69 



ing the sides, a small, irregular pulse, and swelling of the 

 legs. When the water-line is not higher than one third of 

 the chest the patient may recover. In some few cases there 

 are adhesions of the pleura from the effects of fibrinous lymph. 



Treatment. — Very much the same style of treatment is 

 required in pleurisy, that has been recommended in the pre- 

 ceding article for pneumonia. 



If the patient is seen in time, before effusion has taken 

 place, blood to the amount of five or six quarts may be 

 taken. The warnings for non-depletive measures are so 

 clearly expressed in my treatment of pneumonia, it would 

 be idle to repeat them. It is there commended, with many 

 cautions and reservations. If the bowels are costive give 

 laxative medicine — four drachms of aloes in solution; give 

 the patient also one ounce of nitre in his water for a few 

 days. In addition to these remedies, counter-irritants, such 

 as ammonia or mustard, must be applied to the sides of 

 patient over the lungs. 



I recommend also tonics and stimulants to be given, as in 

 pneumonia — gentian and carbonate of ammonia. 



Besides this a diuretic ball, for this purpose, take of — 

 r Saltpetre - One ounce. 

 Twice a day < Resin - - " 



(.Soap - 



In some very bad cases the liquid has to be removed by 

 making an opening into the chest with the trocar and canula 

 between the seventh and eighth ribs ; but it is better to avoid 

 this if possible, and trust to the treatment here laid down. 



CHRONIC COUGH. 



Cause. — This is generally an " old follower of the family 

 diseases," such as catarrh and bronchitis, and not so easy to 

 shake off. When badly treated or neglected these disorders 

 generally end in chronic cough. It consists in an irritable 

 state of the mucous membrane of the air passages. It is 

 easily excited by exercise, changes of temperature, and other 

 trivial causes. • 



