Pleurisy
Pleurisy is an inflammation of the pleura, a serous
membrane which envelopes the lungs and also lines the inside of the chest. It
may be acute or chronic, and mild or severe, the disease may be limited to one
side of the chest or it may include both the sides. This disease can attack
people of all ages, from children right through to the very elderly. Like any
other viral infection, pleurisy can occur in small epidemics. The membranes
that cover the lung are called pleura. The outer membrane, known as partial pleura,
is applied to the inner wall of the thorax, and the inner membrane, known as
the visceral pleura, covers the substance of the lungs. There is a capillary
space between the two membranes which is filled with fluid. This fluid enables
the lung s to move freely in the chest.
The parietal membrane is reflected from the chest
wall to cover the upper surface of the diaphragm, and in the midline, it covers
the mediastinum, the partition which separates the two sides of the chest and
contains the heart, great vessels and other structures which run through the
thorax.
Symptoms
The onset of pleurisy is generally marked by a sharp
and stabbing pain, which may be felt in any part of the chest wall or over the
diaphragm. Deep breathing or coughing, increase the pain. In many cases, the
disease begins with a chill, followed by congestion of the pleura and later by fever.
The degree of the fever determines the severity of the disease. The
inflammation destroys the tissues and chokes the circulation within the
tissues. Breathing becomes difficult due to the clogging of the circulation,
and by pain and swelling within the chest. Later a liquid effusion escapes from
the pleura, filling the open spaces in the chest cavity till the effect of the
distension becomes oppressive. After absorption takes place or after the
drainage of the effusion, the pressure is lowered, the pain is reduced and the
patient feels relieved. It is sometimes dry pleurisy, a form where there is
little or no effusion or the effusion may be circumscribed. The effusion may
become gangrenous, or become mixed with blood, or be of a dirty brown colour with
an offensive odor, leading to much suffering.
Causes
The most common among the immediate causes of
pleurisy is that of ‘catching cold‘ , followed by congestion and swelling of
the pleural membrane. It is a disease that is not caused by germs. There will
be germs of putrefaction later in the ooze of serum from the tissue. The
disease may be a complication of pneumonia, or pneumonia may be a complication
of pleurisy. In a few cases, the diseases may also occur in rheumatic fever, uremia
and other conditions.
Treatment
At the first sign of pleurisy, the patient should
observe a complete fast, abstaining from all liquid and solid foods. Nothing
should be taken except plain water, hot or cold, as desired. Water may have bad
taste, but at least three or four glasses should be taken daily for the first
few days. The quantity of water should be gradually increased to five or six or
more glasses each day. It would be helpful if during this period of fasting, a
full hot enema is also taken once daily.
A hot chest pack should be applied two or three times
a day allowing it to remain for an hour or so each time. If the fever becomes
high, the packs may be changed to cold ones. If, however, the reaction is not
prompt and complete, it would be advisable to use the hot packs. Heat is always
helpful for relieving the sharp pain associated with pleurisy. This should be applied
for half an hour twice daily. The patient should practice deep breathing during
this period. Adequate rest and abundance of fresh air are essential.
In cases of dry
pleurisy, further relief from pain can be obtained by strapping the chest.
Heat is not used when the tapping is employed. A neutral immersion bath at 100°F
for one hour daily has also been found beneficial in the treatment of pleurisy.
After the acute
symptoms have subsided, the patient may adopt a milk diet. In this regimen,
he should take 250 ml. of milk every two hours on the first day, every 1 1/2
hour on the second day, every hour on the third day and every three-quarters of
an hour on the fourth day and onwards. The
quantity of milk should not exceed four liters daily. The patient may also take
one orange daily along with the milk diet.
As soon as the patient has gained slightly in
strength, he should undertake moderate exercise as a routine, avoiding fatigue.
Air bath, sun bath and dry friction bath are of particular importance. If there
is any particular disease, present along with the pleurisy whether as a causative
or as a complicating condition, the same should also be given appropriate
attention. Chronic pleurisy should
be treated in the same manner as to the diet and the application of heat. All
efforts should be made to increase the vitality, reduce toxemia, and restore
normal freedom of chest movements. Several short fasts, at regular intervals,
followed by milk diet may be necessary depending on the progress for complete
recovery.
Source: www.healthlibrary.com through www.scribd.com
No comments:
Post a Comment