Lectures on the Theory and Practice of Physic Volume 2 - Softcover

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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1842 Excerpt: ... LECTURE LXXV. Tubercle Of The Lung (continued).--Signs of ulceration--Gradual transition from crepitating to muco-crepitating rhonchus--Cavernous respiration and pectoriloquism the most important signs--Diagnosis between metallic tinkling of a large cavity and pneumothorax with fistula--Signs from atrophy of the lung--Falling in of the chest without atrophy--Ascertained by measurement of the chest--Signs from the state of the circulating system; few in number--Increased action of the subclavian--Varieties of phthisis--Acute inflammatory tubercle without suppuration--General principle of diagnosis of this kind of tubercle--Acute suppurative phthisis--Hemoptysical variety. Signs Of Ulceration.--In most cases, the signs of irritation precede and pass into the phenomena described at the conclusion of the last lecture. In some, however, the latter appear at once, unpreceded by any active auscultatory sign. In general, nothing can be more gradual than the transition from the crepitating to the muco-crepitating rdles, from these to a large mucous rattle, which passes into the rdle of anfractuosities, and ultimately the gurgling of a cavity. This is the ordinary course, and a cavity may thus form, complete dulness having never existed. In other cases, however, more or less of dulness having existed, the signs of excavation at once appear; this occurs from the softening of a large tubercle, or a mass of tubercular infiltration. On the formation of a cavity in the upper portion, we may often detect smaller ulcerations, or the earlier stages of tubercle, in the lower part of the affected lung, and in the upper lobe of the opposite. So rarely, indeed, is tubercle confined to one lung, that the existence of a cavity almost certainly implies disease in the opposite sid...

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