RT Journal
A1 BILLINGS FT
T1 Purulent pleuritis: Pathology and treatment
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1909
FD January 23
VO LII
IS 4
SP 266
OP 268
DO 10.1001/jama.1909.25420300006001b
UL http://dx.doi.org/10.1001/jama.1909.25420300006001b
AB The pleural sac is kept in its normal condition of simple moisture by a definite lymph circulation; the stomata both on the visceral and parietal layers, in health, keep this fluid down to certain limits. The thorax being a closed sac and the pressure within being negative, it follows that the aspirating qualities are usually most efficient. Samuel West1 speaks of this as "the lymphatic pump," and shows that with any collection of fluid within the pleura there must be some mechanical obstruction to the operation of this pump. It is probable there is always more or less absorption of fluid through these minute mouths, and that the attempt of Nature in an inflammatory reaction to block them completely, is ineffectual.PATHOLOGY 
    In the last few years the bacteriologic examination of exudates in the thorax, systematically carried out, has shown to a certain degree the prognosis, and also the methods