Licence: Public Domain Mark
Credit: Outlines of human pathology / by Herbert Mayo. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![more or less diluted with serum. Part of the lymph coagu- lates, and forms a thin, spongy, fibrinous layer, which adheres to the surface of the pleura, and becomes or- ganized, [m. 89.] When the inflammation subsides early, and the quantity of effusion is not great, the part which remains liquid is entirely absorbed. The surfaces covered with lymph then come into contact, and adhere. After a time the medium of union degenerates into a filamentous tissue, the threads of which are drawn into lengths by the motions of the chest and lungs. \u. 91.] When the effusion is considerable in quantity, amounting to nine, ten, or eleven pints, it appears to be incapable of absorption, and requires to be let out by the operation of paracentesis tho- racis. The wound thus made heals. The fluid does not re- accumulate. The air, which has got in, is absorbed. The lung is again dilated. The fluid effused at the commence- ment of pleurisy is probably pure liquor sanguinis,—the blood without the coloured particles. It has been observed, that the tendency of the blood to coagulate is restrained by the contact of a living surface. The same holds with liquor sanguinis. Accordingly, when, upon the chest being punc- tured, fluid which has been some weeks in that cavity is evacuated, a considerable filmy coagulation takes place in it. The liquid and fibrin of pleuritic effusion are sometimes tinged with blood. The symptoms of pleurisy are, inflammatory fever; pain on inspiration or a stitch, the ordinary seat of which is just below and without the nipple, the stitch being commonly on the side diseased, but sometimes on the other; disposi- tion to lie on the affected side ; dyspnoea. When the effu- sion is considerable, the patient can only lie on the side affected, which appears fuller and larger than the other; the intercostal spaces are prominent; the ribs motionless. At the commencement of pleurisy, or when the effusion is small in quantity, a rubbing sound may sometimes be heard by the ear applied to the chest, or even felt; which is supposed to arise from the motion of the opposed surfaces roughened with lymph against each other. But the cha- racteristic stethoscopic sign of pleurisy is one, which de- 2 K](https://iiif.wellcomecollection.org/image/b21066735_0525.jp2/full/800%2C/0/default.jpg)
