PLEURISY (Pleuritia), a word derived immediately from the French Pie-stride, which comes from the Greek saw/Rees, and this again from vAsopbr, the side, which is defined by Rufus Ephosius (` 1)o Corp.
Hain. Part. Appell.; pp. 30, 51, ed. Clinch) to mean sae Tit eri, re assrxiLt0, "all that part which is under the arm-pit."• As this ie one of the diseases of which both the nature and the treatment were understood by the ancients almost as perfectly as by ourselves (except of course that they had not the assistance of auscultation and per cussion to help them in forming their diagnosis), it may be na well to give in their own words those pamagea which have been repeated with more or less alteration by every succeeding writer on the subject, omitting those which are either erroneous from their less accurate knowledge of anatomy, or which rest only upon "some fanciful theo retical speculation, and adding whatever may be necessary to bring the article as far as possible up to the level of the present state of medical science.
" Pleurisy, properly so called," says Pnulus ...Egineta (loco ea., In Mr. Adams's translation, Svo, London, 1534), " ie en iffilninmation of the membrane which lines the ribs, and is etteutled with difficulty of breathing, cough, continual fever, and pain shooting to the clavicle and hypoeliondrium," which definition agree., with that given by Galen (' De Loc. Affec.,' lib. v., cap. 3, p. of. Kuhn ; ' Ad. Dieu°. de )ed.
Meth.; IL, cap. I, p. 77; ' introtL,' cap. 13,p. 734; ' Definite Med.,' § 284), Aretteus, Abatis, and Alexander Trallianus Voris fit.). The disease has been variously divided by different writers; Dr. Good (' Study of Med.') mentions the three following varieties :—1, neuritis rein, True Pleurisy. Fever, a amnia; pain felt chiefly on one side, the inflammation commencing In that part of the pleura which lines the ribs. 2, neuritis mediastina, Pleurisy of the Mediastinum. Heavy pain in the middle of the sternum, descending towards its ensiform cartilage; with great anxiety ; the inflammation, from its symptoms, being obviously seated in the mediastinum. 3, Pleurilis
diaidsraginotica, Pleurisy of the Diaphragm. Painful coustriotion around the pneconlia ; small, quick, laborious breathing; manifesting that the Inflammation is seated chiefly in the diaphragm. lie adds, however, that the subdivisions lead to nothing of practical importance, as the causes are nearly alike, sod the same mode of treatment is applicable to the whole. A more essential distinction is that adopted by Dr. Law (` Cyclop. of Pact. Med.'), namely, acute and chronic, and this will be followed here, because it seems almost impossible to treat either of the nature or the treatment of these two forms of pleurisy under one and the same head.
In acute pleurisy, says Aretacue Voce tit., in 1)r. Reynolds's transla tion, 8vo, London, 1837), " we have acute pain in the clavicular region, together with a sharp burning heat; the recumbent posture is easy on the inflamed because there the membrane remains in its place, but to lie on the opposite one is exceedingly painful, and from the weight, inflammation, and dragging, the pain extends through the whole continuity of membrane to the shoulders and clavicles, in some even to the back and shoulder-blades. To this succeed dyspnoea, watchfulness, loathing of food, bright redness of the cheeks, a dry cough, difficult expectoration. To this description it may be added, from Paulus aEgineta, that " the pulse is hard and serrated ; " and it should be noticed that the decubitus, or position of the patient, mentioned by Ai-et:ens and repeated by numerous modern writers, is not ,constant, and therefore cannot be exclusively relied upon as a diagnostic sign, for it is sometimes observed that the aggravation of the acute laneivating pain caused by the pressure when lying upou this side, makes the patient seek a more easy positiou either upon the opposite one or upon the back.