HYDKOTHORAX 883 



ened to eight hours. If the swelling is very large, the skin should 

 be punctured in from twenty to thirty places, and the parts 

 bathed with hot water three to four times a day. 



HYDROTHORAX, OR WATER IN THE CHEST. 



This is a sequel of pleurisy when neglected or not treated 

 properly, and which can scarcely be said to be curable. When 

 pleurisy is running into this difficulty, there may be some appear- 

 ance of recovery ; the breathing and fever are not so intense ; the 

 horse will perhaps eat a little ; the skin looks sleek and glossy ; 

 these signs of improvement may continue for several days, but if 

 the pulse is gradually increasing in frequency, and its strength 

 diminishing, there is undoubtedly water forming in the chest. 



When this has taken place to any great extent, there is diffi- 

 culty in breathing, and a flapping of the nostrils ; the eyes are 

 clear and unnaturally prominent ; the intercostal spaces bulge 

 out, and the ear applied to the chest can only detect the respira- 

 tory murmur above the surface of the fluid ; the legs and breast 

 will swell ; the circulation becomes more and more impaired, the 

 pulse getting weak and indistinct. 



Prof. Williams states, in relation to the cause of hydrothorax : 

 " Of the termination of pleuro-pneumonia in hydrothorax, I have 

 only to say that since I have abandoned the heroic or counter- 

 irritating treatment [he advises hot fomentations to the chest ; 

 discards all blisters and irritants], hydrothorax has been almost 

 unknown to me. For this the principle of treatment is stimulants, 

 tonics, and diuretics." I give the treatment of a leading author- 

 ity, who advises as follows : 



" Give a pint of warm ale combined with one ounce of nitrous 

 ether three times a day ; blisters applied to the sides, and iodide of 

 potassium in 1 drachm doses twice a day ; feed the animal on 

 nutritious and easily digested food. 



"When a large accumulation of fluid takes place, it must be re- 

 moved by tapping. The puncture is usually made in the intercostal 

 space between the seventh and eleventh ribs, near their junction 

 with the cartilages. The space between the eighth and ninth is 

 usually recommended. An incision is first made with a lance 

 through the skin, the trochar and canula is carefully pushed through 

 the muscles and pleura, directed slightly upward and backward, 

 keeping it close to the anterior border of the ninth rib, so as to 

 avoid wounding the intercostal artery ; when the trochar is with- 



