A manual of clinical medicine and physical diagnosis / by Thomas Hawkes Tanner.

  • Thomas Hawkes Tanner
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A manual of clinical medicine and physical diagnosis / by Thomas Hawkes Tanner. Source: Wellcome Collection.

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    in the left side of the heart (particularly in mitral obstruction), and again in embolism ; or blood poured out into the bronchial tubes, as in phthisis, may be rapidly and freely drawn into the air-cells in inspiration. Pul- monary haemorrhage also occurs in purpura and scurvy and other diseases which lead to a softening of the lung tissue. The symptoms as regards the lungs are, haemop- tysis, quickened respiration, crepitant and sub-crepitant rhonchus, and, according to the amount of extravasation, dulness, and suppression of the respiratory sound over the dull part—all suddenly developed. Gangrrene of the Ziungr.—This condition is characterized by the presence of sputa of a dirty grey or greenish colour, and most offensive odour, the breath being likewise fetid. A patient may have gangrene of the lung, how- ever, without stinking sputa or breath, but this is infinitely rare. The general symptoms are those of extreme prostration, a rapid feeble pulse, a typhoid con- dition, with delirium and the like. Grangrene of the lungs occurs in, it is said, those who are insane and who starve themselves to death, in certain states of blood poisoning, as in pyaemia, fevers, glanders, in the pneumonia of those who are much debilitated, and after pulmonary apoplexy, or the arrest of the circulation through a large artery by the pressure of tumours, such as hydatids or cancer. The physical signs proper to the actual gangrene—viz., in addition to those which belong to the cause of the gangrene—are, dulness on percussion, various rhonchi, and then cavernous and bronchial breathing following the breaking up of the lung tissue. It is important to recol- lect that in bronchitis and pneumonia the sputa may be fetid, but then the lung substance is not disorganized in the same manner as in true gangrene. Cirrhosis of the Iiung-.—In some cases lymph is effused into the cellular tissue of the lung, of a similar kind as regards its nature, and the changes which it undergoes, to that which is seen in cirrhosis of the liver and kidney. Some authors regard the disease as an interstitial ^pneumonia. The effused lymph contracts and obliterates air-cells and vessels, the bronchi dilating under the pressure of inspiration, and the force exerted by the contracting lymph; the lung itself becoming heavy, solid, and tough, and smaller than usual, hence the shrink- ing of the chest on the affected side and the hypertrophy of the opposite lung, the heart being displaced towards