Clinical report on chronic pleurisy : based on an analysis of forty-seven cases / by Austin Flint.

  • Flint, Austin, 1812-1886.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: Clinical report on chronic pleurisy : based on an analysis of forty-seven cases / by Austin Flint. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    12/58
    remain constantly under my observation from the date of the first record. In several instances notes at a single examination only were obtained, and sometimes information of the farther progress, and the issue, is wanting, the cases being lost sight of. The number of complete histories is too few to furnish data for determining with precision the numerical ratio in which dif- ferent symptoms are present or absent in this disease. Nevertheless, an analysis of the facts pertaining to symptomatology which the histories do contain, may be of some practical interest and value. Pain. Most of the histories contain information respecting the amount of pain experienced at the commencement of the disease, and prior to the time that the cases came under my observation. If we exclude the cases in which acute inflammation preceded the chronic form of the disease, and those in which the disease supervened in consequence of perforation, it does not appear that in a single instance pain was severe. In the great majority of i it was not sufficient in amount to render it prominent as a symptom; in several instances it was altogether wanting. When present it was gener- ally confined to the access, or continued for a short time only after the attack; usually disappearing in the course of a few days. Its character was lanci- nating, described by patients as stitch-like, and in each instance in which its situation is specified, it was referred to the inferior part of the chest. With respect to the situation, it thus differs from the usual seat of the pains which accompany the ordinary subacute attacks of pleurisy occurring in the pro- gress of tuberculosis. The latter are referred by patients to the upper part of the chest, very frequently beneath the scapula. Severity of pain, approx- imating to that degree which generally attends the early stage of acute pleu- risy, evidently is rarely a symptom of the chronic variety, when the disease is subacute from the beginning; and its presence in ever so slight a degree, is by no means uniform. Without careful inquiry it would often escape the notice of the practitioner in obtaining the previous history of patients affected with Chronic Pleurisy, having been so slight as scarcely to attract attention at the time, or its occurrence been forgotten, and it is therefore mentioned by patients not of their own accord, but only after they have been requested to endeavor to recollect with regard to the point. This is stated in several of the histories in the present collection. Whenever cases come under obser- vation after the disease has existed for several weeks, or months, the absence of pain is the rule. Occasionally a dull pain, or sense of uneasiness in the affected side is complained of; but, so far as my observations go, even these instances are exceptional. The practical bearing of these facts is too obvious to require remark.