. A practical treatise on medical diagnosis for students and physicians . berculous. Physical Signs. Chronic pleurisy causes great deformity of the chestfrom contraction, and compensatory emphysema, of the healthy lung. Theheart is dislocated or can not be found on physical examination, because itis overlapped by lung or is drawn behind the sternum. There is con-siderable spinal curvature, dislocation of the scapida, deformity of theshoulder, and indrawing and overlapping of the ribs at the base of thechest. Chronic Pleurisy with Effusion. This results from an acute attackof pleurisy, in which
. A practical treatise on medical diagnosis for students and physicians . berculous. Physical Signs. Chronic pleurisy causes great deformity of the chestfrom contraction, and compensatory emphysema, of the healthy lung. Theheart is dislocated or can not be found on physical examination, because itis overlapped by lung or is drawn behind the sternum. There is con-siderable spinal curvature, dislocation of the scapida, deformity of theshoulder, and indrawing and overlapping of the ribs at the base of thechest. Chronic Pleurisy with Effusion. This results from an acute attackof pleurisy, in which the fluid remains unabsorbed, or from a series ofattacks. Symptoms. So far as subjective symptoms go it may remain latent;patients so affected not infrequently go about their work with compara-tively little dyspnoea. There may be an evening rise of temperature andacceleration of the pulse. Chronic effusions are more likely to be puru-lent in children than in adults. When empyema results, the fever PLATE XXIX. FIG. Aspect. v L V -f FIG. 2.—Posterior Aspee. FT: Pneumothorax (left-sided). PNEUMOTHORAX. 917 becomes hectic; there are chills and sweats, pyaemia develops, and deathis likely to occur from some intercurrent suppuration, as cerebral abscess. Physical Signs. The physical signs are the same as in acute effusion. After chronic effusion the chest is rarely restored to its original shape,even if the effusion is finally absorbed. The affected side becomes motion-less and retracted. In course of time the spine may be bent. Theopposite lung becomes hypertrophied. The patient is usually in precari-ous health, liable to acute attacks of pain in the affected side, and liablealso to be carried off by phthisis or some intercurrent affection. Rarelythe patient may maintain good health; complete cure is even possible,with restoration of the retracted side to, or almost to, normal dimensions,especially in children. Pneumothorax. Pneumothorax consists in an accumulation of
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