PLEURISY. 
5 
and was subsequently treated with nitrate of potass and 
antimonials. The urgent symptoms subsided greatly in four 
or five days, and she seemed progressing favorably until 
the 22d, when there w r as a sudden relapse. 
24th. — I saw her for' the first time. The farrier thinks her 
better than yesterday. It is, however, quite evident, from 
general appearances, that she is going on unfavorably. 
The pulse is 75, very defective in volume, also slightly 
irregular. The respirations are 38, and highly abdominal 
in character; inspirations no longer than expirations. The 
ears are cold ; mouth clammy, but not hot ; the legs are 
all warm . The bowels are sufficiently open, and urination is 
tolerably copious. Appetite capricious. 
On percussion there is perfect dulness along the lower third 
of each sterno-costal region; this dulness gradually dimi- 
nishes about half way up the sides. Auscultation detects no 
respiratory murmur where the above noted dulness is com- 
plete ; the respiratory murmur ceases abruptly on both sides 
along a horizontal line fourteen inches above the sternum ; 
a rubbing sound is heard about four inches higher than 
this line on the right side ; still higher and extending 
to the heads of the ribs there is increased, but in other 
respects apparently healthy respiratory murmur. No rub- 
bing sound can be detected on the left side. 
The farrier has been giving sedatives until this morning. 
As fluid, however, is collecting in the chest, and as there is 
no fever to forbid their administration, mineral and vegetable 
tonics combined with diuretics are ordered. Good food to 
be offered. 
30th. — Although I have seen her regularly since the above 
date, a record of daily appearances would be superfluous. 
The tonic and diuretic treatment has been continued till this 
morning, but the symptoms have ^gradually become worse. 
In addition to other and minor signs, the following indica- 
tions of (e water in the chest” are well marked. 
The respirations are 46, and so highly abdominal as to 
cause great lifting of the loins during inspiration which is 
shorter than expiration. The head is greatly extended ; 
the alae nasi are widely dilated during the entrance of air, 
and suddenly collapse afterwards, thus causing that peculiar 
flapping action, which, taken in connection with great lifting 
of the loins, I have generally remarked as being distinctive 
symptoms of this condition. The pulse is 84, weak in tone, 
and irregular; jugular venous regurgitation is also very 
obvious. The eyes are clear and prominent, the features 
“ pinched ,” and the facial veins stand out very distinctly. 
