The practice of surgery . y affected, compress thelung and heart, and bulge into the intercostal spaces, so that in ex-treme cases one lung is thrown out of commission and the heart is 488 INFLAMMATORY DISEASE 489 dit?locat,cd. Localized or pocketed effusions arc confined by adhesionsbetween the visceral and parietal pleurae, so that the collections impingeupon the lungs over limited areas only. With an understanding of the pathologic anatomy the reader willconceive at once what must be the symptoms produced, though he willremember at the same time how symptoms will vary with the under-lying o
The practice of surgery . y affected, compress thelung and heart, and bulge into the intercostal spaces, so that in ex-treme cases one lung is thrown out of commission and the heart is 488 INFLAMMATORY DISEASE 489 dit?locat,cd. Localized or pocketed effusions arc confined by adhesionsbetween the visceral and parietal pleurae, so that the collections impingeupon the lungs over limited areas only. With an understanding of the pathologic anatomy the reader willconceive at once what must be the symptoms produced, though he willremember at the same time how symptoms will vary with the under-lying or associated conditions—pneumonia, phthisis, and the serous effusions cause mild symptoms, as a rule. The sharp,agonizing, initial pain of pleurisy precedes the effusion, and is due to theirritating contact of opposed, dry, inflamed layers of pleura. Withthe onset of effusion the layers are separate and pain is allayed. Thenthere ensue dyspnea, a varying fever, and constitutional signs. r^**® fc>».-^. Fis;. 311.—^Thoracentesis. Treatment.—In a great many cases these simple effusions are ab-sorbed and their treatment is within the domain of the internist, withwhose examination of the chest, by percussion and auscultation, weneed not concern ourselves here. A considerable proportion of casesdo not improve under medication, but may clear up quickly as the resultof aspiration. Aspiration is best performed with a trocar, cannula, andsuction apparatus, and the fluid withdrawn should always be examinedcritically in order to determine especially the presence in it of pus, oftubercle bacilli, or of other organisms. Sometimes guinea-pig inocula-tion alone will demonstrate tuberculosis. The distinction between a 490 THE CHEST simple serous effusion and a purulent effusion is one of degree serous effusions contain few leukocytes and few organisms. As a rule, then, a simple serous effusion will clear up after one or twoaspirations, provided the operator ha
Size: 1693px × 1475px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
