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Encyclopedia Britannica - Main :: PIG-POL |
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PLEURISY, or PLEURITIS (Gr. srXeiipc =ribs) , inflammation of the pleura, caused by invasion by certain specific micro-organisms. (See RESPIRATORY SYSTEM: Pathology
The morbid changes which the pleura undergoes when inflamed consist of three chief
wall
The chief
wall
liver , may in consequence of the presence of the fluid be shifted away from their normal positicn. In favourable cases the fluid is absorbed more or Iess completely and the pleural surfaces again may unite by adhesions; or, all traces of inflammatory products having disappeared, the pleura may be restored to its normal condition. When the fluid is not speedily absorbed it may remain long in the cavity and compress the lung to such a degree as to render it incapable of re-expansion as the effusion passes slowly away. The consequence is that the chest wall falls in, the ribs become approximated, the shoulder is lowered, the spine becomes curved and internal organs permanently displaced, while the affected side scarcely moves in respiration. Sometimes the unabsorbed fluid becomes purulent, and an empyema is the result.The symptoms of pleurisy vary; the onset is sometimes obscure but usually well marked. It may be ushered in by rigors, fever and a sharp
On physical examination of the chest the following are among the chief points observed: (I) On inspection there is more or less bulging of the side affected, should effusion be present, obliteration of the intercostal spaces, and sometimes elevation
thorax , and the normal vocal fremitus is abolished. Should the effusion be on the right side and copious, the liver may be felt to have been pushed downwards, and the heart somewhat displaced to the left; while if the effusion be on the left side the heart is displaced to the right. (3) On percussion there is absolute dullness over the seat of the effusion. If the fluid does not fill the pleural sac the floating lung may yield a hyper-resonant note. (4) On auscultation the natural breath sound is inaudible over the effusion. Should the latter be only partial the breathing is clear and somewhat harsh, with or without friction, and the voice sound is aegophonic. Posteriorly there may be heard tubular breathing with aegophony. These various physical signs render it impossible to mistake the disease for other maladies the symptoms of which may bear a resemblance to it, such as pleurodynia.The absorption or removal of the fluid is marked by the disappearance or diminution of the above-mentioned physical signs, except that of percussion dullness, which may last a long time, and is probably due in part to the thickened pleura. Friction may again be heard as the fluid passes away and the two pleural surfaces come together. The displaced organs are restored to their position, and the compressed lung re-expanded. Frequently this expansion is only partial. In most instances the termination is favourable, the acute symptoms subsiding and the fluid (if not drawn
Pleurisy may exist in a latent form, the patient going.about for weeks with a large accumulation of fluid in his thorax , theordinary acute symptoms never having been present in any Zealand and Tasmania received it in 1864, but it was eradicated in both countries by the sanitary measures adopted. It was carried to Asia Minor, and made its presence felt at Damascus. It prevails in various parts of China, India, Africa and Australia, and until quite recently it existed in every country in Europe, except Scandinavia, Holland, Spain and Portugal. In Great Britain cases occurred in 1897. Symptoms:The malady lasts from two to three weeks to as many months, the chief symptoms being fever, diminished appetite, a short cough of a peculiar and pathognomonic character, with qnickened breathing and pulse, and physical indications of lung and chest disease. Towards the end there is great debility and emaciation, death generally ensuing after hectic fever has set in. Complete recovery is rare. The pathological changes are generally limited to the chest and its contents, and consist in a peculiar marbled-like appearance of the lungs on section, and fibrinous deposits on the pleural membrane, with oftentimes great effusion into the cavity of the thorax. Willems of Hasselt (Belgium) in 1852 introduced and practised inoculation as a protective measure for this scourge, employing for this purpose the lymph obtained from a diseased lung. Since that time inoculation has been extensively resorted to, not only in Europe, but also in Australia and South Africa, and its protective value has been generally recognized. When properly performed, and when certain precautions are adopted, it would appear to confer temporary immunity from the disease. The usual seat of inoculation is the extremity of the tail, the virus being introduced beneath the skin by means of a syringe or a worsted thread impregnated with the lymph. Protection against infection can also be secured by subcutaneous or intravenous injection of a culture of Arloing's pneumo-bacillus on Martin's bouillon, and by intravenous injection of the lymph from a diseased lung, or from a subcutaneous lesion produced in a calf by previous inoculation. End of Article: PLEURISY, or PLEURITIS (Gr. srXeiipc =ribs) If you wish, you can link directly to this article.
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