CHEST, PAINS IN.—The lung has so little sensitiveness that even exten sive destruction of its tissue may take place without producing the least amount of pain. The distressing symptoms to which this name is given come from the pleura, the thoracic muscles, the ribs, or from the intercostal nerves.
Pain as the result of irritation or inflammation of the pleura is very fre quent, and in the early stages of a pleurisy it constitutes the most significant and distressing symptom. If, after the inflammatory process has subsided, adhesions are left between the pleura covering the lungs and that covering the ribs, sensations are produced which are annoying and even painful. This is due to the tearing action to which the bands are subjected by movements necessitated by the respiratory act.
The pain which results from any affection of the ribs is increased by pressure over the diseased area. This is also true in fracture of the ribs, and here the condition may furthermore be recognised by the crepitation which is produced when the broken ends of the bones are rubbed together by the fingers of the examiner. Contusion of the soft parts of the chest, caused by a fall or a blow, is also accompanied by pain. In other cases,
pain in the intercostal muscles may be due to rheumatism or to a neuralgia of the intercostal nerves. The latter affection is seen more often in women than in men, and the pain is localised along one or more of the intercostal spaces corresponding to the affected nerves, or it may be more severe at certain points than at others.
The treatment of pain in the chest must be merely local, but must be governed entirely by the cause as determined by a most careful examination. In all cases rest (preferably in bed) must be insisted upon, because motion and deep respirations always aggravate the pain. If medical assistance cannot be had at once, hot applications to the back and chest will afford a great deal of relief. A faulty position of the body Nvill undoubtedly bring on pain in the chest, and this is a fact Nv hic h is not fully appreciated. Persons who follow sedentary occupations should be cautioned to sit straight ; and at frequent intervals, if only for a few minutes at a time, they ought to get up and, with arms outstretched, take a few deep, long breaths.