Pulmonary consumption, pneumonia, and allied diseases of the lungs : their etiology, pathology and treatment, with a chapter on physical diagnosis / by Thomas J. Mays.

  • Thomas Jefferson Mays
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: Pulmonary consumption, pneumonia, and allied diseases of the lungs : their etiology, pathology and treatment, with a chapter on physical diagnosis / by Thomas J. Mays. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    ored serum, containing flakes of fibrin, leucocytes and red blood-corpuscles. Again the tension in the circulation of the pleural mem- brane may be so great that the blood, instead of allowing its serum to filter through the walls of the capillaries, breaks bodily into the pleural cavity and accumulates there. This is the hemorrhagic variety of pleurisy, and it finds its coun- teri)art in the hemoptysis which occasionally accompanies croupous ])neumonia. Furthermore, the analogy between pleural efi^usion and acute pneumonia liobls true in other re- spects. Just as the red blood-corpuscles transude into the air cells of the lung during the acute pneumonic process and give rise to the red or rusty expectoration, so is there more or less of a constant tendency towards hemorrhage from the pleural surface in both the serous and fil)rinous variety of pleurisy, resulting mi a brownish or bloody discoloration of the efTused liquid. On the other hand, an enormous number of colorless blood-cells, or leucocytes, may migrate through the walls of the dila'.ed pleural caiiillaries, collect in the pleural cavity, and multiply there still further by division. These cells be- come incorporated at once with the serum that is effused sinniltaneously and give rise to what is known as a purulent exudation, or emjiyema. Rindfieisch* describes the mechan- ism of this process in the following language: The exuda- tion thus becomes purulent on its way from the blood-vessels to the free surface of the serosa, and thus we obtain the pur- ulent exudation. Xot every purulent effusion of the pleural cavit\- is such from the beginning of the affection, but is transformed into it during its course. .According to Rind- fleischt a fibrinous pleurisy may apparently pursue a favor- able career when suddenly the fibrous pseudo-membrane, in virtue of its luxurious vascularization, begins to generate an • Text-Bonk of Pathological Histology-, p. 268. f Op. cit . ;6q.