Acute Fibrinous Pneumonia. Pneumonitis in the Horse. 269 



cular walls at once adapt themselves to the lessened amount. Nor 

 is the mere lessening of the volume a vital point. After moderate 

 bleeding, this is made up in a few hours : after severe bleeding in 

 24 to 48 hours. The loss of adult red globules is more lasting. 

 Bleeding to the extent of one per cent, of the body weight may- 

 have the number restored in seven days. The young red globules 

 though rapidly produced have individvally less haemoglobin, and 

 they can convey less oxygen to the tissues. This should mean 

 less oxidation, less heat, less waste, less urea, uric acid, hippuric 

 acid and other poisonous products in the tissues. Yet Baur says 

 that in anaemia there is a greater metabolism of proteids and more 

 excretion of urea. How easy it is to blunder in looking from one 

 single point of view. Again after bleeding there is a great relative 

 increase of the various forms of white blood globules, most of 

 them young and therefore with somewhat altered functions. The 

 paucity of red globules and excess of white, are brought about by 

 the pneumonia and independently of bleeding, so that it is difficult 

 to say whether the phlebotomist is enhancing an evil, or helping 

 a natural therapeusis. It seems hopeless to estimate the effects 

 of these and other changes in the blood after bleeding, upon the 

 metabolic processes of nutrition, secretion and sanguification. 

 This digression has not been made to elucidate the results or the 

 modus operandi of bleeding, but rather to illustrate the complexity 

 of the problem involved, and to warn against broad and unwar- 

 ranted generalization from insufficient premises. 



Even to-day practitioners of the soundest judgment meet with a 

 Umited number of cases in which they resort to bleeding, with ad- 

 vantage. These occur mainly in strong, robust constitutions, in 

 individuals accustomed to an invigorating, open air life, liberal 

 diet and abundant exercise. Even in these this measure is chiefly 

 resorted to, to relieve an acute pulmonary congestion, with a 

 dangerous distension and over charging of a fatigued and over- 

 worked heart. In short, the condition is one closely allied to acute 

 congestion in which the value of bleeding is all but universally 

 admitted. It is especially warranted early in the disease, though 

 it may still be adopted with caution, in a similar condition which 

 has supervened at a later stage. A strong pulse and bright red 

 mucous membranes, are not as has been supposed, essential pre- 

 requisites to its employment. The mucosae may be pale, or more 

 likely cyanotic, and the pulse small and weak, from the over 



