrill at 

 each beat, the limbs and lower aspect of the chest swell, the 

 patient moves unsteadily and falls suddenly to die. 



In other cases the effusion is re-absorbed and a good recovery 

 is made. In others it ceases to increase, but fails to be taken 

 up and remains as a cause of short wind ; it may even give off 

 gases, in which case a gurgling sound may be heard in the 

 chest, or a sound as of drops falling into a half-empty barrel, 

 after the patient rises from the recumbent position. In other 

 cases still there remain false membranes attaching the lung to 

 the inner sides of the ribs, or enveloping the lung in whole or 

 in part, and in either case impairing respiration. 



Treatment. — Give the same general care as in bronchitis and 

 pneumonia. In the early stages of chill treat as for congested 

 lungs. Later give a laxative (horse, aloes ; ox and sheep, 

 Glauber salts ; swine and dogs, castor-oil), following it up with 

 neutral salts (nitre, acetate of potassa, liquor of the acetate of 

 ammonia), in full doses, and anodynes (digitalis, aconite). 

 These may be used in the fullest doses after effusion has taken 

 place, and in weak subjects stimulants (sweet spirits of nitre, 

 ether, alcoholic liquids, tincture of gentian) should be added. 

 Iodide jf potassium may also be given internally and tincture 

 of iodine rubbed on the chest 



