FRENCH SCHOOL-ON PLEURISY. 
329 
gestion of cold liquids into the stomach when the body is in a state 
of perspiration; sudden suppression of cutaneous perspiration 
or an old discharge, the sudden repression of an exanthematous 
eruption ; exterior violence, such as blows, bruises; w^ounds pe¬ 
netrating the chest, are the most frequent causes. Pleurisy is 
often consequent on affections of the lungs; it is then exceedingly 
dangerous. 
It is not easy at the commencement of the disease to dis¬ 
tinguish inflammation of the pleura from that of thc-^lungs. 
Shivering, anxiety of countenance, laborious respiration, heat of 
the expired air, dryness of the mouth and skin, being symptoms 
common to both pleurisy and pneumonia, are of very little 
assistance in determining the disease: but when the complaint is 
of some few days’ standing, pleurisy developes itself; a dry cough 
without expectoration, short and interrupted inspiration, pain 
when the chest is compressed, hardness, frequency, smallness, 
or strength of the pulse; these are the symptoms by which it 
may be recognized. 
It is usually about the fifth or sixth day that pleurisy termi¬ 
nates, either in resolution or gangrene. This latter termination 
is rare. When it passes this period without diminution of the 
intensity of the symptoms, it is to be feared that it will terminate 
in hydrothorax. The respiration then becomes more laborious, 
the heaving of the flanks is increased ; the nostrils are dilated ; 
the chest yields a dull sound on percussion. If the ear is applied 
to the thorax, the noise made by the fluid during the act of 
breathing may be sometimes heard ; the beats of the heart are 
dull, and occasionally scarcely recognizable by the ear; the 
animal stretches his fore-legs apart; sometimes the external 
region becomes oedematous. The symptoms increase in intensity, 
the respiration is extremely impeded, and the patient dies of 
suffocation. 
The liquid which is effused contains flakes of albumen float¬ 
ing in it. The pleurse are covered with similar productions, 
in some cases having already begun to undergo the process of or¬ 
ganization; and it is very evident that by means of these pseudo¬ 
membranes the pleurae contract adhesions, and this in conse¬ 
quence of their inflammation. When pleurisy has been very 
intense, and death has quickly followed, the effused liquid is 
occasionally not serous, lemon-coloured, and limpid ; but of 
a milky appearance, purulent, and with an insipid and nauseous 
odour. it also frequently happens, that it is a veritable san¬ 
guineous or sero-sanguineous effusion which takes place. 
When pleurisy first begins, and we arc certain that it is occa¬ 
sioned by the sudden impression of cold air, which checks the cuta- 
