Acute Sero- Fibrinous Pleurisy in the Horse. Pleuritis. 331 



The hot air, steam bath, and hot compress have the advantage 

 over the mere irritant derivatives that their action is from first to 

 last soothing and free from all risk of inducing sympathetic irrita- 

 tion and yet as derivatives they are eminently efiicient. A wet 

 cloth or ice bag should be kept on the poll while in the hot air 

 bath. Next to them in safety and efficacy comes dry cupping. 



The irritant derivatives are often the most valuable, but must 

 be used with great judgment. They are always dangerous when 

 the pleural inflammation runs very high and when the local irri- 

 tation and suffering are specially acute. Under such circum- 

 stances it is usually desirable to adopt other measures to moderate 

 the severity of the inflammation, and to fall back on baths, com- 

 presses and cups until the irritation is alleviated before vegetable 

 or animal vesicants are resorted to. In acute and severe attacks 

 these latter are especially applicable to the early stages before the 

 inflammation has been fully formed, or after the stage of free 

 effusion has set in. 



With high fever and no benefit from hot local applications, 

 cold irrigation or refrigerant compresses to the walls of the chest, 

 have proved useful, but considering the r61e filled by cold in cau- 

 sation and the suggested relation between pleurisy and rheuma- 

 tism this is not to be followed as a general practice. 



If the patient has been a hearty feeder and if there is evident 

 costiveness a purgative (aloes or sulphate of soda) is often desir- 

 able -at the outset, but if the disease is of a low type this is always 

 dangerous, owing to susceptibility of the intestinal mucosa and it 

 is safer to correct constipation by injections or at most by a pint 

 of olive oil. 



When the suffering is very acute and is aggravating the fever, 

 a hypodermic injection of morphine will often greatly relieve and 

 even favor a revulsion of blood toward the skin, but as it tends to 

 suppress the action of both bowels and kidneys it should be 

 avoided unless it seems absolutely necessary, and above all it 

 should not be given by the stomach. Cocaine hypodermically 

 may be used to relieve pain. 



Both fever and suffering can sometimes be greatly relieved by 

 large doses (2 drachms, 3 or 4 times daily) of salicylate of soda, 

 which again suggests a close relation of the disease to rheumatism. 

 Acetanilid or phenacetin may be used to fill the same indication. 



