The aetiology, immediate and remote prognosis of primary pleurisy with serous effusion / by C.E. Hedges.

  • Hedges, Charles Edward, 1866-
Date:
[1900]
Catalogue details

Licence: In copyright

Credit: The aetiology, immediate and remote prognosis of primary pleurisy with serous effusion / by C.E. Hedges. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    1/72 (page 75)
    h. [ icjoP THE ETIOLOGY, IMMEDIATE AND REMOTE PROGNOSIS OF PRIMARY PLEURISY WITH SEROUS EFFUSION.1 C. E. HEDGES, It has always been a point of the greatest interest to me, and must be to others who have worked in the wards of a large general hospital, as to the fate of those patients who have been admitted with pleurisy with effusion, and, as far as one can find out, with nothing whatever else ailing them. How often does one see during the treatment that the effusion is evacuated or absorbed, and the patient, often much debilitated, enters upon a period of convalescence. Now examine that same chest after all the physical signs diagnostic of fluid have disappeared, and one finds only too often the signs of grave mischief wrought by the slow inflammatory process, “impair- ment of resonance,” due to the presence of false membranes, or to the collapsed condition of the lung, or to both combined; “ deficient expansion ” of the affected side, obscuring or “ altera- tion of the pitch of the vesicular murmur,” and perhaps “ friction ” persisting at some point. One might almost say that, except in a few cases, and those chiefly in children, a patient admitted with the physical signs of pleurisy with effusion never leaves the hospital without some abnormal physical signs still persisting, denoting a more or less serious impairment of the function of the contents of that half of the chest in which the effusion took place. If on the left side of the chest, the inflammatory process may have spread to the pericardium and caused pericarditis with effusion, and subsequently an adherent pericardium with all its results, as I well remember in the case of a boy of 13 years of age admitted into the City Eoad Chest Hospital. This is for- 1 A Thesis for the degree of Doctor of Medicine of the University of Cambridge.