Clinical report on chronic pleurisy : based on an analysis of forty-seven cases / by Austin Flint.
- Austin Flint I
- Date:
- 1853
Licence: Public Domain Mark
Credit: Clinical report on chronic pleurisy : based on an analysis of forty-seven cases / by Austin Flint. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
13/58
![Cough and expectoration. An examination of the facts noted with rasped to these symptoms, leads to the following general conclusions: They are aometimes entirely absent, and are not, therefore, essential to the diagnosis. When present, they are generally not prominent symptoms. This, in fact, so far as these observations go, expresses the rule, the exceptions being very few. Cough and expectoration did not precede the development of the pleurisy except in the few cases in which it was inferred from the history that the patient, prior to the latter disease, was laboring under tuberculosis. The pre-existence of these symptoms, for a considerable length of time, should render the supposition of antecedent tuberculosis highly probable. Pleurisy occurring in patients not tuberculous, is oftener accompanied by cough with- out, than with an expectoration, or the latter is insignificant in amount. The cough is usually dry, and short or hacking. The expectoration, when pres- ent, usually consists of mucus, more or less modified. These facts show that Chronic Pleurisy is often uncomplicated with bronchitis, and if the latter affection coexists, it is of a mild grade. A copious purulent expectoration sometimes occurs suddenly during the progress of pleurisy, and continues for a greater or less period. Under these circumstances ulceration of the pleura commencing on the free surface of the membrane, and perforation of the lung, opening a communication between the pleura] sac and the bronchial tubes may be suspected. This happened in two cases in the present collection, in both instances the pleurisy being circumscribed; and it was supposed to occur in another case after the patient had passed from my observation. The two cases just referred to I shall give in full under another head. In the cases in which tuberculosis appeared to be developed during the progress of, or subsequent to the pleurisy, cough and expectoration became more or less prominent. Prominence of these symptoms, when before they had been either absent or slight, provided they are not due to perforation, should give rise to strong suspicion of tubercle. This practical consideration is the more important, inasmuch as the physical signs of tubercle are ren- dered less available by the existence of pleurisy with effusion, and also by the permanent effects of the latter upon the chest. Respiration. Excluding the cases of perforation, the frequency of the respirations was almost uniformly somewhat increased. To this rule, how- e, er, there are exceptions. In one of the cases, while the quantity of effusion was'very large, removing the heart to the right side of the sternum, the res- pirations were but sixteen per minute. The increased frequency was not usually great, varying from twenty-five to thirty-five per minute. In one case](https://iiif.wellcomecollection.org/image/b2111965x_0013.jp2/full/800%2C/0/default.jpg)
