830 
FRENCH SCHOOL—ON PLEURISY. 
neous perspiration, it is often of service to rouse the action of the 
skin, by keeping the patient warm and grooming him well. 
Pleurisy is also advantageously opposed by bleeding, both 
local and general; revulsives under the chest; warm, emollient, 
gummy, and slightly diaphoretic drinks, strict regimen, &c. 
The patient should be placed in a mild temperature, and care¬ 
fully kept from all draughts. 
We have succeeded by the use of mustard poultices under 
the breast of the patient. This revulsive is far preferable 
to a blister at the commencement of the disease, as its action 
is much quicker, and we can more easily have recourse to 
local bleeding afterwards. All temporizing may be fatal to the 
patient, and therefore we should commence by a general bleeding, 
if the inflammation is intense. We should apply a strong and 
hot poultice of mustard powder to the inferior part of the chest, 
these regions having been previously rubbed with hot vinegar 
until redness of the skin appears. At the end of two hours, and 
rarely after that time, we scarify the enlargement which results 
from this application, and we expose the part to the vapour of 
boiling water. After having obtained a sufficient quantity of 
blood, we apply the hot poultice again; and we repeat the local 
bleedings as often as the state of the patient requires it (as many 
as four or five times in four-and-twenty hours). We sometimes 
have again recourse to general bleedings, when the blood does not 
flow fast enough from the wounds made in the enlargement. 
When we think we should cease the local bleeding, we cover 
the part again with a poultice of linseed meal, which is changed 
as often as the state of the part requires it. 
When pleuritis is followed by effusion, it scarcely ever happens 
that the patient recovers. He may remain a long time in this 
state, but he usually dies very suddenly. Rarely indeed is the 
liquid effused absorbed again. In such cases the administration 
of diuretics and diaphoretics is advisable, such as nitre, resin, 
digitalis, oxymel of squills, colchicum, &c. Puncture of the 
chest (paracentesis), to give vent to the liquid accumulated there, 
is seldom efficacious; and it is only when there no longer remain 
any signs of inflammatory irritation that it can be attempted. 
Chronic Pleurisy ,—It usually follows acute pleurisy. It is, in 
general, produced by the same causes, acting with less intensity. 
It is very difficult to recognize before effusion of the pleura 
(hydrothorax) has taken place. Its progress is always slow. 
If it preserves all the characters of acute pleurisy it requires the 
same mode of treatment, modified to suit the intensity of the 
disease (see acute pleurisy). If, on the contrary, the pain pour- 
tray ed by the symptoms is^not so lively; if the frequency of the 
