PLEUEIST— PLEURODYNIA. 345 



PLEURISY. 



This IISEASE is characterized by a very peculiar respiration, 

 the expirations being much longer than the inspirations, owing to 

 the pain which is given by the action of the muscles necessary for 

 the latter, while the former, if the chest is allowed quietly to fall, 

 is almost painless. Nevertheless, the breathing is quicker on tho 

 whole than natural, being from forty to fifty per minute. The 

 pulse is quick, small, and incompressible. Nostrils and eyes of a 

 natural color, and the former are not dilated. The countenance is 

 anxious, and the legs are rather drawn together than extended, as 

 in bronchitis and pneumonia, and they are not colder than usual. 

 There is a short hurried cough, with great restlessness, and the 

 sides are always painful on pressure ; but this symptom by itself is 

 not to be relied on, as it is present in pleurodynia, which will be 

 presently described. 



The treatment should consist of copious bleeding, followed by a 

 mild purgative, and the same ball as recommended for pneumonia, 

 with the addition of half a drachm of calomel. Blisters are not 

 desirable to be applied to the sides of the thorax, as there is so 

 little space between the two surfaces of the pleura and the skin 

 that they are apt to do harm by immediately irritating the former, 

 rather than to act beneficially by counter-irritation of the skin. A 

 large rowel, may, however, be placed in the breast with advantage. 



Hydrothorax, or water in the cavity of the chest, is one of 

 the sequels of chronic pleurisy, the serum thrown out being the 

 means by which a serous membrane relieves itself. It can be 

 detected by the entire absence of respiratory murmur, and by the 

 dullness on percussion. No treatment is of any avail but tapping, 

 which may be readily and safely performed (if the diagnosis is 

 correct) by passing a trocar between the eighth and ninth ribs, 

 near their cartilages. If, however, an error has been committed, 

 the lung is wounded, and death will probably ensue. 



PLEURODYNIA. 



Between this disease and the last there is some simi- 

 larity in the symptoms ; but in their nature, and in the treatment 

 required, they are widely separated. It is, therefore, necessary 

 that they should not be confounded, for in the one case blood- 

 letting and other active measures may be unnecessarily adopted, 

 and in the other a fatal result will most probably occur for want 



