282 PLEURISY. 



accomplished, indicating the pain felt from the distention of the irritable, 

 because inflamed, membrane. This symptom is exceedingly characteristic. In 

 the human being it is well expressed by the term stitch, and an exceedingly 

 painful feeling it is. The expiration is retarded, as much as possible, by the 

 use of all the auxiliary muscles which the animal can press into the service 

 but it at length finishes abruptly in a kind of spasm. This peculiarity of 

 breathing, once carefully observed, cannot be forgotten. The next character is 

 found in the tenderness of the sides when the costal pleura is affected. This 

 tenderness often exists to a degree scarcely credible. If the side is pressed upon, 

 the horse will recede with a low painful grunt; he will tremble, and try to get 

 out of the way before the hand touches him again. Then comes another indi- 

 cation, both of pain and the region of that pain, — the intercostal muscles, 

 affected by the contiguous pleura, and in their turn affecting the panniculus 

 carnosus, or subcutaneous muscular expansion without — there are twitchings 

 of the skin on the side — corrugations — waves creeping over the integument. 

 This is never seen in pneumonia. There is, however, as we may expect,the same 

 disinclination to move, for every motion must give intense pain. 



The pulse should be anxiously studied. It presents a decided difference of 

 character from that of pneumonia. It is increased in rapidity, but instead of 

 being oppressed and sometimes almost unappreciable, as in pneumonia, it is 

 round, full, and strong. Even at the last, when the strength of the constitu- 

 tion begins to yield, the pulse is wiry, although small. 



The extremities are never deathy cold ; they may be cool, they are oftener 

 variable, and they sometimes present increased heat. The body is far more 

 liable to variations of temperature ; and the cold and the hot fit more frequently 

 succeed each other. The mouth is not so hot as in pneumonia, and the breath 

 is rarely above its usual temperature. 



A difference of character in the two diseases is here particularly evident on 

 the membrane of the nose. Neither the crimson nor the purple injection of 

 pneumonia is seen on the lining of the nose, but a somewhat darker, dingier hue. 



Both the pneumonic and pleuritic horse will look at his flanks, thus pointing 

 out the seat of disease and pain ; but the horse with pneumonia will turn himself 

 more slowly round, and long and steadfastly gaze at his side, while the action of 

 the horse with pleurisy is more sudden, agitated, spasmodic. The countenance 

 of the one is that of settled distress; the other 'brightens up occasionally 

 The pang is severe, but it is transient, and there are intervals of relief. While 

 neither will lie down or willingly move, and the pneumonic horse stands fixed 

 as a statue, the pleuritic one shrinks, and crouches almost to falling. If he 

 lies down, it is on the affected side, when the disease is confined to one side 

 only. The head of the horse, with inflammation of the substance of the lungs, 

 hangs heavily ; that of the other is protruded. 



We here derive most important assistance from Auscultation. In a case 

 of pleurisy we have no crepitating, crackling sound, referable to the infiltration 

 of the blood through the gossamer membrane of the air-cells ; we have not 

 even a louder and distincter murmur. Perhaps there is no variation from the 

 sound of health, or, if there is any difference, the murmur is fainter ; for the 

 pleural membrane is thickened, and its elasticity is impaired, and the sound is 

 not so readily transmitted. There is sometimes a slight rubbing sound, and 

 especially towards the superior region of the chest, as if there was friction 

 between the thickened and indurated membranes. 



To this may be added the different character of the cough, sore and painful 

 enough in both, but in pneumonia generally hard, and full, and frequent. In 

 pleurisy it is not so frequent, but faint, suppressed, cut short, and rarely attended 

 by discharge from the nose. 



