HYDRO-PNEUMO-THORAX AND PYO-PNEUMO-THORAX. 367 



amphoric souffle accompanied Ijy a sound like that of drops of water 

 falling into a metallic vessel, and by the signs of secondary exudative 

 pleurisy, viz., moderate fever, dulness over the lower zones of the chest, 

 limited above by a horizontal line, slight splashing sound, and a soft 

 distant pleuritic souffle. 



All the secondary symptoms — loss of appetite, suppressed rumination, 

 sighing, accelerated pulse, etc. — are found in a more or less accentuated 

 form. 



In pyo-pneumo-thorax fever is more marked, while the signs noted 

 on auscultation and percussion are identical, and are accompanied by 

 digestive disturbance and marked cedema of the wall of the chest, 

 which can be seen or detected by palpation. 



Diagnosis. The diagnosis is relatively easy when the lesion is 

 secondary ; but the difficulty (as in simple pneumo-thorax) is to identify 

 the exact character of the primary affection. 



On the other hand, pyo-pneumo-thorax and hydro-pneumo-thorax 

 are not always complete ; adhesions of very varying character may exist 

 between the lung and the chest wall ; hence it is impossible to group 

 together all the possible symptoms. 



Diagnosis is facilitated by aseptically puncturing the chest with a 

 Pravaz's syringe. 



Prognosis. The prognosis is extremely grave even in cases of hydro- 

 pneumo-thorax. Treatment is useless, for even allowing that the primary 

 disease might be cured, this process of cure, after reabsorption of the 

 transudate, would be extremely tedious, and the animals would long 

 remain in poor condition. 



Treatment. In hydro-pneumo-thorax no treatment is advisable. 

 Nothing is gained by thoracentesis, at least at an early stage, or before the 

 lesion causing the pneumo-thorax has closed. 



In pyo-pneumo-thorax, on the contrary, the theoretical course is to 

 evacuate the pus and completely wash out the pleural sac with lukewarm 

 non-irritant solutions of antiseptics. 



