Clinical illustrations of fever : comprising a report of the cases treated at the London fever hospital, 1828-1829 / by Alexander Tweedie.

  • Tweedie, Alexander, 1794-1884.
Date:
1831
Catalogue details

Licence: Public Domain Mark

Credit: Clinical illustrations of fever : comprising a report of the cases treated at the London fever hospital, 1828-1829 / by Alexander Tweedie. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    bronchial membrane to the substance of the lungs, so that when the disease proved fatal, besides the traces of inflammation in this membrane, portions of the structure of the lung were found hepatized. These changes were in most instances recent, though sometimes from the resistance made to the knife, when the diseased parts of the lung were cut into, they were evi- dently of long standing ; in some of these cases, small tubercles were found in different states of soltening. How far these were produced by the previous inflammatory action, I am unable to determine, though, from the researches of some recent writers, and more lately from those of Pro- fessor Alison, of Ethnburgh, there is a strong presumption, that those bodies are in many instances the product of inflam- mation. The occurrence of expectoration was almost uniformly ob- served to be followed by marked relief, particularly in recent cases; in the more chronic form, however, the secretion from the inflamed membrane was often so abundant, that it added much to the general distress, by increasing the dyspnoea, and ultimately exhausting the patient. When from the failure of the general powers, the cough and expectoration became sup- pressed, the issue of the case was exceedingly doubtful; as it showed that, while the affection in the chest was going on, the patient's strength was declining; and that death by asphyxia would in all probability be the result. In a few instances the fits of coughing were accompanied by vomiting, by which effort a quantity of bilious fluid was brought up. In these cases I was inclined to suspect that the inflammation was not confined to the bronchial membrane, but had extended to the mucous membrane of the intestines. Several opportunhies occurred of observing an insidious form of bronchitis, to which the French writers have given the term latent; there is scarcely any cough or expectoration, nor is the alteration in the breathing so great as to attract atten- tion, till the bronchial inflammation has made considerable progress. The application of the stethoscope does not, even to a prac- tised ear, assist our diagnosis, because, as Laennec has justly observed, the state of parts in this disease is extremely un- favourable for perceiving every kind of sound originating in the lungs. In the first place, the greater number of the air- cells are habitually distended by the air, so that the pulmonary