REPORTS OF CASES. 
197 
This treatment was continued for about two weeks, but 
failed to produce any important change in the symptoms, for 
though the pulse and the temperature had returned to their 
normal rate, the appetite was still delicate, the external 
appearance of the swellings remained about the same and 
the respiration was still disturbed, being at times accelerated 
and labored, though at others quite normal. 
Examination of the lungs showed no change. There was 
the same loss of respiratory murmur, which if not completely 
absent, was at least very weak and had the same dulness on 
percussion. The condition of the lung was evidently due to 
a passive rather than to an active pathological condition. 
Was there heart disturbances; was there structural changes ; 
or to what must the trouble be referred ? The administration 
of heart regulators was then ordered, and digitalis and nitrate 
of potash, with a view to their diuretic effects, were both 
administered for several days, but with no other result than a 
disturbance in the character of the pulse, which soon rose 
from 42 0 to 6o°. Exercise was then tried, but the slightest 
exertion was followed by extreme fatigue, the respiration 
becoming greatly accelerated and the breathing of heaves to 
an extreme degree becoming manifest, and suffocation soon 
threatening. After four weeks of treatment, without any 
manifestation of change, the owner ordered the patient to be 
destroyed. 
The post-mortem revealed the following lesions: The inte¬ 
rior portions of both lungs had collapsed, and were dark in 
color, the superior two-thirds normal; there was the exten¬ 
sive collection of yellowish fluid in the thoracic cavity, but no 
inflammation of the pleura and no pleuritic adhesions; the 
heart was normal in size and in structure; and the bronchial 
lymphatic glands wer.e enormonrly enlarged, assuming the 
size of the fist of a man, and pressing upon the blood vessels 
at the base of the heart, principally upon the anterior vena 
cava*and the pulmonary veins. The lymphatic enlargements 
were hard, and on section showed a large increase of the con¬ 
nective tissue, with here and there a caseous degeneration 
gathering in various spots in little suppurative masses. 
