PLEURISY. 203 



pressing the lungs on every side, rendering expiration diiEcult 

 and at length impossible, and destroying the animal by suffoca- 

 tion. The very commencement of effusion may be detected by 

 auscultation. There wiU be the cessation of the respiratory mur- 

 mur at the sternum, and the increased grating — not the crepitat- 

 ing, crackling noise as when congestion is going on — ^not the 

 feebler murmur as congestion advances ; but the absence of it, 

 beginning from the bottom of the chest. 



It is painfuUy interesting to watch the progress of the effu- 

 sion — ^ho-«? the stillness creeps up, and the murmur gets louder 

 above, and the grating sound louder too, imtil at length there 

 is no longer room for the lungs to play, and suffocation ensues. 



The fluid contained in the chest varies in quantity as well as 

 appearance and consistence. Many gallons have been found in 

 the two sacs, pale, or yellow, or bloody, or often differing in the 

 two sides of the thorax ; occasionally a thick adventitious coat 

 covering the costal or the pulmonary pleura — rarely much adhe- 

 sion, but thi lungs purple-colored, flaccid, compressed, not one- 

 fourth of the t usual size, immersed in the fluid, and rendered 

 Incapable of -xpajiding by its pressure. 



Here, as in pneumonia, the bleeding should be prompt and 

 copious. Next, and of great importance, aperient medicine 

 should be administered — ^that, the effect of which is so desirable, 

 but which we do not dare to give w^hen the mucous membrane 

 of the respirat iry passages is the seat of disease. Here we have 

 to do with a serous membrane, and there is less sympathy with 

 the mucous membranes of either cavity. Small doses of aloes 

 should be given with the usual fever medicine, and repeated 

 morning and night until the dung becomes pultaceous, when it 

 will always be prudent to stop. The sedative medicine is that 

 which has been recommended in pneumonia, and in the same 

 doses. Next should follow a blister on the chests and sides. 

 It is far preferable to setons, for it can be brought almost into con- 

 tact with the inflamed surface, and extended over the whole of 

 that surface. An airy, but a comfortable box, is likewise even 

 more necessary tban in pneumonia, and the practice of exposure, 

 im.covered, to the cold, even more absurd and destructive. The 

 blood, repelled from the skin by the contractile, depressing 

 influence of the cold, would rush with fatal impetus to the neigh 

 boring membrane, to which it was before dangerously deter 

 mined. Warm and comfortable clothing cannot be dispensed 

 with in pleurisy. 



The sedative medicines, however, should be omitted much 

 sooner than in pneumonia, and succeeded by diuretics. The 

 common turpentine Is as good as any, made into a ball with 

 Unseed meal, and given in doses of two or three drachms twice in 



