PLEURARTHRON 



1118 



PLEUROCELE 



frpdpov, joint; kokoc, evil]. Disease of the costo-ver- 

 tebral joints ; also, caries of the ribs. 



Pleurarthron (plu-rar' '-thron) [jrAevpov, rib ; apOpov, 

 joint]. The articulation of a rib. 



Pleurenchyma (plu - reng'- him -ah) \nAevpa, side; 

 eyxvfia, infusion]. In biology, woody tissue. 



Pleurenchymatous ( plu - reng - kim'- at - us) \iz7\.evpa, 

 side; eyxvp-a, that which is poured in]. Pertaining 

 to, or of the nature of pleurenchyma. 



Pleurisy (plu'-ris-e) [nAevpa, side]. Pleuritis ; in- 

 flammation of the pleura. It may be acute or chronic. 

 Three chief varieties are usually described, depending 

 upon the character of the exudate : (a) Fibrinous or 

 Plastic; (b) Sero-fibrinous ; (c) Purulent. In Fibrin- 

 ous Pleurisy, the pleura is covered with a layer of 

 lymph of variable thickness, which, in the acute form, 

 can be readily stripped off. This form is usually second- 

 ary to another disease, as pneumonia. Carcinoma, ab- 

 scess, and gangrene of the lungs usually give rise to 

 a plastic pleurisy when the disease reaches the surface 

 of the lung. Then there seems to be an apparent idio- 

 pathic form, following exposure to cold. P., Sero- 

 fibrinous, is generally due to tuberculosis, either of 

 the lung, or, more rarely, primarily of the pleura. 

 Other infectious diseases such as measles, scarlet 

 fever, influenza, rheumatic fever, and sepsis some- 

 times cause a sero-fibrinous pleurisy. In a few cases 

 no microorganismal cause can be discovered. P., 

 Purulent, or Empyema, may be (i) a sequence of 

 the acute sero-fibrinous form ; (2) it may arise as a 

 purulent pleurisy in the beginning, especially in acute 

 infectious diseases — thus in scarlet fever, typhoid 

 fever, pneumonia, influenza, measles, whooping- 

 cough ; tuberculous pleurisy is often purulent ; (3) 

 empyema may be due to local disease, as fracture 

 or caries of the ribs, caries of the vertebrae, pene- 

 trating wounds, malignant disease of the lung or 

 esophagus, or to perforation into the pleura of tuber- 

 culous cavities, of perityphlitic abscesses, of subdia- 

 phragmatic abscesses, of hepatic abscesses, and of 

 gastric ulcers. The onset of acute pleurisy is marked 

 by agonizing pain in the side, sharp and stabbing, 

 increased on coughing, and in its milder forms 

 called a "stitch;" there may be an initial chill, 

 followed by fever; or the disease may begin in- 

 sidiously ; friction-fremitus may be felt on palpation 

 and a to-and-fro friction-sound is heard on ausculta- 

 tion. In the sero-fibrinous variety a liquid effusion 

 takes place, varying in amount. The pain now stops 

 and the signs of effusion become marked : bulging of 

 the intercostal spaces and chest- wall, absence of 

 vocal fremitus, displacement of the heart, movable 

 dulness with a curved upper line, and a tympanitic 

 percussion-note (skodaic resonance) beneath the clavi- 

 cle and above the level of the effusion. Chronic 

 pleurisy may be sero-fibrinous, coming on insidiously 

 or following an acute sero-fibrinous pleurisy. A dry 

 chronic pleurisy is a sequence of acute sero-fibrinous 

 pleuritis, or is a primitive plastic inflammation. Tuber- 

 culosis and syphilis may cause chronic plastic pleurisy. 

 Peripleuritis is a rare affection in which the connec- 

 tive tissue between the costal pleura and the thoracic 

 wall becomes the seat of an inflammation that gen- 

 erally proceeds to suppuration. The etiology is 

 obscure. P., Areolar. Synonym of P., Multilocu- 

 lar. P., Calcareous, a process characterized by the 

 deposition of lime-salts in a thickened pleura. P., 

 Costo-pulmonary, pleurisy affecting both the costal 

 and the pulmonary pleura. P., Diaphragmatic, a 

 form of the disease which is restricted to the pleural 

 surface of the diaphragm. Vomiting, hiccough, and 

 icterus are occasionally present. P., Double, pleurisy 



on both sides of the chest. P., Dry, that form in 

 which there is little or no effusion of fluid. It is 

 common in rheumatic and tuberculous patients. P., 

 Dyscrasic, the presence of a fetid exudate in the 

 pleural, as well as in the pericardial and peritoneal 

 sacs, of still-born infants. It is a septic 'condition, 

 and is most frequent in, if not confined to, hospitals 

 in which puerperal sepsis rages. P., Encysted 

 pleurisy in which the effusion is circumscribed by 

 adhesions or separated, into pockets or loculi. It 

 is most common in empyema. P., Gangrenous, 

 pleurisy in which the exudate and the pleural mem- 

 brane become gangrenous. P., Hemorrhagic, a 

 variety in which the exudate contains a varying 

 proportion of blood. It occurs: (a) in the pleurisy 

 of asthenic states, such as carcinoma, chronic ne- 

 phritis, and in the malignant infectious fevers ; some- 

 times also in hepatic cirrhosis ; (b) in tuberculous 

 pleurisy; (c) in carcinomatous pleurisy; (</) blood 

 may become accidentally mixed with the effusion from 

 the wounding of the lung during aspiration. P., 

 Ichorous; Putrid Pleurisy; a form characterized 

 by the presence of a gray or dirty-brown fluid which 

 gives off an offensive odor. It is usually dependent 

 upon pyemia, septicemia, pulmonary gangrene, or 

 putrid bronchitis. P., Interlobar, inflammation oi 

 the pleural layers between adjoining lobes of the lung. 

 P., Latent, a form in which the subjective symptoms 

 are absent. P., Mediastinal, inflammation of the 

 pleural layers about the mediastinum. P., Meta- 

 pneumonic, pleurisy dependent upon a pneumonia. 

 P., Multilocular, an encysted pleurisy in which 

 connective-tissue bands separate the effusion into sev- 

 eral, usually intercommunicating, sacs. P., Post- 

 pneumonic. Synonym of P., Metapnetanouic . P., 

 Putrid. See P. , Ichorous. P., Pulsating. Synonym 

 of Empyema, Pulsating. P. -root. See Asclepias. 

 P., Spurious. Synonym of Pleurodynia. P., Sup- 

 purative. Synonym of P., Purulent. See under 

 Pleurisy. P., Tuberculous, pleurisy due to the 

 tubercle-bacillus. 



Pleuritic ( plu-rit' '-ik) [n?.evpd, pleura; trig, inflamma- 

 tion]. Pertaining to, or affected with, or of the nature 

 of, pleuritis. 



Pleuritis ( plu-ri' -lis) [jrAEvpa, pleura; trig, inflamma- 

 tion]. Inflammation of a pleura. See Pleurisy. P. 

 deformans, chronic inflammation with great thicken- 

 ing and induration of the pleura, usually accompanying 

 fibroid pneumonia. P. duplicata, bilateral pleurisy. 

 P. humida, pleurisy with effusion. P. incapsu- 

 lata. Synonym of Pleurisy, Encysted. P. pul- 

 sans, a form that usually, but not always, occurs in 

 chronic cases, and in which the fluid is purulent. The 

 pulsation is generally universal. It occurs more fre- 

 quently among men, and between the ages of twenty 

 and thirty years. It may be confounded with aneur- 

 ysm. Its seat, however, is different ; there is no 

 bruit; it grows smaller under pressure and larger 

 after coughing. P. sicca, dry pleurisy. P. spuria. 

 Synonym of Pleurodynia. P. vera, simple pleurisy 

 without complication. 



Pleuro- (plu'-ro-) [nlevpa, side]. A prefix to denote 

 connection with the pleura, or with a side. 



Pleuroblastic {plu -ro -bias'- tik) [irAevpa, the side; 

 /SAao~n5c, a germ]. In biology, applied to certain 

 fungi (Peronosporece) that produce globular or branched 

 lateral outgrowths which act as haustoria. 



Pleurocarpous (plu-ro - kar'-pus) \jr\zvpa, the side; 

 napir6q, fruit]. See Cladocarpous. 



Pleurocele (plu'-ro-sel) [Tr?.£vpa, pleura; k///' ; , tumor]. 

 I. Hernia of the lung; pneumocele. 2. A s 

 effusion into the pleural cavity. 



