The practice of pediatrics . e side of the chest or, not infrequently, in the abdo-men, sometimes simulating that of appendicitis or some other abdominaldisease, and on one occasion I have seen it referred to the region of theshoulder-joint on the affected side. The pain is generally severe andcutting and accompanies inspiration, especially if a deep breath istaken; movement of the chest on the affected side is often voluntarilylimited to avoid it. At the beginning the pain is increased by pressure 64S DISEASES OF THE RESPIRATORY TRACT over the inflamed area, and the child inclines to lie on t
The practice of pediatrics . e side of the chest or, not infrequently, in the abdo-men, sometimes simulating that of appendicitis or some other abdominaldisease, and on one occasion I have seen it referred to the region of theshoulder-joint on the affected side. The pain is generally severe andcutting and accompanies inspiration, especially if a deep breath istaken; movement of the chest on the affected side is often voluntarilylimited to avoid it. At the beginning the pain is increased by pressure 64S DISEASES OF THE RESPIRATORY TRACT over the inflamed area, and the child inclines to lie on the back or theopposite side, but as the effusion forms the pain goes, and the childlies on the affected side to give more play to the healthy lung. The breath inr/ depends on the local conditions present. At thebeginning it is quick and shallow, owing to pain caused by deep inspi-ration; when an effusion is present, if small, the breathing may not heappreciably altered from the normal, but when large the respirations Fig. HO. Pleurisy: line of fluid anteriorly. are again rapid and shallow, the ala? nasi work, and the pulse-respirationratio may be altered so as almost to simulate that of pneumonia. The temperature is generally high during the acute stage, 101° or102° F. being a common figure. It usually remains raised for four daysto a week and sometimes longer, with considerable fluctuations. Theskin is hot and often dry during the day, with profuse sweating in thenight and early morning hours. During the attack the child loses flesh, is weary and restless, andconstipation often demands treatment. The tongue is furred, the face PLEURISY 649 pale, with often a slight straw-yellow tint observable, mostly around theeyes and mouth. This is less noticeable in cases of serous effusion thanin empyema, where the rapidly produced anemia heightens the finger-tips may become glazed in a few cases where the fluid hasremained unabsorbed for two or three weeks, but any definite
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