SPONTANEOUS NON-TUBERCULOUS PNEUMOTHORAX
American Journal of the Medical Sciences
By spontaneous non-tubcrculous pneumothorax wo understand a pneumothorax occurring suddenly in healthy individuals, without the cause being discoverable by physical examination or by the history of the case, and in which thero is rarely formation of liquid. Pneumothorax was, no doubt, known to tho ancients; but no clear account has como down to us, It is truo that Hippocrates mentions tho sitccussion splash, but this was wrongly interpreted as meaning pus In the pleural cavity; whilo, in
... y; whilo, in reality, it means tho presence of both nir and fluid. Apparently tho first to appreciate the condition was Riolan, a contemporary of Harvey, although the first exact description of it was not givou until a century ago, in 1803, by Itnrd,1 a French physician, who coined the term pneumothorax-. His studies wero nmdo in tho post-mortem chamber, and neither ho nor Ids immediate suc¬ cessors seem to have recognized tho condition during life, This was reserved for Lncmieo,* whoso investigations, particularly of the symp¬ toms and diagnosis of tho disease, wero so thorough that posterity has been able to add but little to them. Lncuncc gave the probnblo causes of pneumothorax ns: (1) tuber¬ culosis ; (2) decomposition of. pleural effusions; (3) gangrene of the lung; (4) emphysema of tho lung ; (6) idiopathic formation of nir in tho pleural cavity. By tho latter, Lnenneo understood a sort of gaseous secretion on tho part of tho pleura. Tho second and last of these causes wero finally, in tho light of many observations, put aaido; although tho second, decomposition of pleural effusions, has lately been revived on good evidence. Tims, Levy* reported a caso in which it seemed boyond doubt that a pneumothorax had supervened on a pyothorax,* ns tho result of decomposition by an anaerobic organism, apparently tho bacillus aerogencs capsulatua. May and Gebliardt1 likowiso reported a similar case of pneumo¬ thorax duo, in this instance, to the bacillus coli communis, and thoy proposed tho nnmo zymotic pneumothorax for ono having such nn origin. Tho protcus vulgaris and other undetermined organisms have also beon found in cases of this kind, particularly by French writers, who employ tho term pneumothorax par fermentation gaum. Tho most common causo of pneumothorax is tuberculosis; this is not nlono the oxporienco of individual observers, but is shown to bo tho fact N0N-TUBER0UL0U8 PNEUMOTHORAX.