6 
PLEURISY. 
The Schneiderian membrane is of a dull almost leaden colour, 
and there is a thin mucous discharge from the nose. 
Percussion detects perfect dulness, extending on the right 
side about half way from the sternum to the vertebrae. On 
the left side the dulness is less extensive. Auscultation 
detects an absence of respiratory murmur below a horizontal 
line, eighteen inches above the sternum, and a rubbing sound 
is audible till within a few inches of the, vertebral column. 
A slight friction sound can be heard on the left side, extend- 
ing only about two inches above the fluid. 
There is a slight watery swelling below the brisket, and 
extending along the abdomen. The legs are less warm 
than formerly, but they are not cold, nor anasarcous in the 
slightest degree. The only thing which promises relief is to 
draw away the fluid ; operation is postponed till to-morrow, 
in order that the students may be present. 
3 1st. —Ten, a.m. — No material change in any way, and cer- 
tainly no improvement. I introduced the trocar and canula 
between the upper ends of the seventh and eighth costal 
cartilages on the right side. A full stream of fluid immedi- 
ately followed the withdrawal of the trocar, and continued to 
flow until three gallons were abstracted. No more could be 
obtained. The fluid was of a dull pink colour in conse- 
quence of being tinged with blood : when dried between the 
fingers, its tenacity was slight, but a considerable amount of 
albumen was precipitated by acids and heat. After standing 
twenty-four hours it formed a very slight jelly, and the bot- 
tom of the containing vessel, for about two inches deep, was 
covered with a dirty brown mass, consisting of blood globules 
and plastic corpuscles. The upper surface of the clot was 
almost colourless and covered with thin serum. 
The patient bore the operation well, and took both food 
and drink soon afterwards. Ordered iodine 3j, potass, 
hydriod. 3J, ginger, 3ij., morning and evening, and carbonate 
of ammonia, 3iv at mid-day. 
Five, p.m. — Several students who have visited her at my 
request, report that she is easier than before the operation. 
At 8 p.m. the farrier states that she is greatly relieved. 
Nov. 1st. — Her general appearance is improved, and she 
has fed during the night. The pulse is actually down to 62, 
and more full in volume. Respirations 37, and less abdomi- 
nal in character. Complete dulness on auscultation extends 
only ten inches from the sternum on both sides ; there is how- 
ever a strong rubbing sound along the chest for about six or 
seven inches higher on the right side. The legs are colder 
than before. Mouth less clammy. 
