PHYSICAL DIAGNOSIS. 
501 
or central it may take two or three days. Inspection notes 
diminished movement of the chest wall on the affected side. 
On both sides if it is double pneumonia; also the increased 
use of the abdominal muscles. Percussion in first stage 
gives some dullness of diseased part. Central pneumonia 
may not yield dullness until advanced to the second stage. 
Auscultation in first stage is not satisfactory until exuda¬ 
tion has taken place. Then we hear the crepitant rale. It 
lasts but a few hours. Inspection in second stage shows the 
wall over the affected lung to be more quiet than in the first 
stage. Movement of the normal side increased. Percussion 
yields dullness over the diseased part of the lung while nor¬ 
mal portions yield increased resonance. Auscultation in the 
second stage yields no vesicular murmur over the affected 
portion. The crepitant rale has disappeared and bronchial 
breathing taken its place. The more condensed the lung 
tissue, the plainer the bronchial breathing becomes. Percus¬ 
sion in the third stage yields less and less dullness until the 
exudate has been absorbed. Auscultatioyi in this crepitant 
rale may be heard, then the sub crepitant as the exudate be¬ 
comes more liquefied, and finally the vesicular murmur re¬ 
turns. Should purulent infiltration set in the temperature 
remains high ; the pulse is frequent and weak, prostration is 
marked, bronchial breathing continues; also dullness and 
percussion. A discovery of minute gurgling rales may com¬ 
plete the diagnosis. Termination in gangrene is known by 
great prostration or collapse. We look for the gangrene 
odor. 
Chronic interstitial pneumonia or pulmonary tuberculosis 
in the horse is rarely seen, but may be in old horses. It may 
arise from the extension of an ordinary pneumonia. It is ac¬ 
companied by formation of tubercle or caseous material. 
Catarrhal pneumonia is always secondary, due to the ex¬ 
tension of the inflammation from a previous bronchitis. 
Acute bronchitis is an inflammatory condition of a part or 
the whole of the mucous membrane of the large bronchial 
tubes. In the first stage we find congestion of the mucous 
membrane. It becomes dry and swells. In the second stage 
