Pleurisy

(phi’-ris-e) \jrlevpd, rib]. Pleuritis; inflammation 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) Ser of i brin ous; (c) Purulent. In fibrinous P., the pleura is covered with a layer of lymph of variable thickne , which, in the acute form, can be readily stripped off. Ser of i brin ous P., is characterized by the presence of a considerable quantity of fluid containing flocculi of lymph, and the deposit of some fibrin on the pleural surface. Purulent P., or empyema, is characterized by the presence of a purulent exudate. Acute pleurisy is marked by sharp and stabbing pain (stitch) in the side, increased by breathing and coughing; by fever, and by a friction-fremitus felt on palpation and a to-and-fro friction-sound heard on auscultation. In the ser of i brin ous variety a liquid effusion takes place, the signs of which are: bulging of the intercostal spaces and chest-wall, absence of vocal fremitus, displacement of the heart, movable dulne with a curved upper line, and a tympanitic percu ion-note (Skodaic resonance) beneath the clavicle and above the level of the effusion. Chronic P. may be dry or ser of i brin ous. P., Encysted, pleurisy in which the effusion is circumscribed by adhesions. P., Hemorrhagic, a variety in which the exudate contains blood. P., Mediastinal, inflammation of the pleural layers about the mediastinum. P., Meta pneumonia. monic, pleurisy dependent upon a pneu- 504