DISTEMPER. 361 
must be that the patient was very ill; while if there was a sudden rise in 
temperature, it would be evidence of some serious complication, as capillary 
bronchitis or inflammation of the lungs or brain. 
It follows, therefore, that the thermometer can scarcely be dispensed with 
in this and other serious febrile diseases, since it uncovers hidden and grave 
dangers suddenly occurring in their course, also plainly indicates the essential 
remedies ; when treatment must otherwise often be erratic and perhaps alto- 
gether wrong. Consequently it should be used at least twice daily, and in 
severe cases at noon as well as in the morning and at night. 
In very mild attacks the patients seem to be on the gain in the course of a 
week or ten days. In severe cases, however, not only is there no sign of im- 
provement thus early, but the tendency is still downward; and if recovery 
eventually takes place, a change for the better is scarcely likely to be plainly 
evident before the third week has been entered; or it may have passed before 
the crisis has been reached. 
Inflammation of the lungs is a very grave complication, which may occur 
at any point in the course, although the accident generally happens within 
ten days from the beginning of the attack. 
It is manifested first by a chill and sudden, rapid and great rise in the 
temperature. Then follow the characteristic symptoms of pneumonia. 
When the temperature, which has for several days been not over 104°, rises 
suddenly to 105° or to 106°, as a rule it indicates that some serious complica- 
tion is occurring ; and if the inflammation is not within the chest it will gen- 
erally be found to have involved the brain. 
Here it is well to state that if high fever has persisted for several days the 
indications are far more unfavorable than when there is a sudden and tempo- 
rary rise to even a little higher degree. The danger is also great where the 
high fever cannot be materially reduced by means of aconite, quinine, antipy- 
rin, or the like. . 
When the brain is affected during distemper, indications of acute menin- 
gitis may be exhibited, and perhaps violent convulsions occur, but generally 
this extension of the inflammation is not marked by any very pronounced 
symptoms, probably because of the great weakness and depression, and, as a 
rule, the evidence of it is mainly, increasing dullness in the patient and uncon- 
sciousness of what is going on about him, muscular twitchings, and likely a 
short but not violent spasm now and then; or there may be some loss of power 
in the hind legs and possibly complete paralysis of them. 
Sight and hearing are greatly affected; and no matter how uncomfortable 
the position in which he is placed he is not likely to change it; thus showing 
how benumbed his brain. 
With such symptoms the chances of recovery are small indeed. The 
patients weaken rapidly, and death usually occurs within two or three days. 
