JDiseases of the Bespiratory Or gam. 183 



breathing becomes labored and attended with a lifting ol 

 the flank and loins, the nostrils are widely dilated, the 

 nose protruded, the elbows turned out, the skin sweats, 

 and there may be signs of imminent suffocation. Auscul- 

 tation detects no sound over the lower part of the chest iip 

 to a given horizontal line, and up to the same level there 

 is dullness on percussion. This shows the extent of wa- 

 tery effusion. The pulse becomes weak, with a peculiar 

 thriU at each beat, the limbs and lower aspect of the 

 chest swell, the patient moves unsteadily and falls sud- 

 denly to die. 



In other cases the effusion is re-absorbed and a good 

 recovery is made. In others it ceases to increase but fails 

 to be taken up and remains as a cause of short wind ; it 

 may even give off gases, in which case a gurgling sound 

 may be heard in the chest, or a sound as of drops falling 

 into a half-empty barrel, after the patient rises fi'om the 

 recumbent position. In other cases still there remain 

 false membranes attaching the lung to the inner sides of 

 the ribs, or enveloping the lung in whole or in part, and in 

 either case impairing respiration. 



Treatment. Give the same general care as in bronchitis 

 and pneumonia. In the early stages of chill treat as for 

 congested lungs. Later give a laxative (horse, aloes ; ox 

 and sheep, Glauber salts; swine and dogs, castor-oil,) 

 following it up with neutral salts (nitre, acetate of potassa, 

 liquor of the acetate of ammonia,) in full doses, and ano- 

 dynes (digitalis, aconite). These may be used in tlie 

 fullest doses after effusion has taken place, and in weak 

 subjects stimulants (sweet spirits of nitre, ether, alcohoUc 

 liquids, tincture of gentian,) should be added. Iodide of po- 

 tassium may also be given internally and tincture of iodine 

 rubbed on the chest. If froni exposure use salicylate of 

 ammonia. 



In very severe cases, a large linseed poultice may be applied 

 over the chest, or it may be shaven and subjected to dry cup- 

 ping, or an active blister may be applied as for pneiimonia. 



