488 THE HOKSE. 



however, in a great majority of cases prevent that develop- 

 ment. 



Pleukisy, or inflammation of the serous covering of the lungs 

 and the lining of the cavity of the chest, is generally connected 

 with inflammation of the substance of the lungs ; but it occa- 

 sionally exists independent of any state of those organs. The 

 pulse is in this case hai'd and full, instead of being oppressed ; 

 the extremities are not so intensely cold as in pneumonia; the 

 membrane of the nose is a little reddened, and the sides are 

 tender. It is of importance to distinguish accurately between 

 the two, because in pleurisy more active purgation may be 

 pursued, and the effect of counter-irritants will be greater, from 

 their proximity to the seat of disease. Copious bleedings and 

 sedatives here also should be had recourse to. It is in connec- 

 tion with pleurisy that a serous fluid is effused in the chest, the 

 existence and the extent of which may be ascertained by the 

 practised ear, and which in many cases may be safely evac- 

 uated. 



The heart is surrounded by a serous membrane — the peri- 

 cardium, that secretes a fluid, the interposition of which pre- 

 vents any injurious fi-iction or concussion in the constant action 

 of this organ. If this fluid increases to a great degree, it con- 

 stitutes dropsy of the heart, and the action of the heart may be 

 impeded or destroyed. In an early stage it is difficult to detect, 

 and in every stage difficult to cure. 



The heart itself is often diseased ; it sympathizes with the 

 inflammatory affection of every organ, and therefore is itself 

 occasionally inflamed. Carditis, or inflammation of the heart, 

 is characterized by the strength of its pulsations, the tremor of 

 which can be seen, and the sound can be heard at a distance of 

 several yards. Speedy and copious blood-letting will afford the 

 only hope of cure in such a case. 



The outer coat of the stomach and intestines is composed of 

 a serous membrane — the peritoneum, which adds strength and 

 firmness to their textures, attaches and supports and confines 

 them in their respective places, and secretes a fluid that pre- 

 vents all injurious friction between them. This coat is exceed- 

 ingly subject to inflamuiation, which is somewhat gradual in its 

 approach. The pulse is quickened, but small ; the legs cold ; 



