ducted with more regularity, made shorter, and done up more effectually" ("Medical Reform," p. 312).
After the paroxysm of the disease has subsided, the pectoral fever can be alleviated by the free use of cold water and strict abstinence from solid food. Avoid over-warm bedclothing. By a load of warm covers alone a common catarrh can be aggravated into a hot fever till the blanket-smothered patient is awakened by the throbbing of a galloping pulse. Exercise would promote the discharge of the accumulated serum, but, while the patient is too sore to turn over in his bed, gymnastics are out of the question, and their effect must be accomplished by "passive exercise," manipulation of the thorax, and a swinging motion in a hammock or a rocking easy-chair. With the aid of fresh air and abstinence the remedies of the movement-cure might be entirely dispensed with, if the accumulation of purulent matter were the only risk, but in acute pleurisy there is a greater danger from another cause, namely, that the inflamed surface of the visceral pleura has a tendency to adhere to the lining of the thorax and thus obliterate the pleural cavity. The consequences of that result would be a permanent embarrassment of breathing, or even the total paralysis of the affected lung. Passive exercise and friction (rubbing the less affected parts of the chest with a bathing-brush) will, however, not fail to obviate that danger. As soon as Nature finds relief in a copious expectoration, the crisis of the disease is weathered, and further precautions may be limited to rest and a sparse but emulsive diet—a modicum of sweet cream, with oatmeal-gruel and stewed raisins. That pleurisy was formerly considered a most fatal disease can be more than sufficiently explained by the fatal measures of treatment which were then in vogue. Dr. Buchan's "Family Medical Library," not more than thirty years ago about the most popular pathological compend, contains the following directions: "In the beginning of a pleurisy the only efficient course is to make the patient stand up on the floor, while blood is drawn from a large orifice until he faints or is about falling. . . . If, after the first bleeding, the pain, with the other violent symptoms, should still continue, it will be necessary to take eight or nine ounces more. If the symptoms do not then abate, and the blood shows a strong buffy-coat, a third or even a fourth bleeding may be requisite. . . . Topical bleeding has also a good effect in this disease. It may be performed by applying a number of leeches to the parts affected, or by cupping, which is both a more certain and expeditious method than the other. . . . Then, take: Solution of acetated ammonia, three drachms; mint-water, one ounce; tincture of opium, twenty-five drops; sirup of tolu, two drachms; antimonial wine, thirty drops. Nothing is so certain to give speedy and permanent relief as a combination of ipecac, calomel, and opium." And in that form of the disease known as "bilious pleurisy," "emetics and mercurial cathartics are of the utmost im-
