Surgery pp 1551-1570 | Cite as

Pleura: Anatomy, Physiology, and Disorders

  • Joseph S. Friedberg
  • John C. Kucharczuk


Disorders of the pleura and pleural space reflect some of the oldest diseases encountered in surgical history. Hippocrates described the symptoms of empyema 2400 years ago: “Empyema may be recognized by the following symptoms: In the first place the fever is constant, less during the day and greater at night, and copious sweats supervene. There is a desire to cough and the patient expectorates nothing worth mentioning.” He also described an open drainage procedure: “When the fifteenth day after rupture has appeared, prepare a warm bath, set him upon a stool, which is not wobbly, someone should hold his hands, then shake him by the shoulders and listen to see on which side a noise is heard. And right at this place, preferably on the left, make an incision, then it produces death more rarely.”1,2 Beyond providing less-wobbly stools, few advances were made for more than 2000 years that allowed surgeons to routinely enter the pleural cavity, the fear being a potentially fatal pneumothorax. With the advent of positive pressure ventilation in the early 1900s, pneumothorax was no longer a prohibitive risk, and the era of surgical intervention in the pleural cavity had begun.3


Pleural Effusion Chest Tube Malignant Pleural Mesothelioma Pleural Space Malignant Pleural Effusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Joseph S. Friedberg
    • 1
  • John C. Kucharczuk
    • 2
  1. 1.Division of Thoracic Surgery, Department of SurgeryUniversity of Pennsylvania Medical Center at PresbyterianPhiladelphiaUSA
  2. 2.Department of Cardiothoracic SurgeryHospital of the University of PennsylvaniaPhiladelphiaUSA

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