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Updated: June 25, 2025
In one case the pleural cavity was washed out with a five per cent solution of boric acid and was followed by distressing symptoms, vomiting, weak pulse, erythema, and death on the third day. In the second case, in a youth of sixteen, death occurred after washing out a deep abscess of the nates with the same solution. The autopsy revealed no change or signs indicative of the cause of death.
The thin space between the lungs and the rib walls, called the pleural cavity, is in health a vacuum. Now, when the diaphragm contracts, it descends and thus increases the depth of the chest cavity. A quantity of air is now drawn into the lungs and causes them to expand, thus filling up the increased space.
Pleural and peritoneal adhesions to the organs within the body cavities are common. The carcass of a tubercular cow. The tubercle usually undergoes a cheesy degeneration. Old tubercles may become hard and calcareous. Sometimes the capsule of the tubercle is filled with pus. A yellowish, cheesy material within the capsule of the tubercular nodule or mass is typical of the disease.
Subsequently pleurisy, pneumonia, or even pus in the pleural cavity often result. Hemoptysis is a possible, but not a marked symptom. The mechanism is identical with that of the bursting of an inflated paper bag when struck by the hand.
Diseased animals should be carefully isolated until slaughtered, and all animals exposed to them should be subsequently tested for glanders. This is an infectious disease of solipeds that usually results in a fatal inflammation of the lungs and pleural membrane.
In another case the patient lived twenty-six hours after reception of the injury, the conical pistol-ball passing through the anterior margin of the right lobe of the lung into the pericardium, through the right auricle, and again entered the right pleural cavity, passing through the posterior margin of the lower lobe of the right lung; at the autopsy it was found in the right pleural cavity.
The lungs are two in number, and occupy the pleural chamber of the thorax, one en each side of the median line, being separated from each other by the heart, the greater blood vessels and the larger air tubes. Each lung is free in all directions, except at the root, which consists chiefly of the bronchi, arteries and veins connecting the lungs with the trachea and heart.
Recently Joly described congenital hernia of the stomach in a man of thirty-seven, who died from collapse following lymphangitis, persistent vomiting, and diarrhea. At the postmortem there was found a defect in the diaphragm on the left side, permitting herniation of the stomach and first part of the duodenum into the left pleural cavity.
The stomach, small intestines, and part of the large omentum lay in the left pleural cavity; both the phrenic nerves were normal. Many similar cases of diaphragmatic hernia have been observed.
It may also follow the sudden withdrawal of fluid from a large cavity, as in tapping an abdomen for ascites, or withdrawing fluid from the pleural cavity. Syncope sometimes occurs also during the administration of a general anæsthetic, especially if there is a tendency to sickness and the patient is not completely under.
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