326 
INFLAMMATION OF THE LUNGS. 
derably; she is continually lying down and getting up, looking 
at her flanks, and groaning with agony; the faeces are soft, and 
a rumbling noise may be heard in the intestines. These symp¬ 
toms increased in urgency until about five p.m., when she died in 
dreadful suffering. 
Inspectio Cadaveris. 
The left lung was highly inflamed, and the parenchymatous 
portion almost black, in consequence of the congestion which 
had taken place; the pleura, also, was much inflamed and thick¬ 
ened, and in the cavity about six quarts of serous fluid had been 
poured out. The right lung was not so much diseased as the 
left; but the inflammation was evidently making great advances. 
The pericardium partook of the inflammatory appearances. The 
intestines, but chiefly the ccecum and colon, were in a high state 
of inflammation. No other peculiar appearance. 
A consideration of this case will naturally elicit a remark or 
two. In the first place, I may by some be blamed for not pur¬ 
suing the depletive treatment; but, in my own mind, I am con¬ 
vinced that if I had done so, I should have acted in direct op¬ 
position to the course pointed out by the peculiar and annoying 
pulse, and the great degree of debility under which the patient 
laboured from the very commencement of the disease. From some 
experience in the use of digitalis, I have been in the habit of 
placing so much confidence in it, that I have almost fancied that 
in some cases the pulse, to a certain extent, was under the con- 
troul of the practitioner; but here the drug never had the least 
power over the action of the heart, for I never once detected any 
tendency to intermit. The white hellebore, which has been 
justly extolled, equally failed ; but the trial of its powers was not 
so extended as that of the digitalis, in consequence of the super¬ 
vention of symptoms of inflamed bowels. With respect to the 
enteritis, which was the immediate cause of death, I am at a loss 
to account for the cause. Had I been treating the case with 
u small doses of aloes,” there would have been no mystery 
whatever; but when the only aperient medicine administered 
was two drachms of aloes, at two separate times, and that, too, 
at the very commencement of the disease, I certainly cannot 
attribute it to that cause. Neither can the hellebore be blamed ; 
for no more than three doses of 9j each were given before it was 
suspended. But whatever was the cause, it is an additional proof 
to me of the great sympathy existing between the lungs and the 
intestines; and a memento directing me to be very wary how I 
administer any thing in the shape of a purgative in cases of 
pneumonia. If enteritis had not supervened, such was the state 
of the lungs, that the mare could not have survived long. 
Southampton, May 22, 1832. 
