66 DISEASES OF THE PLEURA 



withdrawn and the opening covered with tar or collodion. 

 Thoracentesis should be performed early and repeatedly to 

 be of curative value. 



HYDROTHORAX. 



Definition. — A collection of transudate in the chest not 

 due to an inflammation of the pleura. 



Etiology. — In a general way hydrothorax is due to a 

 congestion in the vena cava? or its tributaries. It is most 

 commonly noted in chronic heart, lung and kidney diseases 

 and is usually associated with ascites, anasarca, and hydro- 

 pericardium. 



It may also accompany general anemia, hydremia and 

 prolonged cachectic conditions following parasitism, carcino- 

 matosis, etc. 



Symptoms. — Same as the effusion stage in serofibrinous 

 pleuritis. , 



Diagnosis. — History, finding organ primarily attacked 

 (heart, lung, kidneys) and the prolonged, feverless course 

 generally suffice to secure a diagnosis. In doubtful cases, 

 the thorax may be tapped and fluid withdrawn and examined. 

 It is usually much clearer, less flocculent and more watery 

 than pleural exudate. It is straw-yellow in color and has 

 a specific gravity of 1016, the albumin content below 2 per 

 cent. Leukocytes are only sparingly represented. 



Treatment. — As the primary condition is usually incur- 

 able, little can be done in hydrothorax. In great dyspnea, 

 thoracentesis will afford relief. 



PNEUMOTHORAX. 



Definition. — The entrance of air into the pleural sacs. It 

 is rarely due to other gases. 



Etiology. — (a) Penetrating wounds through the outer 

 wall of the chest or through the diaphragm (from the retic- 

 ulum). (6) Rupture of the esophagus from the rough use 

 of the probang. (c) Abscesses or gangrenous foci in the 

 lungs which rupture, opening bronchi into communication 



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