FATAL CASE OF PLEUUO-PNEUMON Y. 
77 
chest evidently produces much uneasiness; percussion over dif- 
ferent parts of the thorax produces a sound of an exceedingly 
dull character, and the respiratory murmur is entirely absent. 
Under these circumstances, the succeeding treatment was 
adopted : but in consequence of the fatal tendency which the 
complication assumed, before any remedial measures were em- 
ployed to impede its progress, I was induced to believe that my 
patient would speedily sink under the oppressive load of disease 
that assailed her, despite of any effort on my part. In this in- 
stance I was but too truly borne out in my prognosis. 
A large quantity of blood was immediately abstracted, which 
she bore tolerably well, and which, seemingly, afforded much re- 
lief. Counter-irritation over the lateral portions of the chest 
with the ordinary blistering ointment ; laxative injections until 
the bowels have become acted on ; stimulating frictions to the 
extremities, and, afterwards, the application of flannel rollers, 
together with the administration of a ball composed of protochlor. 
hydr. tart, antim. and kali were the means adopted. Pulv. digital, 
and nit. kali were given every six hours. 
2d day . — Symptoms same as yesterday, but, if any thing, more 
aggravated in their character. Pulse slow and feeble. The bowels 
have been relaxed. Continue the medicine. 
3d day . — Considerable prostration of strength has taken place. 
Respiration very oppressive ; pulse small and almost impercepti- 
ble. A cold clammy perspiration invests the entire surface of the 
body ; the kidneys have become engorged, as she has voided 
some bloody urine during the night ; the bowels acting too freely. 
Medicine discontinued ; warm clothing thrown over her, and 
stimulants internally administered. 
From this period until the night of the fourth day, my patient's 
sufferings progressively increased, until death ultimately released 
her from their influence. 
Post-mortem examination . — On carefully opening the thoracic 
cavity on the succeeding day, the following morbid appearances 
presented themselves: — Lungs in a collapsed state, and literally 
deluged in the mass of fluid that surrounded them, amounting in 
quantity (by computation) to at least five gallons, or thereabouts, 
of a sero-sanguineous character, and exhaling a very disagreeable 
odour: shreds of detached lymph were observed floating through 
it; adhesions were formed between the opposing surfaces of the 
pleural sac at different points bv bands of pseudo-membrane, pre- 
senting an exceedingly irregular appearance ; masses of unor- 
ganized lymph were here and there pendant from the pleura cos- 
talis, which tissue bore traces of an inflammatory action to a very 
considerable extent; a portion of the left lung was in an emphy- 
VOL. XV. L 
