ordinary acute symptoms never having been present in any marked degree. Cases of this sort are often protracted, and heir results unsatisfactory as regards complete recovery.
In the treatment of early pleurisy, pain may be relieved by a hypodermic of morphia or the application of leeches. A purgative is essential. Fixation of the affected side of the thorax by strapping with adhesive plaster gives great relief. The icebag is useful in the early stages, as in pneumonia. The open-air treatment of cases is recommended, as the majority of the cases are of tuberculous origin. When effusion has taken place, counter irritation and the exhibition of iodide of potassium are useful. Dry diet and sahne purgatives have been well spoken of The most satisfactory method of treatment is early and if necessary repeated aspiration of the fluid. The operation (thoracenteszs) was practised by ancient physicians, but was revived in modern times by Armand Trousseau (1801–1867) in France and Henry I. Bowditch (1808–1892) in America; by the latter an excellent instrument was devised for emptying the chest, which, however, has been displaced in practice by the still more convenient aspirator. The chest is punctured in the lateral or posterior regions, and in most cases the greater portion or all of the fluid may be safely drawn off. In many instances not only is the removal of distressing symptoms speedy and complete, but the lung is relieved from pressure in time to enable it to resume its normal function.
In cases of chronic pleurisy after the failure of repeated aspirations, Samuel West reports well of free incision and drainage. He has reported cases of recovery of effusion, fifteen or eighteen months standing. Sir James Barr has advocated the treatment of these cases by the withdrawal of the fluid and the substitution of sterilized air and solution of supra-renal extract; others have introduced physiological salt solution or formalin solution into the cavity, after the removal of the fluid. Vaquez injects nitrogen into the cavity and reports a number of cases in which it prevented recurrence.
PLEURO-PNEUMONIA, or Lung-Plague, a contagious disease peculiar to cattle, generally affecting the lungs and the lining membrane of the chest, producing a particular form of lobar or lobular pleuro-pneumonia, and, in the majority of cases, transmitted by the living diseased animal, or, exceptionally, by mediate contagion. It cannot be communicated to animals other than those of the bovine race. Inoculation of healthy cattle with the fluid from the diseased lungs produces, after a certain interval, characteristic changes at the seat of inoculation, and though it does not develop the lung lesions always observed in natural infection, yet there is a local anatomical similarity or identity. Though numerous investigations have been made, the nature of the infective agent remains doubtful. In 1888 Arloing, of Lyons, described various bacilli obtained from the lesions, but the pathogenic organism of lung-plague has not been discovered.
The earliest notices of this disease testify that it first prevailed in central Europe, and in the 18th century it was present in certain parts of southern Germany, Switzerland and France, and had also appeared in upper Italy. Though Valentine described an epizooty occurring among cattle in 1693 in Hesse, doubts have been entertained as to whether it was this malady. It was not until 1769 that it was definitely described as prevailing in Franche-Comté by the name of “murie.” From that date down to 1789 it appears to have remained more or less limited to the Swiss mountains, the Jura, Dauphiné and Vosges, Piedmont and upper Silesia, it showed itself in Champagne and Bourbonnais about the time of the Revolution, when its spread was greatly accelerated by the wars that followed. In the 19th century its diffusion was accurately determined. It invaded Prussia in 1802, and soon spread over north Germany. It was first described as existing in Russia in 1824; it reached Belgium in 1827, Holland in 1833, the United Kingdom in 1841, Sweden in 1847, Denmark in 1848, Finland in 1850, South Africa in 1854, the United States-Brooklyn in 1843, New Jersey in 1847, Brooklyn again in 1850 and Boston in 1850, it was also carried to Melbourne in 1858, and to New South Wales in 1860; New Zealand and Tasmania received it in 1864, but it was eradicated in both countries by the sanitary measures adopted. It was carried to Asia Minor, and made its presence felt at Damascus. It prevails in various parts of China, India, Africa and Australia, and until quite recently it existed in every country in Europe, except Scandinavia, Holland, Spain and Portugal. In Great Britain cases occurred in 1897.
Symptoms.—The malady lasts from two to three weeks to as many months, the chief symptoms being fever, diminished appetite, a short cough of a peculiar and pathognomonic character, with quickened breathing and pulse and physical indications of lung and chest disease. Towards the end there is great debility and emaciation, death generally ensuing after hectic fever has set in. Complete recovery is rare.
The pathological changes are generally limited to the chest and its contents, and consist in a peculiar marbled-like appearance of the lungs on section, and fibrinous deposits on the pleural membrane, with oftentimes great effusion into the cavity of the thorax.
Willems of Hasselt (Belgium) in 1852 introduced and practised inoculation as a protective measure for this scourge, employing for this purpose the lymph obtained from a diseased lung. Since that time inoculation has been extensively resorted to, not only in Europe, but also in Australia and South Africa, and its protective value has been generally recognized. When properly performed, and when certain precautions are adopted, it would appear to confer temporary immunity from the disease. The usual seat of inoculation is the extremity of the tail, the virus being introduced beneath the skin by means of a syringe or a worsted thread impregnated with the lymph. Protection against infection can also be secured by subcutaneous or intravenous injection of a culture of Arloing's pneumo-bacillus on Martin's bouillon, and by intravenous injection of the lymph from a diseased lung, or from a subcutaneous lesion produced in a calf by previous inoculation.
PLEVNA (Bulgarian Pleven), the chief town of the department of Plevna, Bulgaria; 85 m. N.E. of Sofia, on the Tutchinitza, an affluent of Vid, which flows north into the Danube and on the Sofia-Varna railway (opened in 1899). Pop. (1906), 21,208. A branch line, 25 m. long, connects Plevna with Samovit on the Danube, where a port has been formed. After the events of 1877, it was almost entirely forsaken by the Turks, and most of the mosques have gone to ruin; but, peopled now mainly by Bulgarians, it has quite recovered its prosperity, and has a large commerce in cattle and wine.
Battles of 1877.—Plevna, prior to the Russo-Turkish War of 1877 (see Russo-Turkish Wars) a small and unknown town without fortifications became celebrated throughout the world as the scene of Osman Pasha's victories and his five months' defence of the entrenched camp which he constructed around the town, a defence which upset the Russians' plans and induced them to devote their whole energies to its capture. Osman Pasha left Widin on the 13th of July with a column consisting of 19 battalions, 6 squadrons and 9 batteries, a total of 12,000 men and 54 guns. Hearing that he was too late to relieve Nikopol, he pushed on to Plevna, where there was a garrison of 3 battalions and 4 guns, under Atouf Pasha.
Passing through Plevna on the afternoon of the 19th of July he at once took up a position, previously selected by Atouf Pasha, on the hills covering the town to the north and east. The column had been joined en route by 3 battalions from the banks of the Danube, so that Osman's command now consisted of 25 battalions. He was none too soon. General The First Battle of Plevna. Schilder-Schuldner, commanding the 5th division of the IX. corps, which had just captured Nikopol, had been ordered to occupy Plevna, and his guns were already in action. The Turkish batteries came into action as soon as they arrived and returned the fire. A desultory artillery duel was carried on till nightfall, but no attack was made by the Russians on the 19th. Osman distributed his troops in three sections: on the Janik Bair, facing north, were 13 battalions and 4 batteries, with advanced posts of 2 battalions
