-The outer covering of the lungs and the lining of the chest is composed of a serious membrane called the pleura. This membrane has a smooth surface, and secretes a fluid which in health just suffices to keep it moist and bright,so that the lungs may expand and contract and move up and down with the ascent and descent of the diaphragm or midriff -the muscle which separates the chest from the abdominal cavity. When it is inflamed, as is often the case after a severe chill, the membrane becomes first dry, when every movement of the lungs gives sharp pain. Then matter is formed on the surface,creating a roughness, which causes a creaking noise to be heard when the ear is put to the chest. At this period there may be a large secretion of the fluid thrown out, causing congestion of the lungs, bulging of the chest wall,and, in some cases,threatening life.
Pleurisy usually begins with severe chills, and there is a good deal of fever and some cough and every motion causing sharp stitching pains in the side.
It has recently been recognised that many cases of pleurisy are really of a tubercular nature. This renders it necessary to have patients kept under medical observation for a considerable time after an attack, since a severe chill may in these cases light up the tubercular process.
Diagnosis.-See under BRONCHITIS,and compare below False Pleurisy.
General Treatment.-Rest in bed and fever diet are the chief measures to adopt before the services of a doctor can be obtained.
Medicines.-(Every half-hour or every hour)
– When due to a chill. Pain, heat, thirst,cough. This is the first medicine to give, and will often be the only one required.
-When exudation sets in. Symptoms worse at night.
-Sharp pains in chest, worst by every breath or every movement;dry cough;yellowish tongue;bitter taste;constipation.
-A dose once a week for one or two months after an attack will be useful to clear up the after-effects of an attack and prevent later developments.