Maryland medical journal . renic pleuritis), inflammation is supposed togive rise to symptoms which are distinctive, namelv. hiccoughattended with pain, and pain referable to the diaphragm in the actsof coughing. I am of the opinion that these symptoms are largelvdue to inflammation of the diaphragm, and not to a circumscribedpleuritis. ^ 392 MARYLAND MEDICAL JOURNAL sept., 1902 In the literature I find no reference to inflammation of the dia-phragm as a compHcation of pneumonia. Pleurisy, pericarditis,endocarditis, meningitis, colitis, and numerous other minor com-plications receive due consi
Maryland medical journal . renic pleuritis), inflammation is supposed togive rise to symptoms which are distinctive, namelv. hiccoughattended with pain, and pain referable to the diaphragm in the actsof coughing. I am of the opinion that these symptoms are largelvdue to inflammation of the diaphragm, and not to a circumscribedpleuritis. ^ 392 MARYLAND MEDICAL JOURNAL sept., 1902 In the literature I find no reference to inflammation of the dia-phragm as a compHcation of pneumonia. Pleurisy, pericarditis,endocarditis, meningitis, colitis, and numerous other minor com-plications receive due consideration. But inflammation of thediaphragm, it seems, has been overlooked entirely. A knowledgeof its occurrence, I think, is important, as the cUnical symptoms,so characteristic of pneumonia, are in part due to its presence. Forinstance, much of the pain usually attributed to the pleurisy asso-ciated with the disease is due to the movements, restricted thoughthey may be, of the inflamed diaphragm. That the so-called pleu-. I.—Section of a normal diaphram, showing a vein and artery in the center. Thelarge white bands represent the perimysium. The finer white net-workrepresents the endomyseum, separating individual muscle fibres. The smallblack dots are sarcolemma nuclei. ritic stitch—pain, due, I think, largely to the diaphragmitis—isintensified on deep inspiration and on coughing is not to be won-dered at when one considers the fact that the diaphragm is the prin-cipal muscle of inspiration, and is brought into active play oncoughing. To quote still further from Roberts: The serous covering ofthe diaphragm, either on its thoracic or abdominal aspect, is notuncommonly involved in cases of acute pleurisy or peritonitis, re-spectively, and the inflammatory process may penetrate its struc- INFLAMMATION OF THE DIAPHRAGM—Rohrer. 393 ture. It may also be involved by extension from of my specimens most beautifully show this condition. Theinflammatory process e
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectmedicin, bookyear1902
