THE SIGNIFICANCE OF PAIN IN THE CHEST.
By David Paulson, M.D.
PAIN is always a cry of nature that she is being abused. The significance of pain depends upon two things, the intensity of it, and the part of the body it is in. A small pain in the foot or knee may be of very little consequence. It may result simply from overexertion, or a slight bruise. That same amount of pain in the eyes, or the throat, or over the heart, may signify that there is some serious trouble. A severe pain in the knee is not to be overlooked; it may indicate tubercular disease of the knee-joint, and thus in reality be a very important symptom. But there is one part of the body in which the existence of pain generally produces considerable anxiety, and that is when it occurs in the chest. Pain in this region may be due to three different diseases:— First, it may be in the lung itself. Pneumonia generally causes a very severe pain. Second, it may be located in the pleura. The pleura is a membrane or sac covering the surface of the lining and also lining the inside of the chest wall. There may be a congestion which causes these two membranes to adhere. When a man has pleurisy, the pain is nearly always the most severe at the end of a deep breath. Third, the pain may be due to an intercostal neuralgia in the chest wall. If the following suggestions are borne in mind, they will often throw some light on the cause of a pain in the chest. If a man has pneumonia he will have a high temperature, with more or less difficulty in breathing; if he has pleurisy, there will only be a slight rise of temperature, and a sharp pain in taking a full breath, but no pain on the outside of the body. If he has intercostal neuralgia, there will be severe pain under the ribs, which is increased by pressure, but no rise of temperature. So pain in the chest may be either due to pneumonia, to pleurisy, or to intercostal neuralgia, or to a combination of these troubles.